1. Fees for care. In this model the fees charged are directly related to medical care, as described by the IRS, and would generally be considered as eligible medical expenses under the HSA guidelines.
2. Annual Physical. Here a fee is charged for an annual physical, usually comprehensive in scope, that includes no additional non-medical services. The physical is considered to be medical care and would generally be considered as eligible medical expenses under the HSA guidelines.
3. Annual physical plus amenities. Here a fee is charged for an annual physical and some additional non-medical services (amenities). The physical is considered to be medical care and would generally be considered as eligible medical expenses under the HSA guidelines. The amenities (e.g. retainer fess or timely access to a physician) are not eligible medical expenses under the HSA Guidelines. If the Physician group provides itemized billing for the services included, the physical can be reimbursed from the HSA as a medical expense, but the “amenities” cannot. In the case where the physician group furnishes only a global bill with no itemization for specific services, it may be difficult to prove the expense was eligible.
4. Amenities Only. Here the fees collected by the physician groups are exclusively for amenities like retainer fees or guaranteed timely access. These are not medical expenses and as such are not generally reimbursable by the HSA.

The rationale is detailed below.

The final decision as to whether an expenditure is primarily for medical care, or is merely beneficial to general health, is a question of fact ( i.e. would be supported by evidence unique to the situation in question). If you have questions about your situation after reviewing this answer, you should consult your tax advisor or tax attorney.

Section 213(a) Of the IRS code allows a deduction for uncompensated expenses for medical care of an individual, the individual’s spouse or a dependent, to the extent the expenses exceed 7.5 percent of adjusted gross income. Section 213(d)(1) provides, in part, that medical care means amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body. This is the basis for all HSA eligible medical expenses.

Under § 1.213-1(e)(1)(ii) of the Income Tax Regulations, the deduction for medical care expenses will be confined strictly to expenses incurred primarily for the prevention or alleviation of a physical or mental defect or illness. An expense that is merely beneficial to the general health of an individual is not an expense for medical care. Whether an expenditure is primarily for medical care or is merely beneficial to general health is a question of fact.

This is echoed in IRS Publication 502:

“Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body. They include the costs of equipment, supplies, and diagnostic devices needed for these purposes. They also include dental expenses. Medical care expenses must be primarily to alleviate or prevent a physical or mental defect or illness. They do not include expenses that are merely beneficial to general health, such as vitamins or a vacation.”

Pub 969 (which speaks directly to additional HSA allowable expenses) again references 502 and makes no mention of physician concierge services:

“Qualified medical expenses. Qualified medical expenses are those expenses that would generally qualify for the medical and dental expenses deduction. These are explained in Publication 502, Medical and Dental Expenses. ” Publication 969 goes on to include over the counter medications and certain insurance premiums but is silent on the issue of concierge services, considering them to have been addressed in Publication 502.

Yes. IRS Notice  2008-59, Q&A 33 addresses the question of a dependent being claimed by a former spouse.   

Q-33. Do qualified medical expenses for HSA purposes include the § 213(d) medical expenses incurred by an account beneficiary’s child who is claimed as a dependent by the account beneficiary’s former spouse?

 A-33. Yes.

Am I required to take the money out of my HSA at a specific age?

There is no maximum balance limitation. There is no mandatory disbursement age. The account is yours for life. It continues to grow for as long as you have it.

The following list, while not intended to be all inclusive, illustrates medical or medical-related expenses which may be reimbursed tax-exempt under a Health Savings Account.  IRS publications 502 and 969 provide similar information. Section 213(d) of the Tax Code contains the full provisions of the applicable tax deductions.

 
Abortion if legal abortion
Acupuncture, if treating a medical condition
Alcoholism treatment for inpatient treatment (including meals and lodging) at a center for alcohol addiction
Allergy medicine if treating sickness or injury
Ambulance
Antacid
Antihistamine
Artificial limbs and teeth
Aspirin 
Bactine 
Bandages 
Birth control pills 
Birthing classes / Childbirth classes / Lamaze if classes relate to child birth and not child rearing. Expenses for coach (or doula) or significant other are not eligible
Blood pressure monitoring device 
Blood sugar test kit and test strips 
Body scan 
Braille books and magazines for visually-impaired person, but only the amount above cost of regular printed material
Breast pump Not unless there is a medical need
Breast reconstruction surgery following mastectomy  if mastectomy was done following cancer
Calamine lotion 
Carpal tunnel wrist supports 
Chelation therapy if used to treat medical condition such as lead poisoning
Childbirth classes See Lamaze
Chiropractors 
Condroitin  if used to treat medical condition and not just for general health
Circumcision 
Claritin 
Co-insurance amounts and deductibles 
Cold medicine 
Cold packs 
Condoms 
Contact lenses, related materials & equipment if the lenses are needed for medical reasons.
Contraceptives 
Cosmetic procedures or surgery only amounts paid for surgery necessary to improve a deformity arising from a congenital abnormality, personal injury from an accident or trauma, or a disfiguring disease
Cough suppressants 
Counseling for medical reason. Not for marriage counseling
Crutches for rental or purchase
Decongestants 
Deductibles  
Dental treatments see restrictions for orthodontia, teeth whitening and bleaching
Dentures and denture adhesives 
Diabetic supplies. See Glucose monitoring devices and insulin
Diapers or diaper service may be reimbursable where used to relieve the effects of a particular disease
Diaper rash ointments and creams 
Diagnostic services 
Diarrhea medicine 
Drug addiction treatment for inpatient treatment (includes meals and lodging) at therapeutic drug center
Drug overdose treatment 
Drugs and medicines if legally obtained and generally accepted as medicines and drugs and if treating a medical condition. This includes both prescribed drugs and over the counter drugs.
Ear plugs  if treating medical condition
Egg donor fees 
Eye examinations, eyeglasses and related equipment and materials amounts paid for eyeglasses and lenses prescribed by doctor for medical reasons, eye examinations and eyeglass cleaners are eligible
Fertility enhancement (e.g. treatments, surgery, GIFT, IVF, etc.) to extent procedures are intended to overcome an inability to have children. Expenses for in vitro surrogate not deductible unless the surrogate is a tax dependent.
First aid cream and first aid kits 
Flu shots 
Gauze pads 
Glucosamine  if primarily for medical care
Glucose monitoring equipment blood glucose meters and test strips for diagnostic purposes
Guide dog or other animal aide includes expenses related to purchase, training and care of animal used by vision-impaired or hearing-impaired person
Hearing aids includes cost of hearing aid and batteries
Hemorrhoid treatments 
Home care if expenses qualify as nursing services. Not if for long term care
Hormone replacement therapy  if used primarily for medical care
Hospital services 
Immunizations 
Insect bite creams and ointments 
Insulin 
Lab fees if part of medical care
Language training for dyslexic/ disabled child 
Laser / Lasik eye surgery / Radial Keratotomy if for correction of eye function
Laxatives  
Learning disability expenses for special school or specially trained teacher (prescribed by doctor) for a child who has severe learning disability caused by mental or physical impairment
Lodging at hospital or similar institution  if there to receive medical care
Lodging not at hospital or similar institution up to $50/night, provided: (1) lodging is primarily for and essential to medical care, (2) medical care is provided in a hospital or medical facility related to or equivalent to licensed hospital (3) lodging is not lavish (4) no element of personal pleasure, recreation or vacation in the travel.
Medic-alert bracelet or necklace if recommended by a medical practitioner in connection with treating a medical condition
Medical conference admission & transportation 
Medical monitoring and testing devices including blood pressure monitors, syringes, glucose kit, etc.
Medical records charges (to transfer records to new practitioner) 
Medical services  if legal medical service is recommended by physician, surgeon, specialist or other medical practitioner
Motion sickness pills 
Nasal sprays or strips  if used to treat sinus problems or sleep apnea
Nicotine gum or patches 
Norplant insertion or removal
Nursing services provided by nurse or other attendant so long as services are of a kind generally performed by a nurse.
Obstetrical expenses 
Occlusal guards to prevent teeth grinding 
Optometrist   
Orthodontia   unless for cosmetic purposes
Orthopedic shoes and inserts  to the extent they exceed cost of regular shoes
Over-the-counter medicines See Drugs and Medicines
Ovulation monitor 
Pain relievers 
Patterning exercises for exercises to a mentally retarded child
Physical exams if not employment-related
Physical therapy to treat specific medical condition
Pregnancy test kits 
Prenatal vitamins   
Psychiatric care  if for medical care
Psychoanalysis or psychologist if for medical care and not just for the general improvement of mental health, relief of stress, etc.
Schools and education, residential possibly, if the school or program is to treat behavioral, emotional and/or addictive conditions if the primary purpose of the program is medical care 
 Schools and education possibly, if the main reason for using the school is its resources for relieving the disability of a mentally-impaired or physically-disabled person. Includes Braille, lip-reading and remedial language training.
Screening tests  if used for medical diagnosis
Smoking cessation program including both prescription and over the counter drugs and medicines
Special foods (such as foods needed for a gluten-free or salt-free diet) if prescribed by a physician to treat a specific illness or ailment and is not a substitute for normal nutritional requirements. Reimbursement is limited to the difference between the cost of special food and the cost of commonly available regular food
Spermicidal foam 
Sterilization procedures  if legally-performed operation
Sunglasses if they are prescription lenses
Supplies to treat medical condition if used to diagnose or treat a specific medical condition and is not a personal comfort item
Taxes on medical services and products to the extent imposed on reimbursable medical care or products.
Telephone equipment for hearing impaired persons for expenses of buying and repairing special telephone equipment for hearing-impaired person
Television equipment for hearing impaired persons but reimbursable amount is limited to the cost that exceeds cost of regular item
Thermometers 
Toothache and teething pain relievers 
Transplants for surgical, hospital and labor services and transportation expenses for donors
Transportation to and from medical conference for admission and transportation expenses to a medical conference relating to the chronic disease of the individual’s dependent (meals and lodging are not eligible)
Transportation and related travel expenses for person receiving medical care if travel is primarily for, and essential to, medical care. Includes parking fees and tolls. Car mileage is reimbursed at the current rate set by the IRS each year
Vasectomy 
Viagra to treat medical condition
Weight loss programs and/or drugs prescribed to induce weight loss if prescribed by doctor to treat obesity or other medical condition
Wheelchair 
X-ray fees if received for medical reasons

Qualifying Insurance Premiums

Long Term Care Insurance for Qualifying Policies
COBRA Premiums Under Certain Circumstances

1. Contributions
2. Reimbursements
3. Taxes