Unlock HSA Approved Weight Loss Programs That Actually Work – Your Ultimate Guide!

Losing weight for medical reasons doesn't have to break the bank. Flexible Spending Accounts (FSAs), Health Savings Accounts (HSAs), and Health Reimbursement Arrangements (HRAs) can be valuable tools to help manage the costs associated with weight loss programs when they are deemed medically necessary. It's important to understand how these accounts work, what expenses qualify, and how to navigate the reimbursement process.

Understanding HSAs, FSAs, and HRAs

These accounts allow you to pay for certain health care, vision, and dental costs with pre-tax dollars, effectively lowering your overall expenses. Here's a breakdown of each:

Health Reimbursement Arrangement (HRA): You can use your HRA to pay for eligible medical, dental, or vision expenses for yourself or your dependents enrolled in the HRA. Your employer determines which healthcare expenses are eligible under your HRA.
Health Savings Account (HSA): An HSA is a tax-advantaged savings account that can be used to pay for qualified medical expenses.
Health Care Flexible Spending Account (FSA): A Health Care FSA allows you to set aside pre-tax money to use on eligible out-of-pocket healthcare costs.

It is important to note that not all weight loss expenses are eligible for tax breaks or HSA/FSA reimbursement. Costs related to overall fitness or wellness-without a diagnosed medical condition-aren’t deductible, and you can’t deduct them or use HSA/FSA funds to cover them.

Weight Loss Programs and Eligibility

Weight loss programs may be eligible for reimbursement with flexible spending accounts (FSA), health savings accounts (HSA), and health reimbursement accounts (HRA) with a Letter of Medical Necessity. They are not eligible for reimbursement with dependent care flexible spending accounts and limited-purpose flexible spending accounts (LPFSA).

If your doctor recommends weight loss for a specific condition (including but not limited to obesity, hypertension, or heart disease) the Internal Revenue Service (IRS) may allow you to use funds from your pre-tax accounts such as your FSA or HSA to pay with tax-free dollars.

WeightWatchers and FSA/HSA Funds

You may be eligible for up to 100% reimbursement on your WeightWatchers membership. Any WeightWatchers membership costs, including access to the app and Workshops, are eligible for reimbursement. Registered dietitian visits are also eligible.

Steps to Reimbursement:

Sign up for WeightWatchers.
Take the quiz to find the weight-loss solution that fits you.
Check with your insurance provider.
Get a copy of your receipt through the WeightWatchers app. Open your “Settings” menu and navigate to the “Billings” tab to find your receipt. If you have not purchased your membership yet, we recommend a pay-up front plan to simplify the reimbursement process.
Submit your receipt and letter of medical necessity. Send both to your FSA/HSA provider to be reimbursed. Claim process varies by plan so please check with your provider or HR representative.

For reimbursement of our Points and Workshops memberships, you will need a letter of medical necessity from your doctor that recommends weight loss for a specific condition (including but not limited to obesity, overweight, hypertension, or heart disease). For all other memberships, check with your provider if a letter of medical necessity is required. For all expenses, you will need to submit your WeightWatchers membership receipt. WeightWatchers does not require a letter of medical necessity to join.

Navigating the Reimbursement Process

To successfully utilize your HSA, FSA, or HRA for weight loss programs, keep these points in mind:

Letter of Medical Necessity: A letter of medical necessity (LMN) from your doctor is crucial. This letter should state that weight loss is a necessary treatment for a specific medical condition, such as obesity, hypertension, or heart disease.
Documentation: Keep detailed records of all expenses related to your weight loss program, including receipts for membership fees, dietitian visits, and any other eligible costs.
Plan Guidelines: Each plan has its own specific rules and procedures for reimbursement. Contact your FSA/HSA provider or HR representative to understand the guidelines and terms/conditions of your plan.
Deadlines: FSAs come with a “use it or lose it” rule. Any money left in your account at the end of the year usually doesn’t carry over.

Eligible and Ineligible Expenses: A Detailed Look

Understanding what qualifies as a medical expense is key to maximizing your HSA, FSA, or HRA benefits. The following is a more in-depth look at frequently encountered items and their eligibility status:

Reimbursable Expenses

Alcoholism and drug abuse: Medical expenses paid to a treatment center for alcohol or drug abuse are reimbursable.
Batteries: Expenses paid for the purchase of batteries are reimbursable when they are used for the sole purpose of an item that is also covered. This would include, but not be limited to, batteries for blood pressure machines, wheelchairs, heart defibrillators, etc.
Car: Medical expenses are reimbursable for special hand controls and other special equipment installed in a car for the use of a person with disabilities. Also, the amount by which the cost of a car specially designed to hold a wheelchair exceeds the cost of a regular car is a reimbursable medical expense.
Childbirth classes: Expenses for childbirth classes are reimbursable, but are limited to expenses incurred by the mother-to-be. To qualify as medical care, the classes must address specific medical issues, such as labor, delivery procedures, breathing techniques, and nursing.
Conference: Amounts paid by an individual for admission and transportation expenses to a medical conference relating to the chronic disease of the individual or individual's eligible dependent are deductible if the costs are primarily for and essential to the medical care of the chronic disease.
Dental treatment: Medical expenses for dental treatment are reimbursable. This includes fees paid to dentists for X-rays, models and molds, fillings, braces, extractions, dentures, dental implants and the difference in cost from insurance-approved restorations and alternative materials, etc. Veneers are covered only when medically necessary, but are not covered for purely cosmetic reasons.
Doula: Expenses paid for a doula whose primary purpose is for delivery of the infant are reimbursable.
Ear wax removal: Effective January 1, 2020, a doctor's prescription for reimbursement is no longer needed.
Electric toothbrush: Expenses paid for the purchase of electric toothbrushes are reimbursable when submitted with a medical diagnosis.
Embryo storage: Expenses paid for embryo storage are reimbursable.
Fluoride, prescribed: Expenses paid for fluoride toothpaste or rinses prescribed to treat a specific medical condition are covered.
Guide dog: The cost of a guide dog or other animal used by the visually impaired or hearing impaired is reimbursable.
Hair loss treatments/Rogaine®: Reimbursable when prescribed by a physician for a specific medical condition, but not for cosmetic purposes (that is, to stimulate hair growth).
Herbs: The cost of herbs taken to alleviate a specific medical condition are reimbursable.
Home urine test kit: Expenses paid for home urine test kits are reimbursable.
Human guide: Expenses for a human guide - to take a blind child to school, for example - are reimbursable.
Hypnotherapy: Expenses paid for hypnotherapy are reimbursable when prescribed by a physician as therapy to treat a medical condition.
Impotence or sexual inadequacy: Medical expenses related to the treatment of impotence are reimbursable.
Infertility: Medical expenses related to the treatment of infertility are reimbursable. Eligible expenses may include egg storage, egg donor costs, infertility monitors, in-vitro fertilization, and sperm washing. Surrogate costs associated with a qualified dependent of the taxpayer are reimbursable and may include such things as blood compatibility testing and psychological exams. Storage costs associated with the freezing of blood cords, embryos, placentas and sperm (sperm banks) are generally reimbursable when a specific medical condition exists.
Insoles: Expenses paid for insoles are reimbursable.
Lead-based paint removal: The cost of removing lead-based paints from surfaces in a home to prevent a child who has (or has had) lead poisoning from eating the paint are reimbursable.
Learning disability: Tuition payments to a special school for a child who has severe learning disabilities caused by mental or physical impairments, including nervous system disorders, are reimbursable. Medical diagnosis is required. Also, tutoring fees for a child's tutoring by a teacher who is specially trained and qualified to work with children who have severe learning disabilities are reimbursable.
Legal fees: Legal fees paid to authorize treatment for mental illness are reimbursable.
Lodging and meals: The cost of lodging and meals at a hospital or similar institution are reimbursable if the employee's main reason for being there is to receive medical care. The cost of lodging not provided in a hospital or similar institution while an employee is away from home is reimbursable if four requirements are met: (1) the lodging is primarily for and essential to medical care; (2) medical care is provided by a doctor in a licensed hospital or in a medical care facility related to, or the equivalent of, a licensed hospital; (3) the lodging is not lavish or extravagant under the circumstances; and (4) there is no significant element of personal pleasure, recreation or vacation in the travel away from home. The reimbursable amount cannot exceed $50 for each night for each person.
Maintenance costs: Portion of expense incurred to maintain equipment used to treat a medical condition are reimbursable. For example, the cost of electricity to operate an air purifier when suffering from asthma.
Massage chair: Expenses paid for a massage chair to treat a medical condition are reimbursable.
Mattresses: Mattresses and mattress boards are reimbursable.
Medicines, prescribed: Amounts paid for prescribed medicines and drugs are reimbursable. The cost of insulin is also reimbursable. The cost of a prescribed drug ordered and shipped from another country cannot be reimbursed unless the drug is legal in both the other country and the United States.
Menstrual care/feminine hygiene products: Effective January 1, 2020, menstrual care/ feminine hygiene products are allowed. This may include, but not limited to, tampons, pads, liners, cups, sponges, and other similar products.
Nausea relief: Expenses paid for nausea relief devices such as nausea bands are reimbursable.
Nightguard: Also referred to as occlusal guard.
Nursing home: The cost of medical care in a nursing home or home for the aged for an employee, or for an employee's spouse or dependent, is reimbursable.
Nursing services: Wages and other amounts paid for nursing services are reimbursable. Services need not be performed by a nurse as long as the services are of a kind generally performed by a nurse. This includes services connected with caring for the patient's condition, such as giving medication or changing dressings, as well as bathing and grooming the patient.
Orthodontia: Services are reimbursable. This type of service does not fit the normal 'fee for service' arrangements seen with other care, and reimbursement can be made once charges have been billed.
Over-the-counter medicines and drugs: Effective January 1, 2020, expenses are generally reimbursable unless used for general well-being or for purely cosmetic purposes.
Personal Protective Equipment (PPE): Products to prevent/stop the flow of disease are allowed.
Physical exams: Physical exams are generally reimbursable, except for employment-related physicals.
Plane tickets: Expenses paid for the purchase of a plane ticket for a related hospitalization are reimbursable.
Pre-Adoption Counseling: This counseling is covered as are all services related to adoption.
Propecia®: Reimbursable when prescribed by a physician for a specific medical condition, but not for cosmetic purposes (that is, to stimulate hair growth).
Psychiatric care: Expenses for psychiatric care are reimbursable.

Non-Reimbursable Expenses

Age Management Systems (Cenegenics): This is a comprehensive, evidence-based approach to age management and includes a set of diagnostics establishing a hormonal, metabolic and physical baseline.
Alternative providers: Expenses paid to alternative providers for homeopathic or holistic treatments or procedures are generally not covered unless to treat a specific medical condition. Naturopathic procedures or treatments using natural agents such as air, water or sunshine are generally not reimbursable.
Breast augmentation: Expenses related to breast augmentation (such as implants or injections) are not reimbursable because the procedure is cosmetic in nature.
Clothing: The cost of clothing - even if prescribed - that substitutes for normal clothing is not deductible.
COBRA premiums: COBRA premiums that you pay for yourself or your eligible dependents are not reimbursable under a Health FSA.
Cosmetic procedures: Medical expenses for cosmetic procedures are reimbursable only if the procedure is necessary to improve a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease. However, medical expenses paid for other cosmetic procedures are not deductible medical expenses under Code Section 213(d), and thus are not reimbursable. This applies to any procedure that is directed at improving the patient's appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease. For example, face lifts, hair transplants, hair removal (electrolysis), liposuction, teeth bleaching and dental veneers are generally not deductible.
Dancing lessons, swimming lessons, etc.
Household help: The cost of household help, even if recommended by a doctor, is prohibited.
Insurance premiums: Premiums for any health plan are not reimbursable under a Health Care FSA.
Marriage counseling: Expenses for marriage counseling services do not qualify as medical expenses.
Massage: Fees paid for massages are not reimbursable unless to treat a physical disability or illness.
Medicare Part A: The premium paid for Medicare Part A is not reimbursable under a Health FSA.
Personal use items: Items that are ordinarily used for personal, living, and family purposes are not reimbursable unless they are used primarily to prevent or alleviate a physical or intellectual disability or illness.
Remineralization Products: These products add back the minerals that acid has chewed away and are considered part of normal hygiene.
Savings Club: Dues to join a club that offers discounts on health items is not covered.

Important Considerations

Tax Advice: Remember that HSA For America does not provide tax advice. This information is for general informational purposes only and should not be construed to be tax advice. Check with your FSA/HSA plan administrator or tax professional for eligibility details and plan requirements.
IRS Publications: You can reference IRS Publication 502 and IRS Publication 503 for the full list of expenses that are qualified, are not qualified, and may be qualified based on certain circumstances.

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