Can I Use My HSA to Buy a Mattress?

Health Savings Accounts (HSAs) offer a tax-advantaged way for individuals to save and pay for qualified medical expenses. Many individuals frequently inquire about using HSA funds for items not traditionally considered medical, such as a new mattress. Understanding the specific rules for such purchases is important for compliance and proper use of these funds.

Defining Eligible Medical Expenses

The Internal Revenue Service (IRS) defines eligible medical expenses as costs primarily incurred for the diagnosis, cure, mitigation, treatment, or prevention of disease. This definition also extends to expenses for the purpose of affecting any structure or function of the body. Common examples of eligible expenses include doctor visits, prescription medications, vision care, dental care, and certain medical equipment. (IRS Publication 502)

Conversely, items intended for general health, personal comfort, or cosmetic purposes are typically not eligible for HSA reimbursement. For instance, gym memberships, unless prescribed for a specific medical condition, or nutritional supplements not recommended by a medical practitioner for a diagnosed condition, generally do not qualify.

Mattress Eligibility for HSA Reimbursement

A mattress is generally considered an item for general comfort or well-being, meaning it is typically not eligible for HSA reimbursement. However, an exception exists when a mattress is prescribed by a physician for a particular medical condition. This allows for reimbursement if the mattress is deemed medically necessary to treat, alleviate, or prevent a disease or condition.

To qualify a mattress as an eligible HSA expense, it is usually necessary to obtain a Letter of Medical Necessity (LMN) from a qualified healthcare provider. This letter must clearly state the specific diagnosis of the patient and explain how the mattress directly treats or alleviates the condition, rather than simply providing general comfort. The LMN should detail why the mattress is medically necessary, and it may also need to specify features that go beyond a standard mattress, such as temperature adjustment or customizable firmness, to demonstrate its therapeutic benefit.

The mattress must primarily serve a medical purpose. For example, a mattress prescribed for severe back pain due to a diagnosed spinal condition might qualify, especially if its design offers specific support to address the condition. The cost of the mattress is only eligible if its components and construction costs exceed those of a standard mattress intended for general health.

Reimbursement Process and Record Keeping

Once an expense, such as a medically necessary mattress, has been determined eligible and all required documentation is secured, individuals can initiate the reimbursement process from their Health Savings Account. This typically involves logging into the HSA provider’s online portal or submitting a request form. Funds can then be transferred from the HSA to a personal bank account, or in some cases, a check may be issued.

Maintaining thorough records is important for tax purposes, particularly in the event of an IRS audit. Individuals must keep the original receipt for the mattress and the Letter of Medical Necessity (LMN). These documents are generally not submitted to the HSA administrator at the time of reimbursement but must be retained by the individual to substantiate the expense’s eligibility.

There is no specific deadline for reimbursing oneself from an HSA; you can pay for qualified medical expenses out of pocket and reimburse yourself later, provided you maintain thorough records. The IRS requires that distributions from an HSA be used for qualified medical expenses, were not reimbursed from another source, and were not taken as an itemized deduction. Account holders are responsible for reporting distributions to the IRS using Form 8889.