Your HSA or FSA can cover a recovery device — most people just don't know how

Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) let you pay for medical expenses with pre-tax dollars. For a prescribed medical device, that can lower your effective cost by roughly a fifth to a third, depending on your tax bracket. The barrier is almost never eligibility — it's the paperwork most people don't realize they can get.

What makes a device eligible

Under IRS Section 213(d), a device is a qualified medical expense when it's used to treat a diagnosed condition and is backed by a physician's determination that it's medically necessary. That determination is a document called a Letter of Medical Necessity (LMN).

The Letter of Medical Necessity, demystified

An LMN is a short letter from a licensed physician stating your diagnosis, the device, and why it's appropriate for your care. It includes the ICD-10 codes your HSA/FSA administrator needs to approve reimbursement. Historically, getting one meant an extra appointment — which is why so many eligible purchases are paid for with post-tax dollars instead.

How the friction disappeared

Two paths now exist. Ask your surgeon to include an LMN in your post-op documentation — most can do it in minutes. Or use a telehealth pathway where a licensed physician reviews your intake and issues the letter, typically within 24 hours. Either way, you submit the LMN to your plan administrator and pay with pre-tax dollars.

The device doesn't get cheaper. Your out-of-pocket cost does — because you're paying for it the way the tax code already allows.

Reimbursement rules vary by plan, so confirm the specifics with your HSA/FSA administrator. But the headline is worth repeating: for most people, the only thing standing between a full-price purchase and a pre-tax one is a letter they didn't know they could get.