The Ultimate Guide to HSA/FSA Eligible Expenses & Savings Strategies

• HSA (Health Savings Account): available if you have a high-deductible health plan (HDHP). Contributions are tax-deductible, funds roll over indefinitely, and unused money can be invested and grow over time.
• FSA (Flexible Spending Account): an employer-sponsored benefit, not tied to a specific health plan. Contributions are pre-tax, but most FSAs are "use-it-or-lose-it" within the plan year (with limited exceptions below).

In short, it means the IRS considers a product or service a qualified medical expense. Now where people get confused is the difference between a medical expense that’s automatically eligible or “pre-approved” and a medical expense that requires additional documentation to be eligible. For example, things like prescriptions and bandages are automatically eligible, meaning you can pay for them directly with your HSA or FSA card without any additional paperwork. On the flip side, things like exercise equipment and supplements often require additional documentation, like a Letter of Medical Necessity (LMN), certifying that the purchase is meant to treat, cure, prevent, or mitigate a diagnosed condition.

If you're looking for the full breakdown of what is and isn't eligible, see our complete list of HSA/FSA-eligible expenses and for the full definition on how eligibility is determined, see HSA/FSA Meaning.

There are a few things to keep in mind if you want to maximize the value of your HSA or FSA dollars.

1. Max out contributions where it makes sense. For 2026, HSA contribution limits are $4,400 for individual coverage and $8,750 for family coverage. FSA contribution limits are $3,400 per employee. Every dollar you contribute is a dollar that's never taxed, and for most earners, that's real, immediate savings, not just a budgeting nicety.

2. Use an LMN to unlock additional health interventions. The IRS doesn't automatically classify things like gym memberships, fitness equipment, red light therapy devices, or sleep trackers as medical expenses. But if a licensed clinician documents that a specific product or service is necessary to treat, mitigate, or prevent a diagnosed condition, it may be eligible for HSA/FSA spending, even though it wouldn't qualify without that documentation. Truemed builds this LMN process directly into checkout with partner brands, so you don't have to track it down separately.

3. Combine pre-tax savings with other discounts. Because HSA/FSA savings come from tax savings on the dollars you spend (not a discount on the product itself), you can typically stack an LMN-qualified purchase with a brand's existing sale price or promo code. That means the real-world savings and the pre-tax savings compound rather than replacing each other.

4. Time your spending around your plan's rules. This is where HSA and FSA strategy diverge sharply:

• HSA: No deadline pressure. HSA funds roll over every year and can be invested for long-term growth, so there's no rush to spend by year-end.
• FSA: Most plans require spending within the plan year. Some employers offer either a grace period (typically up to 2.5 months) or a carryover. For 2026, the maximum FSA carryover is $680, up from $660 in 2025. Check your specific plan's Summary Plan Description, since your employer decides which option (if either) applies, and a plan can't offer both.

5. Know when contributions are due. For HSAs, you generally have until the federal tax filing deadline (typically mid-April) to make prior-year contributions, so if you're behind on maxing out, you may have more time than you think.

Truemed partners with merchants to let qualified customers apply HSA/FSA funds toward eligible products, including the interventional health categories like fitness, recovery tools, sleep, and supplements that often require an LMN. Truemed facilitates the LMN qualification step directly at checkout so qualified customers can seamlessly access necessary health interventions, no in person visit required.

Truemed* is a platform that facilitates this process directly at checkout for thousands of health brands. Here’s how it works:

• Check eligibility first. Confirm whether a product is normally a qualifying medical expense on its own, or whether it falls into the category of products that require an additional documentation.
• Complete a health intake survey, reviewed by an independent licensed clinician. Truemed does not make eligibility determinations, the clinician does.
• Buy the item. Pay directly with your HSA/FSA card at checkout, or pay another way and seek reimbursement afterward.
• Get your determination. The independent clinician reviews your medical history and, if you qualify, issues an LMN tied to your specific condition.
• Keep your documentation. Truemed offers support if you receive a reimbursement denial and need to provide substantiation.

*Truemed is for qualified customers. HSA/FSA tax savings vary. Learn more at truemed.com/disclosures.

If you paid for an eligible expense without using your HSA/FSA card directly, you can often still get reimbursed:

Keep your receipt and LMN (if required). Retain documentation showing the purchase and, where applicable, the LMN establishing eligibility.

Submit a claim to your HSA/FSA provider. Most providers offer an online portal; some still accept paper submissions.

Receive reimbursement. Once approved, funds are typically issued by check or direct deposit, depending on your provider.