Can I use my FSA/HSA for gym membership?

How to use a health savings account (HSA) for gym membership:

1. Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) let you reserve pre-tax dollars for eligible medical expenses.
2. Fitness fees do not always qualify as eligible HSA/FSA expenses. But they may qualify if a provider recommends that you exercise to prevent or treat a medical condition.
3. For fitness expenses to qualify for HSA/FSA reimbursement, a provider must write a Letter of Medical Necessity detailing why exercise prevents or treats your medical condition. 

We don’t need medical studies to show that regular exercise benefits our general health.

But scores of research show that physical activity can prevent or help manage specific medical conditions. These include high blood pressure, back pain, high cholesterol, heavy weight, heart disease and mental health issues.

And so if you exercise to prevent or treat a condition, you may be able to save on related fitness fees by using funds from your Health Savings Account (HSA) or Flexible Spending Account (FSA). But you can only unlock those savings if you have the Letter of Medical Necessity from a licensed provider.

Here, we’ll explain how to get a Letter of Medical Necessity for exercise expenses.  Plus, how Dr. B may be able to help qualifying patients get a Letter of Medical Necessity online with a $15 consultation.

What’s the difference between HSA and FSA?

Health Savings Accounts (HSA) and Flexible Savings Accounts (FSA) allow you to set aside pre-tax dollars you can use to pay for qualified medical expenses. By reducing your taxable income, you save money for health-related items. So HSA/FSA funds offer excellent tax advantages, especially for people with regular care needs and those who stay on top of routine care.

This Dr. B article explains the differences between the two accounts in detail. But here are two primary differences.

Availability

Health Savings Accounts: HSAs are available to those with a High-Deductible Health Plan (HDHP). These plans include high deductibles you must pay before the insurer covers any health costs, and specify the most you’ll spend out of pocket annually. If you qualify, you can set up an HSA with any bank or financial institution that offers them.

• In 2026, an individual health plan deductible must be at least $1,700, with an out-of-pocket maximum of no more than $8,500. Individuals can deposit up to $4,400 over the course of the year.
• In 2026, a family health plan deductible must be at least $3,400, with an out-of-pocket maximum of no more than $17,000. Families can deposit up to $8,750 this year.

Flexible Spending Accounts: FSAs are only available if an employer creates an account and offers it to you as a benefit plan. (You can’t open an account on your own.) In 2026, individuals can contribute up to $3,400 to their FSA. Sometimes, employers match or add a percentage of personal contributions as an extra incentive.

HSA/FSA “rollover” funds

Health Savings Accounts: Unused HSA funds immediately “roll over” from one year to another so that you can save untaxed dollars for future medical needs.

Flexible Spending Accounts: Unused FSA funds get forfeited back to your employer. Some employers extend a grace period where you can use those funds for a few months in the next year (often into March). But they’re not required to do so.

They may also set up their FSA plan so employees may roll over a portion of their remaining funds to use in the following year. In 2026, the maximum amount you can rollover is $680.

How can I use FSA/HSA for gym memberships and fitness expenses?

You can only use HSA and FSA funds for medical expenses—*goods and services that prevent or alleviate an illness, injury or disability. Things that benefit *general health don’t qualify. Because exercise benefits general wellness, related costs do not immediately qualify.

However, if a physician recommends exercise to prevent or treat a condition, you can pay for gym memberships, training sessions, class fees and more with HSA/FSA funds.

Qualifying medical conditions include (but are not limited to):

• Arthritis
• Autoimmune disease
• Back pain
• Cancer
• Chronic fatigue
• Cognitive decline disorders like dementia and Alzheimer’s
• Diabetes
• Erectile dysfunction
• Fibromyalgia
• Gout
• Heart disease
• Heavy weight + obesity
• High blood pressure (hypertension)
• Mental health conditions like depression + anxiety
• Migraines
• Pre-diabetes  
• Physical injury
• Respiratory diseases (like asthma)
• Sleep disorders

But for fitness expenses to qualify, a provider must write a Letter of Medical Necessity explaining why they recommend exercise as a treatment for a condition.

What is a Letter of Medical Necessity?

A Letter of Medical Necessity is a document explaining why an expense is medically necessary for preventing or treating an injury, illness or other condition.

Items that are eligible because of medical necessity include:

• Physical therapy after an injury
• Iron supplements for anemia
• Blood sugar test kits for those with diabetes
• Exercise to improve heart health for those with hypertension
• Fitness classes to reduce pain for those with osteoarthritis

Regarding fitness, the letter explains why the expense meets HSA/FSA guidelines.

Can I get a Letter of Medical Necessity online?

Qualifying patients can get a Letter of Medical Necessity online for gym and studio membershipswith a Dr. B $15 fitness consultation.

To find out if you qualify, complete a streamlined health consultation about the condition you’re trying to manage, prevent or reverse.

A licensed health provider will review your information. If eligible, they’ll email you a Letter of Medical Necessity detailing why fitness qualifies as an HSA/FSA-eligible expense—often within 3 business hours.

Your letter is valid for 12 months from the date you receive it. As long as you’re within those 12 months, you may be able to file repeated expenses—like monthly gym membership fees—with the same letter.

How do I get fitness fees reimbursed by my HSA/FSA?

Here’s how to get fitness fees reimbursed by HSA/FSA funds.

1. Make your purchase: Buy or renew a gym membership, class, app, personal training session or other fitness expense—and save your receipt.
2. Find your HSA/FSA plan administrator: Find your HSA provider’s information through the financial institution that set up your HSA. Contact your employer's HR department if you don’t know who your FSA administrator is. 
3. Access your administrator's web service: Set up a new account or use your login details to access your HSA or FSA administrator's online platform.
4. Locate their 'Reimbursement' or 'Claims' section: Find the dedicated area that handles reimbursements or claims.
5. Submit your letter and receipts: Upload your Letter of Medical Necessity and the fitness product or service receipt. Purchases must be made on or after the date of your letter.
6. Wait for your claim to be processed: Your administrator may take a few days or weeks to review and process your claim. Once confirmed, they’ll deposit the reimbursement amount into your specified account. 
7. Submit tax forms: You don’t need to submit additional tax forms for FSA funds. (Unless you use funds to pay for the expenses of a dependent.) For HSA purchases, your administrator will send you Form 1099-SA during tax season. Use the information on that form to fill out Form 8889 with your federal income tax filing. 

What else can I use my HSA/FSA card for?

You can use FSA/HSA funds to pay for copays, deductibles and prescription drug costs. Other HSA-eligible expenses and FSA-qualified expenses include:

• Over-the-counter medications
• Menstrual products
• Dental care
• Eye care
• Substance abuse programs
• Acupuncture
• Covid-19 prevention (like masks and at-home tests)
• Chiropractic care
• Ambulance costs
• Hearing, mobility and service animal aids
• Therapy, psychological or psychiatric care
• Long-term needs like home improvements

Recap: how to use an FSA or HSA for a gym membership:

1. HSA and FSA accounts let you set aside pre-tax dollars for qualified medical expenses, including fitness costs when a provider recommends exercise to treat or prevent a condition.
2. To use HSA/FSA funds for gym memberships or fitness expenses, you need a Letter of Medical Necessity from a licensed provider.
3. Dr. B can provide a Letter of Medical Necessity online through an online consultation, and letters are usually emailed on the same day! Start a Dr. B $15 fitness consultation today to find out if you qualify.

Sources:

Employer Benefits Corporation. (2025). 2026 FSA and Commuter Limits Released.

Health Insurance Marketplace. What’s a health savings account?

Internal Revenue Service. (2024). Publication 969: Health savings accounts and other tax-favored plans.

Internal Revenue Service. (2025). IRS releases tax inflation adjustments for tax year 2026, including amendments from the One, Big, Beautiful Bill.

Mayer, Kathryn. (2025). IRS Announces 2026 HSA, HDHP Limits. SHRM.

Ruegsegger, G. N., et al. (2018). Health benefits of exercise. Cold Spring Harbor Perspectives in Medicine.

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