Quick answer: Most wellness products are HSA/FSA eligible when you have a Letter of Medical Necessity (LMN) connecting the product to a specific health condition. Here's a quick guide to what's eligible and how it works.
The Short Version
There are three categories of HSA/FSA eligible expenses:
Always eligible - Traditional medical expenses (prescriptions, doctor visits, dental, vision, OTC medications). No LMN needed.
Eligible with an LMN - Wellness and health products that qualify when a licensed healthcare provider (MD, DO, PA, NP) says they're medically necessary for your specific condition. This is where Crates Health comes in.
Never eligible - Purely cosmetic procedures, general household items, and things the IRS considers "merely beneficial to general health" without a medical connection.
Popular Products and Their Eligibility
Fitness and Gym
Product | Eligible? | Notes |
Gym memberships (Equinox, 24 Hour Fitness, OrangeTheory, F45, etc.) | Yes, with LMN | Cannot use HSA/FSA card at most gyms - pay normally and reimburse |
Yoga and pilates memberships | Yes, with LMN | Same process as gym memberships |
Personal training | Yes, with LMN | Sessions and packages both qualify |
Home gym equipment (Peloton, Tonal, BowFlex, etc.) | Yes, with LMN | Equipment purchase and subscriptions can both qualify |
Wearables and Health Tech
Product | Eligible? | Notes |
Apple Watch | Yes, with LMN | FDA-cleared health features (ECG, blood oxygen). Can't use HSA card at Apple - pay and reimburse |
Oura Ring | Yes, with LMN | Ring purchase and monthly subscription both qualify |
WHOOP | Yes, with LMN | Subscription model - LMN covers the membership |
Fitbit, Garmin, Samsung Galaxy Watch | Yes, with LMN | Health monitoring features qualify them |
Recovery and Wellness
Product | Eligible? | Notes |
Theragun / massage devices | Yes, with LMN | For chronic pain, muscle conditions, recovery |
Red light therapy devices | Yes, with LMN | FDA has cleared multiple devices as Class II medical devices |
Saunas (home units, studio memberships) | Yes, with LMN | Infrared and traditional both qualify |
Cold plunge / cryotherapy | Yes, with LMN | Equipment and studio sessions |
Eight Sleep (smart mattress) | Yes, with LMN | For sleep disorders, temperature regulation issues |
Supplements and Nutrition
Product | Eligible? | Notes |
Vitamins and supplements | Yes, with LMN | Must be connected to a specific health condition, not general wellness |
Protein supplements | Yes, with LMN | When tied to a health condition |
Electrolytes (LMNT, Liquid IV) | Yes, with LMN | For hydration-related conditions |
Probiotics | Yes, with LMN | For digestive health conditions |
Prenatal vitamins | Yes (always) | No LMN needed for prenatal vitamins |
Mental Health
Product | Eligible? | Notes |
Therapy/counseling | Yes (always) | For diagnosed mental health conditions |
Meditation apps (Headspace, Calm) | Yes, with LMN | When used for anxiety, depression, stress disorders |
Weighted blankets | Yes, with LMN | For anxiety or sleep disorders |
Always Eligible (No LMN Needed)
Prescription medications
Over-the-counter medications (Advil, Tylenol, allergy meds, etc.)
Doctor and specialist visits
Dental care (cleanings, fillings, braces)
Vision care (glasses, contacts, eye exams)
Menstrual care products
COVID tests
Sunscreen (SPF 15+)
First aid supplies
What About [Specific Product Not Listed Here]?
If you don't see your product listed, take our health assessment at crateshealth.com. We'll tell you if it's eligible and which health conditions might qualify you. You can also browse our Explore Eligibility page for a full directory of 100+ products and services.
The Key Rule
The IRS says medical expenses must be "primarily to alleviate or prevent a physical or mental disability or illness." Products that are "merely beneficial to general health" don't qualify on their own. That's what the LMN does - it connects the product to your specific health need, making it a qualified medical expense.
Frequently Asked Questions
Do I need to be "sick" to qualify? No. Prevention counts. If you have risk factors for conditions like heart disease, diabetes, or hypertension (family history, elevated BMI, high cholesterol, sedentary lifestyle), wellness products that address those risks can be eligible.
Is this just for expensive items? No. Gym memberships, supplements, and other everyday wellness expenses all qualify. Our members save an average of $1,487 per year on the Unlimited plan.
What if my product isn't on the Crates website? Take the health assessment anyway. Crates can issue LMNs for any eligible wellness product — you're not limited to a set catalog. If the product can be tied to a health condition and serves a medical purpose, it may qualify. Our licensed healthcare providers review each case individually.
Can the same product qualify for different conditions? Yes. An Apple Watch might be recommended for cardiovascular monitoring for one person and sleep tracking for another. The LMN is specific to your health profile.
Still Need Help?
Not sure if something is eligible? Chat with us or email [email protected]. We'll help you figure it out.