Can You Use an HSA or FSA for IVF in 2026? What’s Allowed and What’s Not

If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), good news! Most HSAs and FSAs can be used to cover the costs of fertility treatment, including in vitro fertilization (IVF), fertility medications, clinic transportation, and many other related expenses. 

In this guide, we’re explaining what qualifies for HSA or FSA coverage in 2026, so you can move forward in your fertility journey feeling more confident about what to expect financially.

What You Need to Know About HSAs, FSAs, and IVF

HSAs are medical savings accounts that allow you to set aside pre-tax dollars for certain medical costs, thereby lowering overall out-of-pocket costs and saving money on taxes. You can only contribute pre-tax dollars to an HSA if you have a High Deductible Health Plan (HDHP).

IVF-related expenses that are eligible for HSA coverage include:

• Fertility treatment, including IVF
• Fertility tests, including at-home tests
• Egg donor fees
• Temporary storage of eggs or sperm
• Fertility medications
• Fertility acupuncture
• Fertility-promoting surgeries
• Necessary travel for fertility treatment
• Necessary lodging for fertility treatment
• Ovulation strips and pregnancy tests
• Certain over-the-counter items, such as a heating pad for after your egg retrieval

FSAs are another form of account for medical expenses. With an FSA, you set aside money from a paycheck, before taxes, to contribute to healthcare costs. You don’t have to pay taxes on FSA-covered costs. FSAs are only available with employer health insurance plans. Employers can but don’t always contribute to FSAs on their employees’ behalf.

IVF-related expenses that are eligible for FSA coverage include:

• Fertility treatment, including IVF
• Fertility tests, including at-home tests
• Egg donor fees
• Temporary storage of eggs or sperm
• Fertility medications
• Fertility acupuncture
• Fertility-promoting surgeries
• Necessary travel for fertility treatment
• Necessary lodging for fertility treatment
• Ovulation strips and pregnancy tests
• Certain over-the-counter items, such as a heating pad for after your egg retrieval

Expenses must be considered medically necessary for HSA or FSA coverage. Your plan may require a Letter of Medical Necessity (LMN) from your fertility team in order to get coverage. Reach out to your plan administrator to make sure your expenses are eligible and figure out what documentation you may need. If an expense is covered, you have the option of either paying using your HSA or FSA card or submitting for reimbursement.

Why This Matters for Patients 

Fertility treatment, especially IVF, can be very expensive out-of-pocket. When building your fertility plan, it’s important to understand what may or not be covered by your health insurance if you have it. Coverage varies widely from plan to plan and may change over time.

What’s more, using an HSA or FSA to pay for IVF-related expenses helps you save money in the long term because these costs can be deducted from your taxes.

Since there’s no way to predict with 100% certainty the timeline for meeting your fertility goals, knowing what to expect cost-wise can help you be as financially ready as possible.

What Factors Affect How Much Your HSA or FSA Will Cover?

There are several factors that can play into what and how much of IVF-related expenses will be covered by your HSA or FSA:

• Insurance plan: Different plans have different requirements. It’s important to reach out to your plan administrator to make sure you know exactly what will be covered and how much of it will be covered. Our clinic can help you make sense of what you learn.
• Limits on contributions: In 2026, the maximum contribution to your HSA during a benefit period is $4,400. The maximum 2026 contribution for an FSA benefit period is $3,400 for individuals and $8,750 for families. While IVF cycles will cost more than the contribution limit, you can use your HSA or FSA to reduce expenses per cycle or cover the costs of related expenses, such as fertility medications, travel, or egg storage.
• The length of your conception journey: Some IVF-related costs, like egg and sperm storage, will only be covered by your HSA or FSA for a short period of time. If you need to store eggs or sperm for more than one year, you may not be able to use your HSA or FSA to pay for the additional year(s) of storage.

FAQs

Does travel count as a qualified medical expense?

Yes, travel that’s essential and primarily for accessing healthcare—including IVF—at a doctor’s office, hospital, or other medical center is a qualified medical expense for most HSAs and FSAs. Types of reimbursable travel costs include:

• Gas, parking, and toll fees
• Rental car
• Bus fare
• Taxi fare
• Train fare
• Plane fare
• Ferry fare
• Ambulatory services
• Costs for dependents or required caregivers

Can I use my HSA or FSA to help with surrogacy costs?

No, surrogacy costs are not eligible for HSA or FSA coverage. Medical expenses are only eligible if the person receiving care is the account holder, their spouse, or their dependent.

Can I use my HSA or FSA for egg freezing?

Sometimes. If egg freezing is considered medically necessary, like it can be prior to undergoing chemotherapy, you can use your HSA or FSA to cover costs. 

Insurance & Coverage Considerations in Texas

Texas health insurance plans are required by law to cover IVF if they cover pregnancy-related healthcare services. However, the policyholder must be undergoing IVF using their own eggs and their partner’s sperm and have a history of fertility-related issues.

If you have a health insurance plan that covers IVF-related costs and you’re eligible for it, you can use your insurance and your HSA or FSA to save the most money on your fertility journey.

Next Steps for Patients at Dallas IVF

We understand that going through fertility treatment—and the associated costs—can be overwhelming. We are here to support you through your journey, which includes providing transparent cost breakdowns and helping you use your health insurance and HSA or FSA to cover costs.

If you have questions about how to pay for care or what other financial assistance may be available, our clinic staff will be there with answers. We are in this with you, every step of the way. 

Schedule your consultation today at Dallas IVF.

Reviewed by Constance Rapson & Kristen Sternat, Ivy Fertility