Most people know they can use their Health Savings Account (HSA) or Flexible Spending Account (FSA) for prescription drugs, eyeglasses, and dental work.
But a growing number of wellness products and services — from temperature-regulating sleep systems to red light therapy panels to weighted blankets — are also eligible, provided you take one essential step first: securing a Letter of Medical Necessity (LOMN) from a licensed healthcare provider.
Understanding how to navigate this process can unlock 30–40% in effective savings on purchases you might already be planning to make.
What Makes a Product “HSA/FSA Eligible?”
The IRS draws a clear line: HSA and FSA funds can be used for items intended to “diagnose, cure, mitigate, treat, or prevent” a medical condition. Products that primarily promote general health or wellness — without a specific medical link — don’t make the cut on their own.
This is where a Letter of Medical Necessity changes everything. When a physician or other qualified healthcare provider confirms in writing that a specific product is medically appropriate for your diagnosed condition, that item crosses the line from “lifestyle purchase” to “qualified medical expense.”
Take the Chilipad by Sleepme as an example. On the surface, it’s a water-cooled mattress pad designed to regulate bed temperature. for many shoppers searching for an, it’s one of the few products that can actually get there. Marketed broadly as a sleep improvement device, however, the HSA cooling mattress topper delivers the precise temperature control that people diagnosed with insomnia, hyperhidrosis, menopause-related sleep disruption, or certain autoimmune conditions need to resume and maintain proper medical function.
With an LOMN in hand, the Chilipad becomes HSA/FSA eligible. Sleepme has even partnered with a platform called Flex to streamline the telehealth consultation and documentation process directly at checkout.
Products You Might Not Know Are Eligible (With the Right Documentation)
The list of products that can qualify with an LOMN is longer than most people expect. Here are some lesser-known categories worth discussing with your doctor:
Cooling and heating sleep systems (e.g., bed temperature regulators): Relevant for insomnia, fibromyalgia, menopause, and multiple sclerosis, all of which are linked to disrupted thermoregulation during sleep.
Red light therapy devices: Used therapeutically for seasonal affective disorder (SAD), wound healing, joint pain, and certain skin conditions. Clinical evidence continues to grow for home-use panels.
Weighted blankets: Often recommended by occupational therapists and psychiatrists for anxiety, PTSD, sensory processing disorders, and sleep disturbances.
Air purifiers and humidifiers: Already eligible in many cases for diagnosed respiratory conditions like asthma or COPD, but often overlooked by account holders.
Cold plunge tubs and contrast therapy equipment: Increasingly used in post-surgical recovery, chronic pain management, and treatment of depression. Growing clinical interest makes physician sign-off more attainable than ever.
Blue light filtering glasses: May qualify for patients with diagnosed migraines, sleep disorders, or certain eye conditions aggravated by screen exposure.
Ergonomic furniture and standing desks: Eligible with documentation for diagnosed musculoskeletal conditions, chronic back pain, or post-injury recovery.
How to Get a Letter of Medical Necessity
The process is more accessible than it sounds — and in many cases, it can happen without leaving your home.
Step 1: Identify the connection. Before your appointment, think clearly about the link between your diagnosed condition and the product. The stronger and more specific the connection, the easier it is for your provider to document it. Generic wellness claims won’t hold up; specific symptom relief will.
Step 2: Talk to your doctor or telehealth provider. Bring documentation of your diagnosis and come prepared to explain how the product addresses your symptoms. Primary care physicians, specialists, and even licensed telehealth practitioners can write an LOMN. Many companies, like Sleepme with its Flex integration, have built streamlined telehealth consultations directly into the purchase flow, making this a matter of minutes rather than days.
Step 3: Keep your documentation. Once issued, store your LOMN alongside your itemized receipts. Your HSA or FSA administrator — or the IRS in an audit — may request proof that a purchase was medically necessary. Well-organized records protect you.
Step 4: Verify eligibility with your plan administrator. Employer-sponsored FSAs can set their own eligibility rules that go beyond IRS guidelines. Before purchasing, confirm your specific plan covers the expense. This is especially important for FSAs, where unused funds may not roll over and the stakes of a rejected claim are higher.
The Bigger Picture
As telehealth has become mainstream, the friction involved in obtaining an LOMN has dropped dramatically. Platforms like Flex, Truemed, and others now embed physician consultations into e-commerce checkouts, making it realistic for consumers to unlock HSA/FSA eligibility on the spot.
The key insight is that HSA and FSA eligibility is not just about the product — it’s about the documented relationship between the product and your health. For patients managing chronic conditions, sleep disorders, mental health challenges, or recovery from injury, that relationship often exists. A brief, honest conversation with a healthcare provider is frequently all it takes to make it official — and to make a significant purchase meaningfully more affordable.
Your pre-tax dollars work hardest when you know how to use them.
