Can I use my FSA or HSA for weight loss costs?

Did you know that you can reduce your taxes by using a health savings account (HSA) or flexible spending account (FSA) for weight loss-related expenses? That means you can use tax-free funds to cover healthcare expenses like prescriptions, health insurance deductibles, and more. 

This article answers all of your FSA and HSA weight loss questions, so you can manage your expenses while using pre-tax dollars to reduce your taxable income.

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You can use your HSA for weight loss — sometimes

You can use your HSA to cover eligible expenses, including medical care and medically supervised weight loss programs. If your doctor prescribes weight loss medication or treatment, you may be able to use your HSA account to cover the cost of these expenses.

Use your HSA to see a provider about your weight loss needs 

Your HSA can be used to cover physical and mental healthcare appointments, including those with qualified medical professionals, like physicians, physician assistants/associates (PAs), nurse practitioners (NPs), dietitians, and therapists. 

A weight loss specialist can help you with medically supervised weight loss. They can give you advice about your diet, help you create an exercise plan, or deal with psychological factors that may affect your progress.

You can also use your HSA or FSA funds to cover the out-of-pocket healthcare costs of weight loss-related treatments, including:

• Services for personal training
• Equipment for home gyms
• Nutritional counseling
• Weight loss injections or prescription weight loss pills
• Surgical interventions, such as gastric bypass 
• Copays related to appointments for weight loss

Use your HSA for weight loss medication, if eligible

You can use funds in your HSA account to pay for weight loss medications if they’re prescribed for a specific medical condition, such as obesity (BMI of 30 or greater), overweight (BMI of 27 or greater with a weight-related health condition), diabetes, or heart disease. 

To use your HSA funds for weight loss medication, you need a letter of medical necessity from your healthcare provider. This documentation outlines your medical condition and why weight loss is necessary to ensure your HSA distribution remains tax-free. 

If you use your HSA account for non-qualified expenses, the money you spend on those ineligible items will be taxed as regular income, causing you to lose the tax savings benefits of the HSA. 

What’s a letter of medical necessity and how does it affect using your HSA for weight loss costs

A letter of medical necessity is written by a licensed healthcare provider to get certain weight loss-related expenses covered by your HSA funds. This document outlines your specific medical conditions and the reasons why weight loss treatment is necessary. It may also include specific recommendations from your healthcare team, including weight-loss programs, nutritional counseling, or exercise equipment to aid your treatment. 

When can’t HSA funds be used for weight loss-related costs

While HSA funds are used for a range of eligible healthcare expenses, some services aren’t covered.

For example, you can’t pay for gym memberships with an HSA account. While physical activity and exercise are part of a healthy lifestyle, gym memberships are considered wellness expenses rather than medical treatments. Unlike yoga or personal training sessions, medical providers don’t typically prescribe a gym membership to treat a specific illness or condition.

Other wellness items, such as organic food, nutritional supplements, meal prep services, or spa memberships, aren’t eligible for HSA or FSA dollars either. 

Using your HSA for weight loss costs — what to know

There are a few ways to use your HSA to cover, or reimburse yourself for, weight loss-related costs. As long as your weight loss expense is eligible for HSA funds, your HSA can cover it, even if your insurance plan doesn’t. 

If you have an HSA debit card, use it to pay for eligible weight-loss services and products directly at the point of purchase. If you don’t have an HSA debit card, you can pay out of pocket for the weight-loss costs, then submit a reimbursement request to your HSA administrator.

Maximize your HSA dollars to use toward weight loss

To maximize your HSA weight loss dollars, it’s important to have as much money as possible in your HSA. Here are some tips to help you maximize your HSA contributions.

Contribute the maximum amount

In order to be eligible for an HSA, you must have a high-deductible health plan. In 2024, individuals with a qualifying health plan can contribute up to $4,150 to their HSA. For those with family coverage, the maximum contribution limit is $8,300 per year. 

For example, a year of the popular weight loss medication, Wegovy, costs nearly $18,000. This means that even if your insurance plan doesn’t cover the cost of your medication, you can use the funds from your HSA to cover the cost. 

Take advantage of employer contributions

Your employer may offer contributions to your HSA, or even match a portion of what your contribution. You can use these contributions to boost your HSA funds as they don’t count against your maximum, giving you more money to spend on weight loss and other healthcare costs.

Earn interest on your HSA balance

Your HSA dollars can earn interest, just like a regular savings account. But unlike a traditional savings account, the interest you earn on your HSA is not taxed. Once your HSA balance reaches a certain threshold, you can invest in mutual funds to potentially grow your savings, similar to a 401(k) or other retirement account.

Check with your program administrator to see if your HSA qualifies for interest-earning or investment options.

Keep track of receipts and documentation 

Maintain proper documentation for weight-loss expenses paid for with your HSA to avoid penalties or repayment requirements. Keep receipts, correspondence, and other relevant documents in a safe place in case you need them later.

What about an FSA? Can you use it for weight loss costs?

Yes, you can use an FSA to cover weight loss costs, though there are a few differences between FSAs and HSAs. In order to qualify for an FSA, you need to be enrolled in an employer-sponsored plan that offers it as part of your benefits package.  

Employees receive the full amount of their annual contributions at the start of their plan year, even before they’ve contributed the full amount via paycheck deductions. As a result, employees have access to the full election amount at the beginning of the year.

Unlike HSAs, FSa funds typically have a “use-it-or-lose-it” policy, meaning you may lose your funds if you don’t use them by the end of the year or the end of your employer’s grace period if they offer one. 

Using your FSA for weight loss costs — what to know

You can save on taxes when you use an FSA for weight loss expenses, but to make the most of it, be aware of the requirements.

You won’t be taxed on withdrawals from your FSA for approved expenses. But, if you use the funds for an expense that isn’t FSA-eligible, you may have to repay the money to your employer.

To access your FSA funds, contact your plan administrator or HR representative. They’ll provide details on the specific requirements for your FSA and let you know if your plan offers a debit card for purchases. 

Key takeaways

HSAs and FSAs are tax-free savings accounts that can be used to cover eligible weight loss-related expenses. You can pay for doctor visits, nutrition counseling, weight loss programs, and medications for weight loss using these funds. 

HSA contributions are made with pretax dollars, and withdrawals for qualified medical expenses are tax-free as well. The same is true for FSA contributions, but unused funds do not typically roll over from one year to the next. 

To use HSA funds for weight loss costs, you’ll need a letter from your healthcare provider stating your specific medical condition and the need for weight loss treatment.

Talk to a provider about weight loss in as little as 24 hours*

It’s never too late to start your weight loss journey. Book an appointment with a qualified weight loss provider on Klarity Health to learn more about treatments that can be paid for with HSA weight loss funds.