Are Mattresses FSA Eligible? The Requirements
While not typically covered, a mattress can be an FSA-eligible expense. Learn the official distinction between a comfort item and a medical necessity.
A Flexible Spending Account (FSA) allows you to set aside pre-tax dollars from your paycheck to cover out-of-pocket medical costs. While you can use these funds for many healthcare products, a mattress is not an automatically approved expense. It can, however, qualify for reimbursement under specific IRS circumstances. Eligibility hinges on the mattress being a medical necessity rather than a purchase for general comfort.
Establishing Medical Necessity
To have a mattress purchase qualify as a medical expense, it must be primarily for the prevention or alleviation of a physical illness or defect. According to IRS guidelines, personal comfort items do not meet this standard. This means buying a mattress to simply get a better night’s sleep will not be approved. The purchase must be directly linked to a diagnosed medical condition.
Several medical conditions may require a specialized mattress, justifying the expense. Conditions such as scoliosis, spinal stenosis, severe arthritis, fibromyalgia, or a herniated disc often necessitate specific support that a standard mattress cannot provide. A physician must determine that the mattress is a necessary treatment for your specific health issue.
The IRS also clarifies that the eligible amount for reimbursement may be limited. If a special mattress is prescribed, the reimbursable cost is the amount that exceeds the cost of a regular mattress. For example, if a prescribed orthopedic mattress costs $2,000 and a comparable standard mattress costs $800, you could only seek reimbursement for the $1,200 difference.
Required Documentation for Purchase
You must obtain a Letter of Medical Necessity (LOMN) from a licensed healthcare provider before purchasing the mattress. This letter is the official proof that substantiates the medical need for the item. An FSA administrator will deny the claim without a detailed LOMN. The letter must be written and signed by your doctor and clearly state your specific medical diagnosis.
The LOMN must explicitly recommend the mattress as a necessary treatment and explain how its features will help your condition. For instance, the doctor might specify the need for a mattress with adjustable firmness for chronic back pain. This documentation is required because a mattress can serve a personal comfort function, and the LOMN proves its primary purpose is medical care.
The Reimbursement Process
Once you have your Letter of Medical Necessity, you can purchase the appropriate mattress. You must get an itemized receipt from the seller at the time of purchase. This receipt must show the vendor’s name, the date of purchase, a specific description of the item, and the amount paid. Credit card slips showing only a total charge are not sufficient.
With your LOMN and itemized receipt, you can submit a claim to your FSA administrator. Most administrators have an online portal where you can upload digital copies of your documents. You will need to fill out a claim form provided by your FSA provider and attach the LOMN and the detailed receipt.
After you submit your claim, the FSA administrator will review the documentation. If the claim is approved, the funds will be paid out to you from your FSA account, usually through a direct deposit or a check. If the claim is denied, the administrator will provide a reason, which could involve insufficient information in the LOMN or an improper receipt.