Can Gym Membership Be Paid With an HSA?

Health Savings Accounts (HSAs) offer a tax-advantaged way for individuals to save and pay for medical expenses. These accounts are designed to help those with high-deductible health plans manage healthcare costs, providing a triple tax advantage: contributions are tax-deductible, earnings grow tax-free, and withdrawals for qualified medical expenses are tax-free. An HSA helps individuals build funds for both current and future medical needs.

Understanding Qualified Medical Expenses

The Internal Revenue Service (IRS) defines “qualified medical expenses” as costs incurred primarily for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any structure or function of the body. Common examples include doctor visits, prescription medications, dental care, vision care, and certain medical equipment. It is important that the expense is incurred to prevent or alleviate a physical or mental disability or illness, not merely for general health benefits.

When Gym Memberships Can Qualify

A gym membership does not qualify as a medical expense because it is considered a general wellness or recreational expense. However, an exception applies if a physician prescribes it as part of a treatment plan for a specific medical condition. In such cases, a “Letter of Medical Necessity” (LMN) from a healthcare provider is required.

The LMN must clearly explain the specific medical condition, how the gym membership treats or alleviates it, and the prescribed duration. For example, it might be deemed medically necessary for conditions like obesity, heart disease, diabetes, hypertension, or post-surgery recovery. The LMN should connect the diagnosis directly to the benefits of the gym membership, avoiding vague language. A valid LMN is typically effective for 12 months, allowing repeated claims for monthly membership fees within that period.

Documentation and Record-Keeping

Once a gym membership qualifies as a medical expense with a Letter of Medical Necessity, record-keeping is important. Retain the physician’s LMN, gym membership receipts, and other relevant medical documentation. These records are important for tax purposes and IRS audits.

It is advisable to keep these documents for at least three years from your tax return filing date, or longer if your HSA remains open. You are responsible for proving expense eligibility, even if your HSA administrator does not require immediate submission. Some HSA providers offer online tools for digital record storage.

Common Non-Qualifying Scenarios

Gym memberships or related wellness expenses do not qualify for HSA reimbursement if they are for general health improvement, weight loss for aesthetic reasons, or preventive measures without a specific medical condition. A doctor’s general recommendation for exercise is insufficient without a formal LMN linking it to a specific medical diagnosis. Expenses merely beneficial to general health, such as vitamins or general fitness equipment, do not meet IRS criteria for qualified medical expenses.