Can HSA Be Used for a Personal Trainer?
Explore the specific criteria and documentation needed for personal trainer services to qualify as an HSA-eligible expense.
A Health Savings Account (HSA) is a tax-advantaged savings account designed to help individuals save and pay for qualified healthcare expenses. It pairs with an HSA-eligible health plan, typically a high-deductible health plan (HDHP), allowing for tax-free contributions, tax-free growth, and tax-free withdrawals for eligible medical costs.
Understanding Qualified Medical Expenses
Expenses must qualify as medical care under Internal Revenue Service (IRS) guidelines. These are costs primarily for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any part or function of the body. Common examples of eligible expenses include doctor visits, prescription medications, dental care, and vision care. Detailed guidance is available in IRS Publication 502, “Medical and Dental Expenses.”
Expenses that are merely beneficial to general health, such as vitamins or a vacation, do not qualify. The definition of medical care is crucial for tax-advantaged health plans like HSAs, as their favorable tax treatment depends on distributions being used for these defined medical expenses.
Personal Trainers and HSA Eligibility
Personal training services are generally not qualified medical expenses when sought for general fitness improvement, routine weight loss, or aesthetic purposes. The IRS differentiates between general wellness activities and those directly addressing a specific medical condition. For example, personal training solely for muscle building or general fitness goals would not qualify for HSA coverage.
However, personal training can become HSA-eligible if a medical professional recommends it for the treatment or prevention of a specific medical condition. This includes situations like rehabilitation after an injury or surgery, managing chronic conditions such as diabetes, heart disease, or obesity, or addressing specific mobility issues. The recommendation must be documented and clearly linked to a diagnosed medical condition, rather than general health improvement.
Securing a Letter of Medical Necessity
For personal training to qualify as an HSA-eligible expense, a Letter of Medical Necessity (LMN) is often required. This document, issued by a licensed healthcare provider, explains why the personal training is necessary to treat or prevent a specific medical condition. The LMN must be obtained before incurring the expense to ensure eligibility.
The LMN should include the patient’s diagnosed medical condition, how the personal training is necessary to alleviate or treat that condition, the specific services recommended, and the duration or frequency of the training. Healthcare providers who can issue an LMN include doctors, physician assistants, nurse practitioners, physical therapists, and psychologists. The letter serves as proof that the training is for a medical purpose, not just general wellness.
Maintaining Proper Documentation
Proper record-keeping is important for all HSA expenses, particularly those requiring an LMN. Account holders are responsible for proving the eligibility of expenses in case of an IRS audit. Necessary documentation includes the original Letter of Medical Necessity, detailed receipts from the personal trainer showing the services rendered, dates of service, and amounts paid, and proof of payment.
These records should be retained for as long as a tax return is open to audit, typically a minimum of three years, or as long as the HSA is open, whichever period is longer. While HSA administrators may not always require submission of receipts, individuals must keep them on file to substantiate the medical necessity and eligibility of the expense if requested by the IRS. Without proper documentation, ineligible expenses may be subject to income tax and a 20% penalty if the account holder is under age 65.