Can I Use My HSA for a Gym Membership? Rules, Exceptions & How to Qualify

Sep 28, 2025

Introduction

Health Savings Accounts (HSAs) are a powerful tool in managing medical costs with tax advantages—but when it comes to gym memberships, things get a little murky. With more people aiming to improve their health through fitness, a common question is: “Can I use my HSA for a gym membership?” In this article, we’ll clarify the rules, exceptions, and what you need to do if you want to make that happen.

What Is an HSA?

An HSA is a tax-advantaged account available to people who are enrolled in a high-deductible health plan (HDHP). You contribute pre-tax (or tax deductible) money; it grows tax-free; and withdrawals for qualified medical expenses are also tax-free.

IRS Rules on Qualified Medical Expenses

To use HSA funds without penalty, the expense must be considered a qualified medical expense. That means:

  • It treats or prevents a diagnosed medical condition (e.g. obesity, hypertension, diabetes). (source)

  • The expense must be prescribed or recommended by a licensed provider as part of a treatment plan.

  • It must affect a structure or function of the body (not just “general wellness”).

Gym Memberships: Generally Not Eligible—With Exceptions

Why They’re Usually Not Allowed

A regular gym membership, simply for fitness, weight loss, or wellness (without a medical directive), is considered a personal expense under IRS rules and is not a qualified medical expense. General wellness expenses like gym fees are excluded.

When Gym Memberships Can Be Eligible

Gym memberships can become HSA-eligible if certain conditions are met:

  1. Letter of Medical Necessity (LMN): A licensed healthcare provider must write a document explaining that the gym membership is medically necessary for treating a specific condition (details here).

  2. Diagnosed Condition: The treatment plan must address a medically diagnosed condition (e.g. obesity, heart disease, diabetes, rehabilitation).

  3. Connection to the Treatment: The exercise or gym access must be part of treatment or management of the condition—not just staying fit or improving appearance.

  4. Documentation & Proof: Keep receipts, the LMN, and any required paperwork. The timing of the doctor’s note may matter (often must be dated on or before the expense or start of the subscription).

Proposal & Legislative Background

There has been proposed legislation (such as the PHIT Act) that aimed to expand what HSAs and FSAs can cover—potentially allowing gym fees, youth sports, and fitness trackers.

As of 2025, a bill informally called the “One Big Beautiful Bill” included provisions related to gym and fitness expenses, but many of these did not make final passage (coverage here).

How to Use Your HSA for a Gym Membership (If You Qualify)

If you believe your situation might meet the exceptions, here are steps to follow:

Step

What to Do

1. See your physician / healthcare provider

Discuss your medical condition. Ask if exercise via gym membership would be helpful as part of treatment.

2. Get a Letter of Medical Necessity

The doctor should clearly specify condition, treatment plan, how gym membership is necessary, duration, etc.

3. Keep Receipts & Documentation

Save membership contracts, payment records, and the LMN.

4. Check with your HSA Administrator / Plan

Some plans have rules or provider requirements. Confirm whether they accept LMNs and reimburse such expenses.

5. Submit your claim/reimbursement

Use your HSA to pay directly if allowed, or pay out of pocket and submit for reimbursement with documentation.

Risks If You Use HSA Inappropriately

  • If the expense isn’t qualified per IRS rules, you may face taxes + penalties when you withdraw HSA funds for that purpose (more info).

  • Your HSA administrator might deny reimbursement.

  • During audits, missing or vague documentation could lead to issues.

Bottom Line

  • General answer: No, you usually cannot use HSA funds for a gym membership unless it is prescribed for a specific medical condition and documented properly.

  • But: If you have a diagnosed medical condition and your doctor provides a valid Letter of Medical Necessity, you may be able to use HSA funds to cover the membership or classes.

FAQs

Q: What medical conditions often qualify?
A: Conditions like obesity, hypertension, heart disease, diabetes, or post-injury/surgery rehab are common (source).

Q: Can I use FSA funds instead of HSA?
A: Similar rules apply for FSAs—general fitness is not covered unless prescribed (read more).

Q: Can I use HSA if the doctor’s note comes after I start the membership?
A: Timing may matter—some administrators require the LMN to cover the period of the membership; it's safer to get the LMN before starting.

Q: Are there tools or services that help with the LMN process?
A: Yes. Services like TrueMed can help you get a Letter of Medical Necessity online.