Partial Eligibility & Mixed-Item Purchases | Truemed Customer Help Center

Not every product qualifies for full HSA or FSA reimbursement. Some items are only partially eligible, and some orders contain a mix of eligible and ineligible products. Understanding how partial eligibility works helps you claim the right amount and avoid issues with your administrator.

What is partial eligibility

Partial eligibility means that only a portion of what you paid qualifies for reimbursement through your HSA or FSA.

This typically happens in two situations:

A single product has features beyond what is medically necessary. For example, a mattress qualifies as a medical expense because of its therapeutic support — but premium add-ons like advanced cooling technology go beyond what is medically required. The base therapeutic value is eligible; the upgrade is not.
An order contains both eligible and ineligible items. For example, a cart that includes a qualifying air purifier alongside a non-medical accessory like a decorative cover. The air purifier may be eligible while the accessory is not.

In both cases, IRS rules require that HSA and FSA funds cover only the medically necessary portion of the expense. Submitting a claim for more than the eligible amount could result in a denial or require you to repay funds.

How to calculate the eligible portion

You do not need to calculate the eligible amount yourself. Truemed’s provider team determines it for you as part of the qualification process.

Here is how it works:

Base model comparison. For products with premium features, the eligible amount is determined by comparing the price of the item you purchased against a comparable base model that meets the same medical need. The difference between your product’s price and the base model’s price represents the ineligible portion.
Your LMN addendum. After qualification, your Letter of Medical Necessity includes an addendum that specifies the eligible amount for your purchase. This is the amount you may claim.
Your Truemed receipt. Your receipt itemizes the eligible and ineligible amounts separately, so there is no guesswork when you fill out your reimbursement claim.

You pay the full price of the product at checkout, and then you submit only the eligible portion for reimbursement. The ineligible portion is covered by your regular payment method and cannot be reimbursed through your HSA or FSA.

Submitting a claim for mixed purchases

When your purchase includes both eligible and ineligible items or amounts, follow these steps:

Locate your Truemed receipt. It will show the eligible amount clearly separated from the ineligible amount.
Locate your LMN and any addendum. The addendum confirms the eligible amount determined by Truemed’s provider.
Log into your HSA or FSA administrator’s portal and navigate to the reimbursement or claims section.
Enter only the eligible amount when filling out your claim. Do not submit the full purchase price if part of it is ineligible.
Upload your supporting documents. Attach your Truemed receipt and your LMN. Some administrators may also request a cost comparison document (see the documentation section below).
Submit and save your confirmation number.

If your administrator’s claim form only has a single amount field, enter the eligible portion shown on your Truemed receipt — not the total order amount.

What documentation is required

To support a partial eligibility or mixed-purchase claim, you will typically need the following:

Letter of Medical Necessity (LMN) with addendum. The addendum is the part of your LMN that specifies the eligible amount for your specific purchase. Both the LMN and addendum are provided by Truemed after qualification.
Truemed itemized receipt. This receipt breaks down the eligible and ineligible amounts and includes the merchant name, product description, and date of purchase — everything your administrator needs to review the claim.
Cost comparison document (if requested). Some administrators require a cost comparison showing how the eligible amount was calculated relative to a base model. For common products, Truemed automatically includes this documentation. If your administrator asks for it and you do not have it, contact support@truemed.com with your order details and the team will send it to you.

Submitting all three documents together in your initial claim reduces the likelihood of follow-up requests and speeds up processing.

Common examples

Here are some products where partial eligibility commonly applies:

Premium mattress with cooling features. The mattress base qualifies as a medical expense for therapeutic support. Advanced cooling technology is considered a non-medical upgrade, so the cost of that feature is excluded from the eligible amount.
High-end treadmill vs. basic model. A treadmill may qualify for cardiovascular or physical therapy reasons. If the model you purchased costs significantly more than a basic qualifying model, only the amount comparable to the base model is eligible.
Smart air purifier. An air purifier may qualify for respiratory health reasons. Smart features like app connectivity or premium filtration upgrades beyond what is medically necessary may be excluded.
Premium orthopedic footwear. Orthopedic shoes can qualify for certain foot or joint conditions. If the specific pair you purchased includes fashion or lifestyle features beyond the orthopedic function, the eligible amount reflects only the therapeutic value.

In each case, your Truemed receipt and LMN addendum will reflect the exact eligible amount so you always know what to submit.