Get fitness fees reimbursed with your HSA/FSA funds

A Letter of Medical Necessity is a document that details why a patient needs a specific product or treatment (like a wheelchair, vitamin supplement or swim therapy) for medical purposes so that the expense can be paid for with funds from an HSA (Health Savings Account) or FSA (Flexible Spending Account).

HSA and FSA accounts allow you to set aside pre-tax money you can use to pay for qualified medical expenses. But sometimes, these health care costs might not be automatically recognized as HSA or FSA-qualified expenses. In such cases, a Letter of Medical Necessity provides documentation explaining why that particular expense is medically necessary so that it meets the criteria for reimbursement under HSA or FSA guidelines.

You are eligible if:

• You have an active HSA or FSA account.
• You are preventing or reversing health conditions like depression, anxiety, chronic fatigue, insomnia, obesity, infertility, diabetes, heart disease and more through an exercise or fitness routine.

Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) are tax-exempt accounts designated to reduce the cost of eligible medical expenses. The IRS determines the differences between HSA and FSA accounts, which are usually established and overseen by an HSA or FSA administrator. You can access that administrator via your employer's HR department or the financial institution where you have your HSA.

Lemonaid Health medical consultations involve a streamlined health assessment about conditions you are working to prevent or reverse. If eligible, you'll receive a Letter of Medical Necessity detailing how exercise can help prevent or treat your condition, qualifying related costs as HSA or FSA-eligible expenses. (The letter comes a few hours after you’ve completed payment.)

If you have an HSA or FSA account, you can submit this letter to reimburse future gym memberships, fitness classes, personal training or other exercise program fees. To ensure compliance, keep that Letter of Medical Necessity and applicable receipts available for the next three years.

HSA and FSA accounts consist of pre-tax funds, meaning you won’t pay income tax on money you put into those accounts and then use to pay for qualified healthcare expenses.

Using pre-tax money from an HSA or FSA account saves you money because you’re not paying tax on income you’ll then use to buy health-related items. This essentially increases your purchasing power for healthcare necessities. In 2025, individuals can contribute up to $4,300 (and families $8,550) to their HSA, and up to $3,300 to their FSA. In 2026, individuals can contribute $4,400 to their HSA, and families can contribute up to $8,750. (The 2026 FSA limits have not yet been announced by the IRS.)

Most patients save between $1,000 and $2,000, depending on their state and tax bracket. (You can calculate your savings based on those parameters.)

1. Find your HSA/FSA administrator: If you're not sure who your HSA or FSA administrator is, contact your employer's HR department. If you have health insurance through the public marketplace, find your administrator's information through the financial institution that set up your HSA.
2. Access your HSA/FSA administrator's web service: Set up a new account or use your login details to access the online platform of your HSA or FSA administrator.
3. Locate their 'Reimbursement' or 'Claims' section: Find the dedicated area on their HSA/FSA website or app that handles reimbursements or claims.
4. Submit your letter and receipts: Upload your Letter of Medical Necessity from Lemonaid Health and the receipt for the product or service you bought as a result of your Lemonaid Health consultation. Note that purchases must be made on or after the date of your letter.
5. Wait for your claim to be processed: Once you've submitted all required documents, it may take a few days or weeks for your HSA/FSA administrator to review and process your claim. Once confirmed, they'll deposit the reimbursement amount into the account you specified. If you run into any issues with your administrator's form submission requirements, request support from our team via your patient dashboard. We'll help sort it out!
6. Use your Letter of Medical Necessity for future claims: You may be able to use your Letter of Medical Necessity for the same items if you file the claim within your 12-month period. For example, if you use your HSA for gym membership fees, you may need to resubmit when you renew your membership. If you want to use your funds for a massage or a nutritionist coaching session, you'll resubmit with every new receipt.

HSA/FSA administrators typically approve expenses 7-10 days after you submit your Letter of Medical Necessity and receipts. But reimbursement timelines can vary depending on your particular HSA/FSA administrator.

Your Letter of Medical Necessity is valid for 12 months. You can file the same letter with any related purchase receipts made on or after the letter's date. You can’t file it with purchases made before the letter was issued.

You don't need to submit any additional IRS tax forms for personal purchases made with FSA funds. (If you use your FSA to pay for the care of a dependent, you’ll have to file Form 2441.)

HSA tax benefits filing involves three IRS tax forms: 1099-SA, 5498-SA and 8889. Form 5498-SA is filed by the provider of your HSA account. During tax season, your provider will send you Form 1099-SA with information you'll use to complete Form 8889, which you'll need to submit with your annual tax filings. Make sure to keep copies of all documents you submit. Contact your HSA administrator's customer service if you need assistance.