Can I Use My HSA/FSA to Purchase a Mattress?

Short Answer:
Yes—if your mattress meets IRS and HSA/FSA requirements by being tied to an intervention that treats, reverses, or prevents a diagnosed medical condition, it can be eligible for reimbursement.

• Revenue Ruling 55-261:

  • States that “the expense of a special mattress and plywood boards prescribed for the relief of physical disease or illness constitutes a medical deduction under section 23(x) of the Code.”

  • This ruling confirms that a special mattress may qualify as a medical expense when it is prescribed to alleviate a specific medical condition.

• Eligibility Criteria:

  • The mattress expense is only eligible when its components and construction costs exceed those of a standard mattress intended for general health.

  • The mattress must be tied directly to a treatment or intervention for a specific medical condition.

• Letter of Medical Necessity (LMN):

  • Your LMN must include a diagnosis and a clinical rationale from a healthcare provider licensed in your state.

  • The LMN should clearly explain why a special mattress is recommended for the treatment, reversal, or prevention of your condition.

• Product Specifications:

  • The mattress you purchase should have features that go beyond a standard mattress. For example, it may offer:

    • Temperature adjustment

    • Customizable firmness

    • Resources for sleep cycle optimization

These features help demonstrate that the mattress is designed to provide a therapeutic benefit for your diagnosed condition.

• Review the Denial:

  • Ensure your claim was denied based on the specifics of your product and LMN documentation.

• Utilize the Appeals Process:

  • Follow the formal appeals process described in your HSA/FSA plan documents.

  • When appealing, include:

    • A reference to Revenue Ruling 55-261.

    • Detailed information on how your mattress’s features exceed those of a standard mattress.

    • A copy of your LMN that ties the mattress directly to the treatment, reversal, or prevention of your condition.

• Contact Support:

  • If you encounter any issues with your appeal or need further clarification on the documentation, please reach out to us.

Your mattress can be an eligible HSA/FSA expense when it is prescribed as part of a medically necessary intervention and its design exceeds that of a standard mattress. The key factors are that your LMN meets IRS requirements and that the product features are tailored to treat, reverse, or prevent your diagnosed condition.

If you have any questions or need assistance with your appeal, please contact Truemed support at support@truemed.com. We’re here to help!