Can I Use my HSA, FSA, or HRA for Supplements/Vitamins?

Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs), and Health Reimbursement Accounts (HRAs) can sometimes be used for vitamins, but the rules depend on the specific type of vitamin and how it is being used.

Important Note: While we can process some HSA/FSA/HRA cards online during checkout, we are unable to confirm if a purchase is a medically covered expense. Completing checkout with your HSA, FSA, or HRA card does not guarantee that the expense is eligible for coverage. You will need to consult with your doctor to ensure that your nutritional supplements are covered. For more information on obtaining a Letter of Medical Necessity, please read below. After your transaction is processed, you will receive a digital receipt, which you can save for your reimbursement claim. Please note, we cannot provide handwritten receipts.


HSA (Health Savings Account): You can use an HSA to pay for vitamins if they are prescribed by a doctor to treat a specific medical condition. Over-the-counter vitamins for general health or wellness purposes are not eligible unless they are recommended by a healthcare provider to treat a medical condition. You would need to get a letter of medical necessity to get these covered. Read more below about a letter of medical necessity. 

FSA (Flexible Spending Account): FSAs follow similar guidelines to HSAs. You can use FSA funds to purchase vitamins if they are prescribed for a medical condition. If they are not prescribed, you generally cannot use FSA funds for vitamins used for general wellness.

HRA (Health Reimbursement Account): HRAs are employer-funded, and the eligibility for using them for vitamins depends on the employer’s plan. Typically, you can use HRA funds for vitamins if they are medically necessary and prescribed by a doctor.

If you are unsure, it’s a good idea to check with your HSA, FSA, or HRA administrator to confirm what is covered under your specific plan.

Letter of Medical Necessity (LMN) for Nutritional Supplements

What Is a Letter of Medical Necessity?

A Letter of Medical Necessity (LMN) is a document provided by a healthcare provider that confirms a particular product or service is essential for managing a patient’s health condition or improving their overall well-being. This letter becomes necessary when a patient’s medical requirements fall outside the typical items covered under HSA guidelines.

LMNs are typically required for products not usually eligible for HSA reimbursement, such as certain vitamins, supplements, or equipment. You generally don't need an LMN for items like prescribed medications, essential medical devices, or treatments that are already covered by standard health plans.

Why Might You Need a Letter of Medical Necessity?

In some cases, individuals may require supplements or wellness products not automatically covered by an HSA. For example, vitamins or fitness-related items, like gym memberships and workout gear, may be crucial for your health but aren't typically eligible for reimbursement without a Letter of Medical Necessity.

This letter helps override the default eligibility rules for HSA funds, providing greater flexibility in what’s available for reimbursement. It expands the list of potential products and services that can be covered, provided that your healthcare provider deems them necessary for your health condition.

What Can You Purchase with a Letter of Medical Necessity?

The LMN serves as a way to broaden your access to a variety of health and wellness products. With this letter, you may be able to use your HSA funds to purchase items such as vitamins or fitness equipment that would otherwise not be eligible. However, each item or service requires a separate LMN. For example, a single LMN won’t cover both workout equipment and dietary supplements—your doctor will need to specify what each letter is for to ensure proper eligibility.

What Supplements Are Covered under a LMN?

The types of supplements covered under FSA, HSA, or HRA accounts can vary based on their medical necessity and whether they are prescribed by a healthcare provider. Generally, here’s a breakdown of what is typically covered:

1. Supplements Covered with a Prescription
If your doctor provides a prescription for a specific supplement to treat a medical condition, it may be eligible for reimbursement under an FSA, HSA, or HRA. Some examples include:

  • Vitamins for Deficiency Treatment: For example, a vitamin D supplement for those with a deficiency or folic acid for certain conditions.
  • Iron Supplements: For those with anemia or low iron levels.
  • Prenatal Vitamins: Often covered if prescribed by a doctor during pregnancy.
  • Omega-3 Fatty Acids: If prescribed for heart health or other medical conditions.
  • Probiotics: If recommended to treat a diagnosed condition such as irritable bowel syndrome (IBS).


2. Supplements Covered without a Prescription
Certain over-the-counter supplements may be eligible without a prescription under specific circumstances. However, this usually applies only when the supplements are specifically needed for a medical condition and supported by documentation or a Letter of Medical Necessity (LMN) from your healthcare provider.

  • Electrolytes and Hydration Supplements: If prescribed for dehydration or other conditions.
  • Calcium and Vitamin D: Often covered for people diagnosed with osteoporosis or similar conditions.
  • Magnesium: If prescribed for managing certain conditions such as migraines or muscle cramps.
  • Fish Oil: For managing cholesterol or other heart-related issues, when recommended by a healthcare provider.


3. Supplements Not Typically Covered

  • General Multivitamins: These are usually not covered unless a doctor has explicitly prescribed them for a specific medical need (e.g., to treat a deficiency).
  • Weight Loss Supplements: Supplements for weight loss (like appetite suppressants or fat burners) are generally not covered unless they are prescribed for a medical condition.
  • Beauty or Anti-Aging Supplements: Supplements meant for cosmetic purposes, such as collagen or skin care supplements, are typically not eligible.

How to Ensure Coverage of Your Vitamins from Your HSA/HRA/FSA*

Prescription: For any supplement to be covered, especially if it’s an over-the-counter product, you may need a prescription or a Letter of Medical Necessity from your doctor.

Documentation: Ensure you keep any receipts, prescriptions, or supporting documents in case you need to submit them for reimbursement.


*Always check with your FSA, HSA, or HRA administrator for specific details, as coverage can vary depending on the plan and provider.

 

Sample Letter of Medical Necessity

You typically won't need to provide this yourself, as most doctors already have a default form on hand. However, it’s a good idea to bring a printed copy of the supplement facts for the specific vitamins you want covered. This will help expedite the process and demonstrate that you are serious about having these vitamins included as part of your health plan.

 

[Healthcare Provider’s Name]
[Provider’s Address]
[City, State, ZIP Code]
[Phone Number]
[Email Address]

[Date]

To Whom It May Concern,

I am writing this letter to confirm that my patient, [patient’s full name], has been under my care for the treatment of [specific medical condition]. As part of their ongoing treatment plan, I recommend the use of [specific supplement], specifically [name of the supplement], to address [reason for the supplement use, such as deficiency, chronic condition, etc.].

Based on my medical assessment and the current health needs of the patient, [name of the supplement] is necessary to support their health and wellness. It is my professional judgment that this supplement is crucial in managing [condition], improving [specific outcomes such as energy, immune function, bone health, etc.], and supporting overall health as part of their treatment.

I request that [name of the supplement] be covered by [FSA/HSA/HRA] funds in order to allow the patient to continue their treatment plan. This supplement is a vital part of the patient's medical regimen and will contribute significantly to their health improvements.

Please do not hesitate to contact me if further information is needed.

Sincerely,
[Healthcare Provider’s Name]
[Healthcare Provider’s Title/Qualification]
[License Number (if applicable)]
[Practice or Hospital Name]