Many workers with a HSA or FSA assume the accounts only cover traditional medical expenses, but a growing list of fitness and recovery devices now qualifies under IRS rules.
Eligibility and the Letter of Medical Necessity
To use pre-tax dollars for a wearable, the purchase must be linked to a documented health condition such as obesity, hypertension, or chronic pain. The IRS requires a Letter of Medical Necessity (LMN), which is essentially a doctor’s note confirming that the device is part of a treatment plan.
Consumers can often obtain an LMN without an in-person appointment. Third-party platforms like Truemed let shoppers answer a brief health questionnaire at checkout; a licensed provider reviews the answers and, if the criteria are met, issues the LMN.
According to Truemed, If you qualify, you’ll get an LMN that will allow you to use your HSA or FSA funds to complete your purchase—all without ever having to meet with your primary doctor. Truemed is one of the companies that provides this service.
Because the LMN is tied to a specific product and a specific health issue, approval can still be denied by a strict FSA administrator. Some brands advertise “HSA/FSA eligible” but rely on the LMN step to make that claim valid.
Comparing this to earlier years, when only blood pressure cuffs and glucose meters were clearly covered, shows how the definition of “medical necessity” is expanding. The shift reflects insurers’ willingness to recognize preventive technology, yet it also places more responsibility on consumers to justify lifestyle-focused gadgets.
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Wearables and equipment that may qualify
Recovery-focused trackers such as the Whoop 5.0 (priced at $359.00) and the Oura Ring 5 ($499.00) can be approved when linked to sleep-related disorders or stress monitoring for a heart condition. These products often face extra scrutiny because they are marketed primarily for wellness.
Smartwatches that provide reliable heart-rate data are also eligible if a cardiovascular issue is documented. The Fitbit Air retails for $99.99, while the Garmin HRM-Fit for women is listed at $89.99. Garmin’s broader lineup, including the HRM-Pro Plus and the HRM-Dual, can be purchased with an LMN, though not all Garmin watches qualify.
Brands like Coros and Amazfit flag eligible models on their sites, allowing shoppers to filter by HSA/FSA status. For example, the Coros PACE 3 Sport Watch is offered at $199.00 and is listed as eligible through Truemed’s verification process.
Home-fitness gear can also meet the criteria when a clinician prescribes structured exercise for conditions such as pre-diabetes. Nike’s Strength line includes an adjustable dumbbell set, a barbell and plate combo, and a grind dumbbell, each of which can be paired with an LMN for purchase.
One concrete example: a user with a documented high-blood-pressure diagnosis completed the Truemed questionnaire, received an LMN, and used their FSA to buy the Garmin HRM-Fit heart-rate monitor at the discounted price of $89.99. The claim was processed without a follow-up request from the employer’s benefits administrator.
Further qualifying wearables and accessories
Screenless recovery trackers such as the Whoop band, Amazfit Helio Strap, and Oura Ring can meet eligibility when linked to sleep-related disorders or HRV-based stress monitoring.
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These devices often undergo additional review because they are primarily marketed for lifestyle improvement rather than direct medical treatment.
Applicants must answer health-history questions accurately; stronger relevance to a documented condition improves the likelihood of LMN issuance.
When the intake indicates chronic pain or a diagnosed sleep apnea condition, the reviewing clinician may deem the recovery tracker medically necessary.
Conversely, generic fitness goals without a specific diagnosis typically result in the request being declined before reaching the benefits administrator.
Some brands display an “eligible” badge at checkout, but the final determination still depends on the LMN tied to the individual’s health issue.
Purchasers should verify that the product description aligns with the condition cited in the LMN to avoid claim rejections.
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Garmin health devices and other brand options
Garmin offers several health-focused tools that can qualify, including the Index BPM blood pressure monitor and the Index S2 smart scale.
Heart-rate monitors such as the HRM-Fit for women, the HRM-Pro Plus, the HRM-Dual, and the HRM-Swim also meet the criteria when a cardiovascular condition is documented.
Unlike many smartwatches, these Garmin items are classified as medical devices rather than general fitness trackers.
Home-fitness equipment that qualifies
Adjustable dumbbells, barbell sets, and rowing machines can be approved when a clinician prescribes structured exercise for conditions like pre-diabetes or high cholesterol.
Clinicians must attest that regular use of the equipment forms part of the patient’s treatment regimen for the LMN to be valid.
