Can I Buy a Weight Scale With My HSA?

A Health Savings Account (HSA) is a tax-advantaged savings account designed to help individuals save and pay for qualified medical expenses. These accounts are available to those enrolled in a High Deductible Health Plan (HDHP). Contributions to an HSA are tax-deductible, earnings grow tax-free, and withdrawals for qualified medical expenses are also tax-free.

HSA Eligibility Rules

The Internal Revenue Service (IRS) sets specific guidelines for qualified medical expenses eligible for HSA reimbursement. An expense must be primarily for the diagnosis, cure, mitigation, treatment, or prevention of disease. Expenses solely for general health or wellness, without a direct link to a specific medical condition, are not eligible.

Commonly eligible expenses include doctor visits, prescription medications, dental care, and vision care services. For items with a dual purpose, a Letter of Medical Necessity (LOMN) from a healthcare provider may be required. This letter substantiates the medical purpose of the expense for IRS compliance. IRS Publication 502 details these eligible medical and dental expenses.

Scales and Medical Necessity

A general bathroom scale used for routine weight monitoring is not considered an HSA-eligible expense. Without a specific medical purpose, a scale falls under general health and wellness, which is not covered.

However, a weight scale can become an eligible medical expense if its use is medically necessary for managing a specific diagnosed condition. This includes conditions such as obesity, diabetes, heart disease, or other illnesses where consistent weight monitoring is a crucial part of a prescribed treatment plan.

To substantiate this medical necessity, individuals need to obtain a Letter of Medical Necessity (LOMN) from a qualified healthcare provider. This letter should clearly state the patient’s specific medical condition and explain how the weight scale is necessary for the diagnosis, cure, mitigation, treatment, or prevention of that condition. Obtain this LOMN before purchasing the scale or seeking reimbursement. The letter should also specify the duration for which the scale is deemed medically necessary.

Specific Scale Types

The eligibility of different types of scales for HSA reimbursement hinges on the principle of medical necessity and a Letter of Medical Necessity (LOMN). Standard digital or analog scales, which primarily measure weight, are only eligible if they are part of a treatment plan for a specific medical condition. Without an LOMN, these basic scales remain ineligible. Their function alone does not qualify them as medical devices.

Smart scales or body composition scales, offering advanced measurements like body fat percentage, muscle mass, and bone density, also fall under the same eligibility rules. Their purchase with HSA funds still requires an LOMN linking their use to a diagnosed medical condition. These advanced metrics must be demonstrated as necessary for the treatment or management of a specific illness. The technology itself does not automatically confer eligibility; the medical purpose does.

Using HSA Funds and Record Keeping

When purchasing a medically necessary weight scale with HSA funds, individuals have a few payment options. Many HSA providers issue a debit card, which can be used directly at the point of sale. This offers immediate payment for the eligible expense. Alternatively, an individual can pay out-of-pocket for the scale and then reimburse themselves from their HSA.

Maintaining accurate records is important for HSA compliance, especially in the event of an IRS audit. Individuals should retain the original receipt for the scale purchase, showing the date and amount. The Letter of Medical Necessity (LOMN) from the healthcare provider must also be kept with these records. Any supporting medical documentation related to the diagnosed condition that necessitated the scale’s purchase should also be retained.