Can FSA and HSA Cover Your Gym Membership? Here's What the IRS Actually Allows

Many people wonder if they can tap into their Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for gym memberships—and the short answer is usually no. However, understanding the nuances could save you from unexpected taxes and penalties.

Why Most Gym Memberships Don’t Qualify

The IRS maintains a strict definition of qualified medical expenses, and recreational gym memberships fall outside that category. While staying active is undeniably good for your health, the IRS classifies general gym costs as personal or wellness expenses rather than medical necessities. This distinction matters because withdrawing HSA or FSA funds for non-qualified expenses triggers both income tax and a 20% penalty.

The same restriction applies whether you’re using an HSA or FSA, though these accounts work slightly differently. Both allow pre-tax contributions, but FSAs require you to spend your money within the plan year or lose it, whereas HSA funds roll over indefinitely, building your balance year after year.

When a Doctor’s Prescription Changes Everything

There’s a critical exception: if your physician explicitly prescribes a gym membership as part of a treatment program for a specific medical condition—such as obesity management, diabetes control, or post-surgical rehabilitation—it may qualify as a legitimate medical expense. The key word is “prescribed.”

To make this work, you’ll need documentation from your doctor outlining why the gym membership is medically necessary and how it fits into your treatment plan. Your HSA or FSA provider will likely require this paperwork before approving the withdrawal. Without it, the IRS could deny the expense and impose penalties.

What Your HSA and FSA Actually Cover

If gym memberships are off-limits, what medical expenses do qualify? Quite a few, actually:

Routine and Emergency Care: Doctor visits, hospital stays, co-pays, deductibles, and surgical procedures all qualify. Prescription medications and over-the-counter drugs prescribed by a healthcare provider are also eligible.

Specialized Care: Dental cleanings, orthodontic work, eye exams, glasses, and contact lenses fall under qualified expenses. So do chiropractic care, physical therapy, and weight-loss programs when prescribed by a doctor.

Medical Equipment and Supplies: Crutches, wheelchairs, blood glucose monitors, and similar medical devices are all covered by HSA and FSA funds.

Contribution Limits and Account Features to Know

For 2024, the IRS sets HSA contribution limits at $4,150 for individual coverage and $8,300 for family coverage. Those 55 and older can add an additional $1,000 catch-up contribution. Some HSA providers allow you to invest your balance in stocks, bonds, or mutual funds, creating potential for long-term growth.

This investment flexibility distinguishes HSAs from FSAs—though FSAs work well for those expecting higher medical expenses in the current year since the funds don’t carry over.

The Bottom Line

Gym memberships generally won’t qualify for HSA or FSA reimbursement unless prescribed by your doctor for a medical condition. To avoid costly penalties, always verify with your provider and ensure you have proper documentation. For managing healthcare costs effectively, focus on the many legitimate qualified expenses your account covers—from doctor visits and prescriptions to physical therapy and dental care. When in doubt, consult your HSA or FSA provider before making a withdrawal.