You Can Now Use Funds From Your HSA/FSA Accounts to Purchase a Fitbit Air Fitness Tracker.

Google’s new Fitbit Air fitness tracker is officially HSA/FSA-eligible for eligible customers, giving you more options for using your health savings before taxes. But before rushing out to buy, it’s helpful to understand how HSA and FSA eligibility actually works for wearables—for most devices, it’s a bit more complicated than it seems.

How does the FSA and HSA wearable device eligibility system work?

Health savings accounts and flexible spending accounts allow you to set aside pre-tax funds to pay for qualified medical expenses. The IRS determines what constitutes a genuine medical expense, and historically, fitness trackers and smartwatches themselves have not been considered. The IRS has ruled that these types of devices are typically used to maintain “general health” rather than to treat or monitor a specific condition, meaning they generally do not qualify as qualified medical expenses.

According to the list of approved devices posted on the FSA Store website , a wearable device becomes approved when it is needed to treat or monitor a specific medical condition, not just for general health maintenance. This is where a “letter of medical necessity” is required.

What is a certificate of medical necessity?

A Letter of Medical Necessity (LMN) is essentially a doctor’s note that classifies a specific purchase as a qualified medical expense under IRS rules. To obtain such a note, your doctor must certify that the device in question will be used to treat or monitor a legitimate medical condition, such as obesity, heart disease, sleep apnea, or diabetes. Once you provide this note to your benefits program administrator, your wearable device purchase will likely be approved for reimbursement.

As for receiving an LMN, you may not even need to schedule a doctor’s appointment, thanks to partnerships between some third-party companies, like Truemed, and a number of health tech companies. You’ll see the “Pay with Truemed” option when checking out on sites like Whoop , Coros , and Amazfit , to name a few. You’ll then be asked a few questions about your health and connected with a doctor to determine your eligibility for an LMN. If you qualify, you’ll receive an LMN, which allows you to use funds from your HSA or FSA to complete your purchase.

How to use funds from your HSA/FSA to buy a Fitbit Air (or any other health tracking device)

Once your eligibility is confirmed—ideally with an LMN in hand—there are two main ways to use your pre-tax healthcare funds to purchase a wearable device: paying directly with your FSA or HSA card at an eligible retailer, or paying cash and then requesting reimbursement.

Option one: Pay directly with your FSA or HSA card.

The easiest way is to use your FSA or HSA debit card at the point of sale, just like any other credit card.

1. Make sure the merchant accepts FSA/HSA payments. Major retailers like Amazon, Walmart, and Target accept FSA/HSA cards for eligible purchases, and the Google Store may accept them directly for the Fitbit Air, given its certified eligibility status. Specialty health retailers like FSA Store and HSA Store are also a good option, as all products they sell are pre-screened for eligibility.

2. Keep your LMN handy. Even if you pay directly by card, your plan administrator may contact you and request documents. Keep your LMN handy.

3. Swipe your card and keep the receipt. The transaction may go through without further action, but if your administrator later flags the purchase as suspicious, your receipt and LMN will serve as proof.

Note: If your wearable device isn’t on the pre-approved beneficiary list, your FSA card may be declined at checkout, even if you have a valid LMN. In this case, you can try the second option.

Option two: pay in cash and then apply for a refund.

If your FSA card doesn’t work at the checkout—or if you prefer to shop at a merchant that doesn’t support FSA/HSA payments—you can pay for the purchase using another payment method and request a refund from your plan administrator later.

1. Purchase the device using a personal credit card or other payment method and keep your itemized receipt.

2. If you don’t already have a certificate of medical necessity, obtain one. Your doctor should state your diagnosis, explain why the device is medically necessary, and confirm that it is intended to treat or monitor your condition (and not just for general wellness).

3. Log in to your account or contact your plan administrator. Most FSA and HSA administrators have an online portal where you can directly submit reimbursement requests.

4. Upload documents. Typically, you’ll need to provide both a detailed receipt and the LMN number. Some administrators may also request additional information about the device.

5. Wait for approval and payment. Application processing times vary depending on the administrator, but most applications are processed within a few business days or weeks. If approved, you will be reimbursed from your FSA or HSA balance via direct bank transfer or check.

If the Fitbit Air isn’t right for you, consider other well-known brands that offer HSA/FSA-compatible fitness trackers.

Result

Even if a device is marketed as health-focused, that doesn’t automatically mean it’s eligible for use under an FSA or HSA. For most smartwatches and fitness trackers, eligibility depends on the documentation provided, not just whether the device’s functionality meets medical standards. Some administrators scrutinize wearable device purchases more thoroughly than others, and approval is never guaranteed. If you have a qualifying medical condition and a doctor willing to certify your case through the Licensed Medical Network (LMN), you have a good chance of using these funds tax-free.

FSA funds are used on a “use it or lose it” basis annually (with some exceptions, such as grace periods), so timing is important. If you’re nearing the end of your plan year and have some remaining funds, purchasing a wearable device can be a smart way to use those funds before they expire. HSA funds, on the other hand, carry over indefinitely, so there’s less urgency (but the reimbursement process is the same).

It’s also worth noting: you can reimburse yourself for past eligible purchases from your HSA at any time, even years later, as long as you have a receipt and supporting documentation. This flexibility makes HSAs particularly useful for medical technology purchases. Whatever you buy, keep careful records. The IRS expects you to be able to substantiate every purchase made through your HSA, and maintaining good records is the easiest way to protect yourself should questions arise.

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