Using Flexible Spending Account (FSA) or Health Savings Account (HSA) funds to acquire a new fitness tracker or smartwatch presents an attractive opportunity to maximize pre-tax savings. Qualifying health purchases through these accounts allow consumers to save an average of 30% compared to standard out-of-pocket spending. However, tax guidelines mandate that devices cannot simply serve general wellness purposes; they must be medically necessary for monitoring, preventing, or treating a diagnosed health condition.
The Role of the Letter of Medical Necessity (LMN) Under IRS Guidelines
To qualify a consumer wearable or fitness device as a qualified medical expense under Internal Revenue Service (IRS) regulations, buyers must obtain a Letter of Medical Necessity (LMN). An LMN operates as an official medical document confirming that a specific product is required to manage a legitimate health issue, such as obesity, cardiovascular conditions, prediabetes, elevated cholesterol, chronic pain, or sleep disorders. Each LMN is issued specifically to an individual for a designated product from a particular merchant. While employer plan administrators review claims carefully, having a properly documented LMN significantly increases approval odds.
How Third-Party Platforms Like Truemed Simplify Approvals
Obtaining an LMN no longer mandates a traditional in-person visit to a primary care doctor. Service platforms such as Truemed have integrated directly into checkout flows on brand websites including Coros (Coros) and Amazfit (Amazfit). When checking out, selecting the "Pay With Truemed" option initiates a health assessment questionnaire that routes the user's information to a licensed independent healthcare practitioner for review. Truemed (Truemed) states that 90% of LMN requests submitted through its system are evaluated and issued within 7 hours.
Truemed co-founder and CEO Justin Mares (Justin Mares) explained that clinicians apply medical standard-of-care practices when reviewing intake responses. "If you go into a doctor's office and say your family has a history of high blood pressure, your doctor probably is not going to ask for lab work before they'll talk to you about it," Mares noted, emphasizing that clinicians rely on patient-reported history regarding risk factors like weight, hypertension, or lipid levels to issue necessity documentation.
Eligible Smartwatches and Recovery Trackers
A broad selection of high-end wearables can be purchased using pre-tax funds once an LMN is secured. Screenless recovery track devices, such as the WHOOP 5.0/MG Activity Tracker with a 12-month membership ($359.00 on Amazon), the Amazfit Helio Strap ($99.00 on Amazon), and the Oura Ring 5 ($499.00 on Amazon), qualify when used for tracking sleep metrics, heart rate variability (HRV) stress levels, or managing chronic conditions. The Google Fitbit Air is also listed at $99.00 on Amazon.
In the smartwatch category, options include the COROS PACE 3 Sport Watch GPS, priced at $199.00 on Amazon after a $30.00 discount from $229.00. Coros provides HSA/FSA eligibility across its entire watch and monitor lineup through Truemed. Additionally, the Amazfit Balance 3 Smart Watch sells for $369.99 on Amazon, with Amazfit offering direct HSA/FSA filtering on its web store.
Garmin Health Devices and Heart Rate Monitors
While Garmin smartwatches themselves are not eligible for HSA/FSA spending, several standalone health monitoring devices from Garmin are fully qualified for purchase using health funds
- Garmin Index BPM smart blood pressure monitor
- Garmin Index S2 smart scale
- Garmin HRM-Fit heart rate monitor for women, priced at $89.99 on Amazon (reduced from $149.99, a $60.00 savings)
- Garmin HRM-Pro Plus heart rate monitor
- Garmin HRM-Dual real-time heart rate monitor
- Garmin HRM-Swim heart rate monitor
Home Gym Equipment and Strength Training Gear
The application of HSA and FSA funds extends beyond wrist-worn technology to structured exercise equipment. Items such as adjustable dumbbells, rowing machines, and stationary bikes can qualify if a clinician certifies that structured physical exercise forms part of a treatment plan for conditions like prediabetes or high cholesterol. For instance, Nike Strength offers eligible items including the Alpha home gym setup, the Nike barbell and plate set, the Nike curl bar bundle, and the Nike grind dumbbell. Ultimate approval depends on individual medical history documented within the LMN.
