When exercise is doctor-ordered, turn to your HSA/FSA

Yes, it could — if you prove the expense is medically necessary. General fitness expenses don’t qualify for HSA/FSA use, but things change when a physician or nurse practitioner prescribes an exercise regimen.

For example, a physician might prescribe weight training or aerobic activity to lower blood pressure. He or she could write a letter of medical necessity, also known as an "LMN", allowing the patient to purchase free weights or an elliptical using HSA/FSA funds.

Or a physician might prescribe swimming to alleviate back pain. In this case, an LMN would allow the patient to use HSA/FSA money for a gym membership to have access to a pool.

You’ll notice these two scenarios — though they have different conditions and treatment plans — have one thing in common. It’s the letter of medical necessity. This document, which must be signed by a physician or nurse practitioner, verifies that the purchased services or items are intended to treat or prevent a medical condition.

The Internal Revenue Service requires an LMN to deduct certain eligible expenses from income taxes. Similarly, the letter allows people to use tax-free funds from an HSA or FSA for those services or items.

By default, LMNs are good for one year from the date they are written. A physician or nurse practitioner could instead recommend a shorter duration for the treatment. If treatment and related expenses continue beyond the initial time period, a new letter is required.

An LMN can be written on a prescription pad, a provider’s letterhead, hospital discharge papers or a form provided by your HSA/FSA administrator. Ask your plan administrator which format they require before asking your physician or nurse practitioner to write or sign a letter.

Regardless of the format, make sure the LMN includes your name, the condition being treated and a detailed description of the treatment. Include the LMN when you submit your receipt or invoice to your plan administrator for reimbursement or payment.

If you end up being unable to use HSA/FSA funds for exercise, you can use those funds to take care of yourself in other ways. If you want help sleeping, starting a family, caring for your skin or dealing with many other everyday health and wellness issues, explore the Optum Store. All items here are eligible — no LMN needed.

Resource: Back Pain (n.d.). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906