HSA/FSA Eligible Fitness Gear 2026: What Athletes Can Buy With Pre-Tax Dollars
A comprehensive guide to using your Health Savings Account (HSA) or Flexible Spending Account (FSA) for fitness and sports equipment. Learn which heart rate monitors, GPS watches, recovery tools, and athletic gear may qualify for pre-tax purchases.
Updated January 2026 · By the RunBikeCalc Team
Key Takeaways
Typically Eligible (with LMN)
- Heart rate monitors (for cardiac conditions)
- Blood glucose monitors (diabetes)
- Custom orthotics (foot conditions)
- Compression gear (vein conditions)
- Recovery tools (prescribed therapy)
Always Eligible (No Rx Needed)
- Sunscreen SPF 15+
- First aid supplies
- Sports tape and bandages
- Athletic braces (for injury)
- Ice packs and cold therapy
The Quick Answer
Most fitness gear is not automatically HSA/FSA eligible because these accounts are designed for medical expenses, not general fitness. However, many items athletes use can qualify when they're prescribed to treat or monitor a specific medical condition. The key is getting a Letter of Medical Necessity (LMN) from your doctor that documents why the item is medically required for your condition.
Some items like sunscreen, first aid supplies, and sports tape are always eligible without a prescription. For expensive gear like heart rate monitors, GPS watches, or recovery equipment, the savings can be significant: 25-35% depending on your tax bracket.
What's in This Guide
- HSA vs FSA: Understanding Your Options
- What Fitness Gear Can Be HSA/FSA Eligible
- Heart Rate Monitors & GPS Watches
- Recovery Tools & Equipment
- Compression Gear & Orthotics
- First Aid & Always-Eligible Items
- How to Get a Letter of Medical Necessity
- Medical Conditions That Qualify
- HSA-Eligible Products at Backcountry
- Frequently Asked Questions
HSA vs FSA: Understanding Your Options
Before diving into eligible fitness gear, it's important to understand the key differences between Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs). Both allow you to pay for qualified medical expenses with pre-tax dollars, but they work differently.
| Feature | HSA | FSA |
|---|---|---|
| Eligibility | High-deductible health plan required | Available through employer |
| 2026 Contribution Limits | $4,300 individual / $8,550 family | $3,200 per year |
| Rollover | Unlimited - funds never expire | $640 max or 2.5-month grace period |
| Portability | Yours forever, even if you change jobs | Lost when leaving employer |
| Investment Option | Yes - can invest like a retirement account | No |
| Tax Benefits | Triple tax advantage (contributions, growth, withdrawals) | Pre-tax contributions only |
The Tax Savings Advantage
When you use HSA/FSA funds for eligible expenses, you're essentially getting a discount equal to your marginal tax rate. In the 24% federal bracket plus state taxes, you could save 30-35% on qualifying purchases. A $400 heart rate monitor effectively costs $260-280 after tax savings.
What Fitness Gear Can Be HSA/FSA Eligible
The IRS defines eligible expenses as those that diagnose, treat, mitigate, or prevent disease. General fitness and wellness purchases don't qualify, but the same item can become eligible when it's prescribed for a specific medical condition.
Always Eligible
- Sunscreen (SPF 15+)
- First aid kits and supplies
- Athletic tape and bandages
- Ice packs
- Antiseptic wipes
- Blister care
- OTC pain relievers
- Antibiotic ointments
Eligible With LMN
- Heart rate monitors
- GPS watches (health features)
- Fitness trackers
- Compression garments
- Custom orthotics
- Massage guns
- Foam rollers
- TENS units
Generally NOT Eligible
- Running shoes (unless orthopedic)
- Gym memberships
- Sports equipment
- Athletic clothing
- Vitamins/supplements
- Bicycles
- Workout equipment
- Protein powder
The Key Distinction
The same Garmin watch is not eligible when purchased to track your marathon training pace, but may be eligible when prescribed by a cardiologist to monitor heart rate during cardiac rehabilitation. The item's purpose and medical necessity determine eligibility, not the item itself.
Heart Rate Monitors & GPS Watches
Heart rate monitors and GPS watches with health monitoring features represent some of the most valuable HSA/FSA opportunities for athletes. These devices can qualify when prescribed for monitoring specific cardiac or metabolic conditions.
When Heart Rate Monitors May Qualify
- Cardiac rehabilitation: Post heart attack, bypass surgery, or cardiac event monitoring
- Arrhythmia monitoring: Atrial fibrillation, tachycardia, or other rhythm disorders
- Heart disease management: Coronary artery disease, heart failure monitoring
- Hypertension management: When exercise heart rate monitoring is prescribed
- Diabetes management: Exercise intensity monitoring for blood sugar control
- Anxiety/panic disorders: Heart rate awareness for managing episodes
Recommended HSA-Eligible Heart Rate Monitors
Polar H10 Heart Rate Monitor
The gold standard for heart rate accuracy. ECG-level precision within 1-2 BPM makes it ideal for cardiac monitoring prescriptions. Used in clinical studies and cardiac rehab programs.
Garmin Forerunner 265
Advanced health features including 24/7 heart rate, HRV status, sleep tracking, and Body Battery. May qualify when prescribed for heart condition monitoring, diabetes management, or sleep disorder tracking.
Garmin Forerunner 965
Premium health monitoring with ECG app, HRV status, advanced sleep analysis, and training readiness. The ECG feature strengthens medical necessity claims for cardiac conditions.
Sample LMN Language for Heart Rate Monitor
"Patient [Name] has been diagnosed with [condition, e.g., paroxysmal atrial fibrillation]. I am prescribing a heart rate monitor to enable continuous monitoring of heart rate during physical activity to detect abnormal rhythms and ensure exercise intensity remains within safe parameters. This device is medically necessary for the ongoing management and monitoring of the patient's cardiac condition."
Recovery Tools & Equipment
Recovery tools like massage guns, foam rollers, and cold therapy equipment can qualify for HSA/FSA when prescribed as part of a treatment plan for a diagnosed condition. The key is documentation showing medical necessity rather than general wellness use.
When Recovery Tools May Qualify
- Physical therapy: Prescribed as home therapy continuation
- Chronic pain conditions: Fibromyalgia, chronic back pain, myofascial pain syndrome
- Post-surgical rehabilitation: Recovery from orthopedic surgery
- Injury treatment: Muscle strains, tendinopathy, IT band syndrome
- Circulatory conditions: Poor circulation, lymphedema
- Inflammatory conditions: When cold therapy is prescribed
Recommended Recovery Equipment
Theragun Pro / Hypervolt
Percussion massage devices used by physical therapists. May qualify when prescribed for myofascial release, chronic pain management, or as part of a home physical therapy program. Keep your PT prescription.
Foam Rollers & Massage Balls
Self-myofascial release tools commonly prescribed by physical therapists for IT band syndrome, back pain, and muscle tightness. Low cost but requires documentation for HSA/FSA.
Ice Packs, Cold Wraps & Cryotherapy
Ice packs and cold therapy wraps for injury treatment are typically eligible. Larger cold plunge systems may qualify when prescribed for specific inflammatory conditions. Ice packs themselves require no prescription.
Pro Tip: Get PT Documentation
If you're seeing a physical therapist, ask them to include specific recovery tools in your treatment plan documentation. A note stating "Patient is prescribed foam roller and percussion massager for home myofascial release as continuation of physical therapy treatment for diagnosed IT band syndrome" provides strong documentation for HSA/FSA claims.
Compression Gear & Orthotics
Compression garments and custom orthotics are among the most commonly approved HSA/FSA items for athletes because they're frequently prescribed for legitimate medical conditions that happen to overlap with athletic activity.
Compression Garments
Medical-grade compression (typically 20-30 mmHg or higher) prescribed for vascular conditions is generally HSA/FSA eligible. Common qualifying conditions include:
- Varicose veins: Compression stockings to prevent progression and manage symptoms
- Deep vein thrombosis (DVT) prevention: Especially for long travel or post-surgical
- Chronic venous insufficiency: Poor circulation in lower legs
- Lymphedema: Compression sleeves for fluid management
- Post-surgical swelling: Compression for recovery
Typically Eligible
- OKMedical-grade compression socks (20-30+ mmHg)
- OKPrescription compression sleeves
- OKPost-surgical compression garments
- OKLymphedema compression
Generally NOT Eligible
- XAthletic compression for performance
- XRecovery compression without prescription
- XLow-grade compression (under 15 mmHg)
- XCompression for general comfort
Custom Orthotics & Insoles
Custom orthotics prescribed by a podiatrist or orthopedist are among the most straightforward HSA/FSA eligible items for athletes. These can significantly reduce foot pain and prevent injuries while saving you 25-35% through tax advantages.
Qualifying Conditions for Orthotics
- Plantar fasciitis
- Flat feet (pes planus)
- High arches (pes cavus)
- Overpronation/supination
- Achilles tendinopathy
- Metatarsalgia
- Morton's neuroma
- Diabetic foot care
- Bunions/hallux valgus
- Shin splints
- Knee pain (related to gait)
- Hip/back pain (gait-related)
Custom orthotics typically cost $200-600 and last 2-5 years. With HSA/FSA, you're effectively paying $130-420 after tax savings. Over-the-counter arch supports may also qualify with a prescription, though custom orthotics provide better documentation.
First Aid & Always-Eligible Items
These items are HSA/FSA eligible without a prescription. Athletes can stock up on training essentials and save 25-35% through their tax-advantaged accounts.
First Aid Supplies
- OKBandages and gauze
- OKAthletic tape
- OKKT tape / kinesiology tape
- OKElastic bandages (ACE wraps)
- OKFirst aid kits
- OKAntiseptic wipes/spray
- OKAntibiotic ointment
- OKBlister treatment (moleskin, etc.)
Pain Relief & Protection
- OKIce packs (reusable and instant)
- OKHot/cold therapy wraps
- OKOTC pain relievers (ibuprofen, etc.)
- OKMuscle rubs and creams
- OKSunscreen (SPF 15+)
- OKLip balm with SPF
- OKInsect repellent
- OKAnti-chafe products
Braces & Supports (for injury treatment)
- OKAnkle braces
- OKKnee braces/sleeves
- OKWrist braces
- OKBack braces
- OKElbow braces
- OKSplints
- OKSlings
- OKWalking boots
Sunscreen: A Year-End FSA Strategy
If you have FSA funds to use before year-end, stocking up on sport sunscreen is a smart strategy. High-quality sport sunscreens cost $15-30 each and you'll use them throughout the training season. Buy a year's supply with expiring FSA funds rather than losing them.
How to Get a Letter of Medical Necessity (LMN)
A Letter of Medical Necessity is your key to using HSA/FSA funds for fitness gear that would otherwise be ineligible. Here's how to obtain one and what it should include.
Steps to Get an LMN
- Schedule an appointment with your primary care physician or relevant specialist (cardiologist, podiatrist, physical therapist, etc.)
- Discuss your medical condition and how the specific device or equipment would help treat, monitor, or manage it
- Request a formal letter on the doctor's letterhead that includes all required elements
- Be specific about the item - mention the exact product type (e.g., "heart rate monitor with continuous tracking" not just "fitness device")
- Keep copies of the LMN with your tax records in case of audit
What an LMN Should Include
- Doctor's letterhead with practice name, address, and contact information
- Date of the letter
- Patient's name and date of birth
- Specific diagnosis/condition using medical terminology (ICD codes are helpful but not required)
- Description of the prescribed item and how it treats or monitors the condition
- Statement of medical necessity - explicit statement that the item is medically necessary
- Duration - how long the item will be needed (ongoing, 6 months, etc.)
- Doctor's signature and credentials (MD, DO, DPM, PT, etc.)
Sample LMN Template
[Practice Letterhead]
Date: [Date]
Re: Letter of Medical Necessity for [Patient Name], DOB: [Date]
To Whom It May Concern:
[Patient Name] is under my care for [diagnosis/condition]. I am prescribing [specific item] as medically necessary for [treatment/monitoring/management] of this condition.
[Explanation of why the item is needed and how it addresses the medical condition]
This item is required for ongoing management of the patient's condition.
Sincerely,
[Doctor's Name, Credentials]
[NPI Number]
[Contact Information]
Pro Tips for Getting an LMN
- Bring a list of specific items you want prescribed - doctors are busy and appreciate preparation
- Explain the specific features that address your medical need (e.g., "24/7 heart rate monitoring")
- Some telemedicine services can provide LMNs - convenient if your regular doctor isn't available
- Physical therapists and podiatrists can write LMNs for items within their scope of practice
- If initially denied by your HSA/FSA administrator, you can appeal with additional documentation
Medical Conditions That Qualify
These medical conditions commonly justify HSA/FSA purchases of fitness-related equipment. If you have any of these conditions, discuss with your doctor which monitoring devices or therapeutic equipment might benefit your treatment.
Cardiac Conditions
May justify: Heart rate monitors, GPS watches with HR, fitness trackers
- Atrial fibrillation
- Coronary artery disease
- Heart failure
- Post-heart attack monitoring
- Cardiac rehabilitation
- Hypertension
- Arrhythmias
- Pacemaker monitoring
Metabolic Conditions
May justify: Glucose monitors, fitness trackers, activity monitors
- Type 1 diabetes
- Type 2 diabetes
- Prediabetes
- Metabolic syndrome
- Obesity (with treatment plan)
- Thyroid disorders
Musculoskeletal Conditions
May justify: Orthotics, recovery tools, braces, compression
- Plantar fasciitis
- IT band syndrome
- Chronic back pain
- Arthritis
- Fibromyalgia
- Tendinopathy
- Post-surgical rehabilitation
- Sports injuries
Vascular & Other Conditions
May justify: Compression, cold therapy, recovery equipment
- Varicose veins
- Deep vein thrombosis risk
- Chronic venous insufficiency
- Lymphedema
- Sleep apnea
- Anxiety/panic disorder
- ADHD (activity monitoring)
- Chronic fatigue syndrome
HSA-Eligible Products at Backcountry
Backcountry offers a wide selection of fitness gear that may qualify for HSA/FSA purchases when prescribed for medical conditions. New customers get 15% off their first order, which stacks nicely with your HSA/FSA tax savings.
Potentially HSA-Eligible Products at Backcountry
Additional Backcountry Categories
Garmin Watches
GPS watches with health monitoring features
Heart Rate Monitors
Chest straps and arm bands
Sunscreen
Sport sunscreens - always FSA eligible
First Aid
First aid kits and supplies
Stack Your Savings
Combine HSA/FSA tax savings (25-35%) with Backcountry's 15% new customer discount for maximum savings. A $600 Garmin Forerunner 965 becomes ~$357 after the new customer discount and 30% tax bracket savings. That's $243 in total savings.
Frequently Asked Questions
Can I buy running shoes with my HSA or FSA?
Generally, no. Standard running shoes are considered general fitness items and are not HSA/FSA eligible. However, custom orthotics or orthopedic shoes prescribed by a doctor for a specific medical condition (like plantar fasciitis, diabetic foot care, or structural abnormalities) may qualify with a Letter of Medical Necessity (LMN).
Are fitness trackers and smartwatches HSA/FSA eligible?
Fitness trackers and smartwatches are generally NOT eligible for HSA/FSA purchases when used for general fitness. However, they may qualify if prescribed by a doctor for monitoring a specific medical condition such as heart disease, diabetes, or sleep disorders. You'll need a Letter of Medical Necessity (LMN) documenting the medical purpose.
What is a Letter of Medical Necessity (LMN)?
A Letter of Medical Necessity (LMN) is a document from your doctor that explains why a specific item is medically necessary to treat, diagnose, or prevent a medical condition. For fitness gear to qualify for HSA/FSA, the LMN must specify the medical condition being treated and explain why the item is required for treatment or monitoring.
What's the difference between HSA and FSA accounts?
HSA (Health Savings Account) is available with high-deductible health plans, has no use-it-or-lose-it deadline, rolls over year to year, and is portable between employers. FSA (Flexible Spending Account) is employer-sponsored, typically must be used within the plan year (some plans allow $640 rollover or 2.5-month grace period), and is not portable. Both allow pre-tax contributions for qualified medical expenses.
Are heart rate monitors HSA/FSA eligible?
Heart rate monitors may be HSA/FSA eligible when prescribed for monitoring a heart condition, cardiac rehabilitation, or other medical purposes. A Letter of Medical Necessity from your doctor is typically required, documenting the specific medical condition (such as arrhythmia, heart disease, or post-cardiac event monitoring) that necessitates heart rate tracking.
Can I use HSA/FSA for massage guns and recovery tools?
Massage guns and recovery tools like foam rollers are not automatically HSA/FSA eligible. However, they may qualify with a Letter of Medical Necessity if prescribed by a doctor or physical therapist for treating a specific condition like chronic pain, muscle injuries, or as part of a physical therapy program. Keep documentation of the medical necessity.
Is sunscreen HSA/FSA eligible?
Yes! Sunscreen with SPF 15 or higher is now HSA/FSA eligible without a prescription. This changed with the CARES Act in 2020. Athletes who train outdoors can stock up on sport sunscreen using pre-tax dollars. This includes spray sunscreens, lotions, and sport-specific formulations.
Are compression socks and sleeves HSA/FSA eligible?
Compression garments may be HSA/FSA eligible when prescribed for a medical condition. Common qualifying conditions include varicose veins, lymphedema, deep vein thrombosis (DVT) prevention, chronic venous insufficiency, and post-surgical recovery. Medical-grade compression (typically 20-30 mmHg or higher) prescribed by a doctor typically qualifies. General athletic compression worn for performance usually does not.
Can I buy a cold plunge or ice bath with HSA/FSA?
Cold therapy equipment like ice baths or cold plunge tubs are generally not HSA/FSA eligible for general recovery or wellness. However, they may qualify with a Letter of Medical Necessity if prescribed for treating a specific medical condition such as chronic inflammation, certain autoimmune conditions, or as part of a prescribed physical therapy protocol. Ice packs and cold therapy wraps for injury treatment are more likely to qualify.
Are custom orthotics and insoles HSA/FSA eligible?
Yes, custom orthotics prescribed by a podiatrist or doctor are typically HSA/FSA eligible. They must be prescribed for a diagnosed medical condition like plantar fasciitis, flat feet, overpronation causing pain, diabetic foot care, or other structural issues. Over-the-counter arch supports may also qualify with a prescription. Keep your prescription and receipts for documentation.
What sports first aid supplies are HSA/FSA eligible?
Most first aid supplies are HSA/FSA eligible without a prescription. This includes bandages, gauze, athletic tape, antiseptic wipes, ice packs, elastic bandages (like ACE wraps), blister treatment, antibiotic ointments, and basic first aid kits. Sports tape, KT tape, and medical-grade braces for injury prevention or treatment also typically qualify.
Can I use HSA/FSA for a gym membership?
Generally, no. Gym memberships are not HSA/FSA eligible for general fitness purposes. However, if your doctor prescribes a specific exercise program as treatment for a diagnosed condition (like obesity, heart disease, diabetes, or physical rehabilitation), the portion of the membership used for prescribed treatment may qualify. You'll need detailed documentation including an LMN and records showing the membership is for treatment, not general fitness.
Are glucose monitors and CGMs HSA/FSA eligible for athletes?
For athletes with diabetes, glucose monitors and continuous glucose monitors (CGMs) are absolutely HSA/FSA eligible as they are medically necessary devices. For non-diabetic athletes interested in glucose monitoring for performance optimization, these devices are generally NOT eligible as there is no underlying medical condition being treated. The key factor is whether you have a diagnosed medical condition requiring glucose monitoring.
How do I submit HSA/FSA claims for fitness gear?
Keep all documentation: the Letter of Medical Necessity from your doctor, itemized receipts, and any prescription paperwork. Submit claims through your HSA/FSA administrator's portal or app. Some purchases can be made directly with your HSA/FSA debit card at eligible retailers. If denied, you can appeal with additional documentation from your healthcare provider.
What happens if I use HSA/FSA funds for ineligible items?
If you use HSA funds for non-qualified expenses, you'll owe income tax on the amount plus a 20% penalty if you're under 65. For FSA, ineligible purchases may be denied reimbursement, or if you used an FSA debit card, you may need to repay the amount. Always verify eligibility before purchasing, and when in doubt, get a Letter of Medical Necessity from your doctor.
The Bottom Line
Using HSA/FSA funds for fitness gear requires documentation of medical necessity, but the savings can be substantial. Athletes with qualifying conditions can save 25-35% on heart rate monitors, GPS watches, compression gear, orthotics, and recovery equipment.
Always eligible without prescription: Sunscreen, first aid supplies, athletic tape, ice packs, and injury braces. Stock up on these training essentials with pre-tax dollars.
Potentially eligible with LMN: Heart rate monitors, GPS watches, fitness trackers, compression garments, custom orthotics, massage guns, and cold therapy equipment. Talk to your doctor if you have a qualifying condition.
Generally not eligible: Running shoes, gym memberships, bicycles, athletic clothing, and general fitness equipment unless specifically prescribed for treatment.
The key is documentation. A Letter of Medical Necessity from your doctor transforms ineligible fitness purchases into tax-advantaged medical expenses. If you have a qualifying condition, schedule an appointment with your doctor to discuss which equipment could support your treatment—and your training.
Related Tools & Guides
Heart Rate Zone Calculator
Calculate your optimal training zones
Max Heart Rate Calculator
Estimate your maximum heart rate
Best Heart Rate Monitors 2026
Expert reviews of chest straps and arm bands
Best Running Watches 2026
GPS running watch buying guide
Best Fitness Trackers 2026
Recovery and health tracking devices
Best Recovery Tools 2026
Massage guns, foam rollers, and more