Interview Notes . . Jenny Smith, age 57, is single. Jenny earned wages of $52,000 and was enrolled the entire year in a high deductible health plan (HDHP) with self-only coverage. During the year, Jenny contributed $2,000 to her Health Savings Account (HSA) and her mother also contributed $1,000 to Jenny's HSA account. Jenny's Form W-2 shows $650 in Box 12 with code W. She has Form 5498-SA showing $3,650 in Box 2.. Jenny took a distribution from her HSA to pay her unreimbursed expenses: 8 visits to a physical therapist after her knee surgery $400 unreimbursed doctor bills for $900 prescription medicine $200 replacement of a crown $1,500 over the counter medication $40 gym membership $240 Jenny is a U.S. citizen with a valid Social Security number. 8. The gym membership is a qualified medical expense for HSA purposes. True False