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. Until December 31, 2010, non-prescription, over-the-counter medications were also eligible, afterward, the Patient Protection and Affordable Care Act stipulates HSA funds can no longer be used to buy over-the-counter drugs without a doctor's prescription.