Check what your health account can pay.

What the accounts are for

A health savings account (HSA) or health flexible spending arrangement (FSA) holds money set aside before tax for paying medical expenses. US tax agency guide to health accounts

The IRS (Internal Revenue Service) treats care for a diagnosed disease differently from spending only to support general health, as of September 2026. IRS answers on medical expenses

Ask whether each charge meets the medical-expense rules. Calling the package a “longevity program” does not explain what each item is for.

The medical purpose matters

IRS guidance, as of September 2026, allows weight-loss expenses for treating a particular disease, such as obesity, that a doctor has diagnosed. IRS guidance on medical expenses

Ask the doctor or other health professional to describe the condition being treated. Ask the administrator which expenses and records meet the account’s terms.

A letter may be part of the paperwork

A letter of medical necessity is a health professional’s note explaining why an expense is needed.

As of September 2026, the person managing your account may ask for this letter. That document title is not an IRS requirement, but the expense must still have a qualifying medical purpose and payment records. IRS on documenting expenses

Keep an itemised receipt and ask for the administrator’s record requirements. A note from the doctor or other health professional and proof of the payment answer different questions.

Check trackers and other extras separately

In guidance added in September 2026, the IRS says a wearable health device is not a medical expense just because it tracks health. IRS guidance on wearable devices

As of September 2026, the device must be bought and used mainly to help diagnose, treat or prevent a specific disease for the expense to qualify under this guidance.

If a plan bundles a tracker, software or general wellness services with care, ask for separate charges and an answer for each item.