A spreadsheet is the most common HSA receipt system in existence. It is genuinely good at arithmetic and genuinely bad at being evidence.
Short answer: A spreadsheet records that a $412 dental expense happened. It does not prove it. Under examination, a self-maintained list of numbers is an assertion, and the underlying documents are the evidence — which means the spreadsheet was always only half the system.
| Feature | SaveMyHSA | A spreadsheet |
|---|---|---|
| Purpose-built for HSA receipts | ✅ Yes | ❌ No |
| Structured fields (provider, patient, service date, amount) | ✅ Yes | ⚠️ You build it |
| Tracks reimbursed vs. unreimbursed | ✅ Yes | ⚠️ Manual |
| Works when you never swipe the HSA card | ✅ Yes | ✅ Yes |
| Survives changing HSA custodians | ✅ Yes | ✅ Yes |
| Built for 20+ year retention | ✅ Yes | ⚠️ If you maintain it |
| Search by patient, year, or category | ✅ Yes | ✅ Yes |
| One-click export (files + CSV index) | ✅ Yes | ✅ Yes |
| Shows what unreimbursed receipts are worth later | ✅ Yes | ⚠️ If you build the formula |
| Holds your HSA money and investments | ❌ No | ❌ No |
| If you… | Use |
|---|---|
| Have very few medical expenses | A spreadsheet plus a folder can work |
| Are disciplined about linking rows to files | DIY is viable |
| Have a family, dental work, and 20 years of horizon | The manual system will drift |
On its own, no. The IRS wants documentation of the expense — provider, patient, date, service, amount — not a self-created summary.
Yes. Many people do exactly that, and the export CSV drops straight into a spreadsheet.
Link rot and abandonment. Rows point at files that moved, and the habit lapses during a busy year.