While you can deduct those expenses as a medical deduction if you itemize, you can’t use HSA distributions for medical expenses incurred before marriage.
In Publication 969, the IRS clarifies that you can withdraw tax-free money from your HSA to pay for qualified medical expenses for:
- Yourself
- Your spouse (regardless of whether you file taxes jointly or separately)
- Any dependents you claim on your tax return (your children, or a qualifying relative dependent) and any children who are claimed on your ex-spouse's tax return
- Anyone you could have claimed as a dependent, but weren't able to because he or she
- filed a joint tax return (for example, your married teenage kid who files a joint return with his or her spouse)
- earned more than $4,300 (in 2020), or you (or your spouse, if you file jointly) could be claimed as a dependent on someone else's tax return.
