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Apparently, all purchases of prescription drugs, whether retail or mail order, will have local sales tax (based on U.S. residence of consumer) applied to cost-sharing regardless of whether it consists of fixed co-payment, fixed coinsurance percentage, deductible (specific or all perils) or combination thereof. If in fact this comes to pass, is sales tax reimbursible from HSA?

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Well in some states we claim sales tax on our IRS annual filing (standard or itemized), so this is going to get interesting for possible double dipping if people itemize every sales receipt they have for the year and also claim it on the HSA not thinking about the reimbursement from two sources.  

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Speaking as someone who pays taxes, not as a tax advisor:

1.  Itemizing sales taxes on the IRS filing is NOT in the nature of a reimbursement.  It would be a deduction (in lieu of state income taxes?), and may or may not have any bottom-line impact on the overall income taxes to be paid.

2.  If the prescription costs are being reimbursed from pre-tax HSA dollars, they cannot also be recognized as tax-deductible sales taxes.  I would anticipate that those are limited to sales taxes that have not been reimbursed.

Always check with your actuary first!

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