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💡 Quick Answer: Yes, gym memberships are HSA eligible when they help prevent or manage health conditions. IRS Publication 502 explicitly covers expenses for “the prevention or alleviation of a physical or mental defect or illness.” You need a Letter of Medical Necessity from a healthcare provider, and Crates Health makes this process simple in a few minutes online.

Table of Contents

1. The Power of Exercise as Medicine
2. What the IRS Says About Gym Membership HSA Eligibility
3. Do You Qualify? A Simple Self-Check
4. The Letter of Medical Necessity
5. How to Pay for Your Gym with HSA
6. Beyond Basic Gym Memberships
7. Frequently Asked Questions
8. Start Saving Today

The Power of Exercise as Medicine

The scientific evidence is overwhelming: exercise is one of the most powerful medical interventions available. A landmark study in JAMA found that regular exercise reduces the risk of chronic disease by up to 40%. The American Heart Association reports that 150 minutes of weekly exercise delivers remarkable health benefits:

• 31% Lower Heart Disease Risk
• 58% Lower Diabetes Risk
• 30% Less Depression
• 27% Lower Stroke Risk
• 33% Lower Overall Mortality

Exercise isn’t just medicine. It’s often better than medicine. A BMJ meta-analysis of 305 randomized controlled trials found exercise interventions performed equally to drug interventions for coronary heart disease and diabetes prevention.

This is why gyms, fitness classes, yoga studios, Pilates, CrossFit boxes, and personal training aren’t luxuries. They’re healthcare delivery systems. The medical community increasingly recognizes this reality.

What the IRS Says About Gym Membership HSA Eligibility

IRS Publication 502 states that medical expenses include costs for “the diagnosis, cure, mitigation, treatment, or prevention of disease” and expenses that “affect any structure or function of the body.”

The IRS specifically recognizes that exercise and fitness activities qualify when they:

• Prevent the onset of disease
• Manage existing conditions
• Alleviate physical or mental health issues

Common qualifying conditions for HSA gym membership

• Obesity and weight management
• Type 2 diabetes and pre-diabetes
• Cardiovascular disease and hypertension
• Depression and anxiety
• Chronic pain and arthritis
• Metabolic syndrome
• Osteoporosis
• High cholesterol
• Sleep disorders

Do You Qualify? A Simple Self-Check

Ask yourself these three questions:

1. Do you have ANY health condition or family history of chronic disease?
If yes → You likely qualify

2. Are you actively trying to prevent future health issues?
If yes → You likely qualify

3. Would a doctor reasonably say exercise benefits your health?
If yes → You likely qualify

If you answered yes to any of these, you’re likely eligible. Remember: the IRS standard is “primarily for prevention”, you don’t need to be sick to qualify.

The Letter of Medical Necessity: Your Key to HSA Gym Savings

A Letter of Medical Necessity (LMN) is a document from a licensed healthcare provider stating that your gym membership is medically necessary for preventing or managing health conditions. Think of it as a prescription for exercise.

The challenge: Many traditional doctors aren’t familiar with LMNs or don’t issue them. They might not understand that prevention qualifies under IRS rules.

The solution: Licensed healthcare providers who understand preventive medicine and IRS guidelines can evaluate you online and issue your LMN in minutes, not weeks.

How to Pay for Your Gym with HSA

Here’s the reality: most gyms don’t accept HSA cards directly. Planet Fitness, Equinox, your local CrossFit box, they all want regular payment. So here’s how it works:

1. Pay normally – Use your regular credit card or bank account
2. Get your receipts – Make sure they’re itemized with dates and amounts
3. Submit for reimbursement – Upload your receipt and LMN to your HSA administrator

Beyond Basic Gym Memberships: What Else is HSA Eligible?

Your Letter of Medical Necessity doesn’t just cover your favorite gym. It opens the door to thousands of wellness expenses:

Fitness facilities

• National chains (Equinox, Life Time, LA Fitness, 24 Hour Fitness)
• Boutique studios (SoulCycle, Barry’s Bootcamp, F45)
• Specialty fitness (OrangeTheory, CrossFit, Pure Barre, SolidCore)
• Yoga and Pilates studios (CorePower Yoga, YogaWorks, Club Pilates)
• Rock climbing gyms and martial arts dojos

Home fitness equipment

• Peloton bikes and treadmills
• Tonal strength system 
• Hydrow rowing machines
• NordicTrack equipment
• Bowflex systems
• Dumbbells, resistance bands, and yoga equipment

Recovery & wellness

• Massage therapy and Therabody devices
• Hyperice and Normatec compression therapy
• Saunas and infrared blankets (HigherDose)
• Cold plunge tubs and red light therapy devices
• Supplements (AG1, Momentous, Thorne)

Frequently Asked Questions

Start Saving on Your Gym Membership Today

You’re already investing in your health through fitness. Now you can do it with pre-tax dollars and save 30-40% on every gym payment, class package, and piece of equipment.

The average American spends $1,800 annually on fitness. That’s $540-720 in unnecessary taxes you’re paying.

It takes minutes, and you can start saving immediately.

About the Author: Anchor Ebanks is the founder of Crates Health and an HSA/FSA optimization expert who has helped users save hundreds of hundreds of thousands of dollars on wellness expenses. With nearly a decade of experience in technology from Google, YouTube, and Deloitte, an MBA from Harvard Business School, and an AI research fellowship at Harvard’s Berkman Klein Center, Anchor combines technical expertise with deep knowledge of health benefits and tax optimization. As a health coach who has guided dozens through their wellness journeys, Anchor founded Crates Health to help millions live healthier and wealthier with a focus on democratizing access to preventive health.