If the procedure is ongoing, you can use the HSA for the parts of the treatment that happen AFTER the HSA was established. But the parts of the procedure that occurred BEFORE the plan was in place is not eligible to be covered.
You would only be able to deduct it as the expense was incurred. For example. If you paid $1,500 in august for your first treatment and then $4,000 is the cost of the rest of the treatment, but you were 75% complete with the treatment BEFORE you started the HSA, then the $1,500 would not be eligible and neither would the $3,000 ($4,000 x 75%). But, if you finished the remaining 25% of the treatment after the HSA was established, then that $1,000 remaining amount would be eligible to be covered by the HSA funds.
It is all about timing of each procedure or visit.
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