an Individual Retirement Account or a 401(k) retirement plan, and funds from such investment vehicles cannot be rolled into health savings account, except for the one-time Individual Retirement Account transfer mentioned earlier. Unlike some employer contributions to a 401(k) retirement plan, all health savings account contributions belong to the participant immediately, regardless of the deposit source. A person contributing to a health savings account is under no obligation to contribute to an employer-sponsored health savings account, but an employer may require that payroll contributions be made only to the employer-sponsored health savings account plan. Withdrawals Health savings account participants do not have to obtain advance approval from their health savings account trustee or their medical insurer to withdraw funds, and their funds are not subject to income tax if they are made for qualified medical expenses. They include costs for services and items covered by the health plan but subject to cost-sharing such as a deductible and coinsurance, or co-payments as well as many other expenses not covered under medical plans, such as dental, vision and chiropractic care; durable medical equipment such as eyeglasses and hearing aids; and transportation expenses related to medical care. Over-the-counter medications were also eligible until December 31, 2010, when the Patient Protection and Affordable Care Act stipulated HSA funds could no longer be used to buy over-the-counter drugs without a doctor's prescription. As a response to the COVID-19 pandemic, the passage of the CARES Act once again made over-the-counter drugs reimbursable without a prescription for amounts paid after Dec. 31, 2019. The CARES Act also recognized menstrual care products as medical expenses, allowing for those products to be purchased or reimbursed with HSA funds. There are several ways that funds in a health savings account can be withdrawn. Some health savings accounts include a debit card, some supply checks for account holder use, and some allow for a reimbursement process similar to medical insurance. Most health savings accounts have more than one possible method for withdrawal, and the methods available vary. Checks and debits do not have to be made payable to the provider. Funds can be withdrawn for any reason, but withdrawals that are not for documented qualified medical expenses are subject to income taxes and a 20% penalty. The 20% penalty is waived for persons who have reached the age of 65 or have become disabled at the time of the withdrawal. Then,