Quick Answer: HSA/FSA eligible expenses include doctor visits, prescriptions, dental care, vision care, OTC medications, mental health services, and - with a Letter of Medical Necessity - wellness products like gym memberships, fitness trackers, supplements, and more.
The IRS Defines What's Eligible
Under IRS rules (Publication 502), qualified medical expenses are costs for the "diagnosis, cure, mitigation, treatment, or prevention of disease" and costs that affect "any part or function of the body."
The key phrase is "prevention of disease" - this is what makes wellness products potentially eligible.
Always Eligible (No Extra Documentation Needed)
These expenses can be paid with your HSA/FSA right away:
Medical Care - Doctor visits and copays - Hospital services and surgeries - Physical therapy and speech therapy - Mental health (psychiatry, psychology, counseling) - Acupuncture and chiropractic care - Lab tests, X-rays, and diagnostic imaging
Prescription & OTC Medications - All prescription medications - Over-the-counter pain relievers (Advil, Tylenol, Aspirin) - Allergy medications (Claritin, Zyrtec) - Cold and flu medicine - Antacids and digestive aids - Sleep aids
Dental - Cleanings, fillings, crowns - Braces and orthodontia - Tooth extractions and dentures - Dental X-rays
Vision - Eye exams - Prescription glasses and contact lenses - LASIK and corrective eye surgery - Contact lens solution
Other - Sunscreen (SPF 15+ broad-spectrum) - Menstrual care products (tampons, pads) - First aid kits and supplies - Hearing aids and batteries - Breast pumps and lactation supplies - COVID-19 tests, masks, and hand sanitizer - Fertility treatments and birth control
Eligible WITH a Letter of Medical Necessity (LMN)
These "dual-purpose" items are eligible when a licensed healthcare provider (MD, DO, PA, NP) documents that they're medically necessary for a specific condition:
Fitness & Exercise - ✅ Gym memberships (Equinox, 24 Hour Fitness, Orangetheory, etc.) - ✅ Fitness classes (yoga, Pilates, boxing, etc.) - ✅ Personal training sessions - ✅ Home fitness equipment (Peloton, Tonal, treadmills)
Wearables & Health Tech - ✅ Apple Watch - ✅ Oura Ring - ✅ WHOOP - ✅ Garmin fitness watches - ✅ Eight Sleep mattress system - ✅ Other health monitoring devices
Supplements & Nutrition - ✅ Vitamins and supplements (AG1, Thorne, Momentous) - ✅ Probiotics (Seed) - ✅ Electrolytes (LMNT, Liquid IV) - ✅ Protein supplements (when for a specific condition)
Recovery & Wellness - ✅ Massage therapy and devices (Therabody, Hyperice) - ✅ Red light therapy (Joovv, HigherDose) - ✅ Saunas (infrared, traditional) - ✅ Cold plunges and cryotherapy - ✅ Compression therapy (Normatec)
Home Health - ✅ Air purifiers (for respiratory conditions) - ✅ Humidifiers (for respiratory/skin conditions) - ✅ Standing desks (for chronic pain) - ✅ Ergonomic chairs (for chronic pain)
Mental Health & Sleep - ✅ Meditation apps (Headspace, Calm) - ✅ Sleep technology - ✅ Weighted blankets (for anxiety)
Crates Health provides the LMN for all of these. Learn more about how it works.
NOT Eligible
These expenses can never be paid with HSA/FSA funds, even with an LMN:
❌ Cosmetic surgery (breast augmentation, tummy tuck, Botox)
❌ Teeth whitening
❌ General health club dues (without LMN connecting to medical condition)
❌ Vitamins for "general wellness" (without LMN)
❌ Dance or swimming lessons
❌ Funeral expenses
❌ Hair transplant or removal
❌ Maternity clothes
❌ Personal care items (shampoo, deodorant, cosmetics)
❌ Controlled substances not legal under federal law
The Key Principle
The IRS looks at purpose, not product. A gym membership for fun? Not eligible. A gym membership recommended by a licensed healthcare provider to help manage your hypertension? Eligible with an LMN.
This is exactly why Crates exists - to help you document the medical purpose of your wellness spending and unlock the tax savings you deserve.
Related Articles
Still Need Help?
Chat with us using the widget in the bottom-right corner or email us at [email protected]. We're here to help!