You could reduce the price of a fitness tracker by approximately 30% when using your HSA or FSA, but doing so means following detailed IRS eligibility requirements that go beyond simply wanting a new gadget. Understand the key rules before applying your health spending dollars toward wearables or exercise equipment.
How HSA/FSA savings become available for fitness tech when a medical need is demonstrated
Despite what many ads suggest, purchasing a Health Savings Account (HSA) or Flexible Spending Account (FSA)-qualified Fitbit Air, smartwatch, or wearable for recovery is only possible if it meets a crucial IRS stipulation: the item must be classified as medically necessary.
The IRS states that HSA or FSA reimbursement is only allowed for devices essential in diagnosing, monitoring, or treating a medically recognized health condition—simple promotion of physical activity or general fitness doesn’t qualify. A qualifying purchase might be one that’s specifically prescribed for health challenges like high cholesterol, prediabetes, obesity, or cardiac issues.
The pivotal step is securing a Letter of Medical Necessity (LMN) from a healthcare professional, which proves that the wearable or device in question is central to your treatment for a genuine medical issue. For instance, your care provider might endorse a recovery tracker for a patient with sleep or stress disorders, or a heart monitor for managing cardiovascular risks.
The LMN shortcut: Digital platforms speeding up approval
Securing an LMN is now simpler, thanks to online offerings like Truemed. These services match you with qualified clinicians—no in-office appointment needed. Certain retailers, including Coros and Amazfit, have a “Pay With Truemed” option at checkout. Completing a health intake form online can lead to a quick evaluation and, if appropriate, a direct connection to a clinician review.
According to Truemed, 90% of LMNs are processed in under 7 hours. Most approvals are achieved based on reported risk factors like elevated cholesterol, signs of hereditary diseases, or concerns about weight. Justin Mares, CEO of Truemed, notes that the approval process usually just requires your medical background to justify the need—lengthy records aren’t standard unless the case lacks a compelling health rationale. Each application is subject to clinician review and could be denied if clinical justification isn’t evidenced by your intake responses.
Bear in mind, eligibility varies case by case: The LMN attaches to both a particular product and merchant as well as a specific diagnosed condition. While some employers and FSA plan administrators are quick to approve these expenses, others require extra scrutiny—even an LMN won’t always ensure approval. Some brands like Coros provide step-by-step guidance during checkout for these requirements, where others use HSA/FSA labels but may not clearly communicate the need for further documentation.
Which devices could pass eligibility requirements?
Numerous well-known wearables may qualify if your documented health needs match IRS-accepted uses:
- Popular recovery trackers—such as Whoop, Amazfit Helio Strap, and Oura Ring—are frequently justified for sleep disturbances, stress-related monitoring, or chronic conditions requiring ongoing recovery insights.
- Devices like smartwatches and heart monitors from brands such as Coros (watches and heart rate monitors) may get approved when a relevant health background is provided. Amazfit, for example, allows users to specifically filter by HSA/FSA eligibility for its smartwatches.
- Garmin’s regular smartwatches generally do not qualify, but select Garmin health devices including the Index BPM blood pressure monitor, Index S2 smart scale, and specialized heart monitors (such as the HRM-Fit designed for women) are eligible. You can browse all eligible Garmin items in this category.
Beyond wearables, home gym equipment—such as adjustable dumbbells, rowing machines, or smart exercise bikes—might also be permitted, given that a healthcare provider prescribes structured exercise as treatment for a diagnosed risk. Products like Nike Strength’s home gym setup are among those potentially eligible with the accompanying doctor’s note.
Important considerations and restrictions
Modern online services may simplify the steps required to qualify, but approval is never automatic. LMNs are written for one device, one individual, often for one condition. Ultimately, your FSA or HSA administrator has the final say, and claims still need to meet your employer’s protocols before funds are released. Providing thorough, accurate intake responses and demonstrating a clear need for medical use gives you the strongest chance—especially with products sometimes marketed for general wellness rather than health conditions.
Taking advantage of pre-tax dollars when making significant health or exercise-related purchases is fully possible, but securing eligibility hinges on strong medical justification and accurate completion of the LMN and approval process. If you’re eyeing a new tracker or workout device, starting the application can reveal whether you’ll see the promised savings or find that your situation doesn’t meet the coverage criteria.