Crates Health

Table of Contents

• The Hidden Cost of Heat Therapy
• Why Sauna Is Actually Medicine (The Science)
• What the IRS Actually Says About Saunas
• Medical Conditions That Qualify for Sauna HSA/FSA
• What Sauna Expenses Are HSA/FSA Eligible
• Letter of Medical Necessity Requirements
• The Real Math on Sauna Tax Savings
• HSA vs FSA for Sauna Purchases
• Frequently Asked Questions

The Hidden Cost of Heat Therapy

Let’s talk numbers. If you’re serious about sauna therapy, you’re spending serious money:

• Studio sessions: $30-50 per visit
• Monthly memberships: $150-300 at premium facilities
• Home infrared units: $2,000-15,000+ for quality equipment
• Annual spending: Easily $1,800-3,600+ for regular users

But here’s what most people don’t know: All of this can be tax-free medical expenses when properly documented.

We’re not talking about a spa day or luxury wellness treat. The IRS specifically allows medical expenses that are “primarily for the prevention or alleviation of disease.” When your healthcare provider recommends sauna therapy for a medical condition, those sessions become qualified medical expenses.

The result? You could save 30-40% on your sauna costs, turning that $3,000 annual expense into $2,100 after tax savings.

Why Sauna Is Actually Medicine (The Science)

The scientific evidence for sauna as medical therapy is robust and growing. This isn’t wellness marketing; it’s peer-reviewed research that healthcare providers can cite when prescribing sauna therapy.

Cardiovascular Health Benefits

A landmark 2015 study in JAMA Internal Medicine followed 2,315 Finnish men for over 20 years. The results were striking:

• Men who used saunas 4-7 times per week had a 50% lower risk of fatal cardiovascular disease
• Risk reduction showed a clear dose-response relationship: more sessions = greater benefit
• All-cause mortality was reduced by 40% in frequent sauna users

Follow-up research published in BMC Medicine confirmed these findings and extended them to stroke prevention, showing a 61% reduction in stroke risk among frequent sauna users.

Blood Pressure and Hypertension

A 2017 study in Hypertension journal found that men who used saunas 4-7 times per week had a 46% lower risk of developing hypertension compared to once-weekly users.

The mechanism is well-understood: sauna exposure causes vasodilation, increased heart rate (similar to moderate exercise), and improved endothelial function. Research shows that regular sauna use can reduce both systolic and diastolic blood pressure.

Pain Management and Recovery

Studies on infrared sauna therapy demonstrate significant benefits for chronic pain conditions:

• Reduced pain scores in fibromyalgia patients
• Improved symptoms in rheumatoid arthritis
• Enhanced recovery from exercise-induced muscle damage
• Reduced chronic fatigue syndrome symptoms

Mental Health Benefits

Research published in Psychopharmacology shows that whole-body hyperthermia (achieved through sauna use) can have antidepressant effects comparable to pharmaceutical interventions.

The bottom line: This isn’t alternative medicine or wellness trends. It’s evidence-based therapy that healthcare providers can confidently prescribe for specific medical conditions.

What the IRS Actually Says About Saunas

The IRS position on sauna eligibility comes down to one key principle: primary purpose.

IRS Publication 502 defines qualified medical expenses as amounts paid for “the diagnosis, cure, mitigation, treatment, or prevention of disease.” The publication specifically states that expenses must be “primarily to alleviate or prevent a physical or mental disability or illness.”

Key IRS Guidelines:

• Medical necessity: The expense must be primarily for medical care, not general wellness
• Healthcare provider recommendation: A qualified professional must prescribe or recommend the treatment
• Specific condition: The treatment must address a diagnosed condition or prevention of a specific disease
• Proper documentation: You need a Letter of Medical Necessity detailing the medical purpose

The IRS has also issued guidance clarifying that wellness expenses can qualify when they treat specific conditions and are properly documented by healthcare providers.

FSAFEDS (the federal FSA administrator) explicitly includes “health club dues” and medical equipment as eligible expenses when medically necessary and supported by proper documentation.

Medical Conditions That Qualify for Sauna HSA/FSA

Based on the scientific evidence and IRS guidelines, sauna therapy can be prescribed for numerous medical conditions:

Cardiovascular Conditions

• Hypertension (high blood pressure)
• Cardiovascular disease
• High cholesterol
• Poor circulation
• Heart failure recovery
• Peripheral artery disease

Pain and Musculoskeletal Conditions

• Chronic pain syndromes
• Fibromyalgia
• Rheumatoid arthritis
• Osteoarthritis
• Chronic lower back pain
• Muscle tension and spasms
• Post-exercise recovery needs

Mental Health Conditions

• Depression
• Anxiety disorders
• Chronic stress
• Sleep disorders
• Seasonal Affective Disorder (SAD)

Other Qualifying Conditions

• Chronic fatigue syndrome
• Type 2 diabetes (for cardiovascular benefits)
• Metabolic syndrome
• Autoimmune conditions
• Skin conditions like psoriasis (for infrared therapy)

What Sauna Expenses Are HSA/FSA Eligible

With proper medical documentation, the following sauna-related expenses can be HSA/FSA eligible:

Sauna Sessions and Memberships

• Individual infrared sauna sessions
• Traditional sauna sessions
• Monthly sauna studio memberships
• Annual membership fees
• Spa packages that include medically necessary sauna therapy

Home Sauna Equipment

• Infrared sauna cabins (portable and built-in)
• Traditional steam saunas
• Infrared sauna blankets
• Sauna suits for therapeutic use
• Installation costs (when part of medical equipment setup)

Related Equipment and Accessories

• Thermometers for monitoring therapeutic temperature
• Timers for prescribed session durations
• Protective equipment required for safe therapeutic use

What’s NOT Eligible

• Sauna use for general wellness or relaxation
• Luxury spa treatments without medical necessity
• Equipment used primarily for non-medical purposes
• Family memberships (unless each member has medical documentation)

Letter of Medical Necessity Requirements

Your Letter of Medical Necessity must include specific elements to satisfy IRS and FSA/HSA administrator requirements:

Required Information

• Patient information: Full name, date of birth, diagnosis
• Medical condition: Specific diagnosis or condition being treated
• Treatment recommendation: Type of sauna therapy prescribed
• Medical justification: Why sauna therapy is medically necessary for this condition
• Treatment protocol: Frequency, duration, and type of sauna sessions
• Treatment period: How long the therapy is expected to be needed
• Provider credentials: Licensed healthcare provider signature and credentials

Sample Treatment Protocols

For Hypertension:
“Patient to use infrared sauna 3-4 times per week, 15-20 minutes per session, for cardiovascular health improvement and blood pressure management. Treatment recommended for 12 months with periodic evaluation.”

For Chronic Pain:
“Patient to use infrared sauna therapy 4-5 times per week, 20-30 minutes per session, for pain management and muscle relaxation related to fibromyalgia. Treatment recommended for ongoing pain management.”

For Depression:
“Patient to use sauna therapy 3-4 times per week as adjunct treatment for major depressive disorder, utilizing heat therapy’s demonstrated neurochemical benefits. Treatment recommended for 6 months with reassessment.”

The Real Math on Sauna Tax Savings

Let’s break down the actual dollar savings you can expect:

Sauna Studio Membership

Annual Cost: $200/month × 12 = $2,400
Tax Bracket: 30% (federal + state)
Annual Tax Savings: $2,400 × 0.30 = $720
Effective Cost: $2,400 – $720 = $1,680
5-Year Savings: $3,600

Premium Sauna Studio

Annual Cost: $300/month × 12 = $3,600
Tax Bracket: 35% (higher earner)
Annual Tax Savings: $3,600 × 0.35 = $1,260
Effective Cost: $3,600 – $1,260 = $2,340
5-Year Savings: $6,300

Home Infrared Sauna

Purchase Price: $8,000
Tax Bracket: 32%
Immediate Tax Savings: $8,000 × 0.32 = $2,560
Effective Cost: $8,000 – $2,560 = $5,440

Additional Benefits:

• No ongoing membership fees
• Unlimited family use (with individual LMNs)
• Home convenience and privacy
• Potential home value increase

HSA vs FSA for Sauna Purchases

Understanding the differences can help you maximize your sauna savings:

Health Savings Account (HSA)

• 2025 Contribution Limits: $4,300 individual, $8,550 family
• Age 55+ Catch-up: Additional $1,000
• Rollover: Funds never expire
• Triple tax advantage: Deductible contributions, tax-free growth, tax-free withdrawals for medical expenses
• Best for: Long-term sauna investment, home equipment purchases

Flexible Spending Account (FSA)

• 2025 Contribution Limit: $3,300
• Use-it-or-lose-it: Must spend by plan year end (some plans allow small carryover)
• Grace period: Some plans offer 2.5 months extra to spend funds
• Carryover: Up to $660 may roll to next year (if plan allows)
• Best for: Annual memberships, regular sessions

Strategic Planning Tips

• Large purchases: Use HSA funds that can accumulate over time
• Annual expenses: Perfect for FSA since they’re predictable
• Timing: Plan sauna purchases around your plan year for FSA optimization
• Documentation: Keep all receipts and LMNs for tax records

Frequently Asked Questions

Is a home sauna HSA/FSA eligible?
Yes, home saunas are eligible with proper medical documentation. Your LMN must state that the primary purpose is to treat or prevent a medical condition, not general wellness or luxury.

Do I need to renew my Letter of Medical Necessity?
Most administrators require LMN renewal every 12 months if treatment continues. Some conditions may warrant longer treatment periods, which should be specified in the original letter.

Can family members use the same sauna with one LMN?
No, each person needs their own LMN for their specific medical conditions. However, a home sauna can benefit multiple family members if each has proper documentation.

What about infrared sauna blankets?
Yes, infrared sauna blankets are eligible with proper medical documentation, especially for chronic pain, circulation issues, or recovery purposes.

How strong is the scientific evidence?
Very strong. The Finnish cohort studies involved thousands of participants over decades, showing significant reductions in cardiovascular mortality, stroke risk, and hypertension. This research is published in top-tier medical journals and is regularly cited by healthcare providers.

Will my HSA/FSA administrator question sauna expenses?
With a proper LMN from a licensed healthcare provider, most administrators approve sauna expenses. Crates Health provides additional support if administrators have questions.

Can I use sauna for workout recovery?
Yes, if prescribed for specific conditions like muscle recovery deficits, chronic pain from exercise, or athletic performance issues related to a medical condition.

What’s the difference between infrared and traditional saunas for HSA/FSA?
Both can be eligible. Infrared saunas operate at lower temperatures and may be better for certain conditions like chronic pain or cardiovascular issues. Traditional saunas operate at higher temperatures. Your healthcare provider will recommend the appropriate type for your condition.

Bottom line: Sauna therapy is evidence-based medicine, not just a wellness trend. With proper documentation, you can save thousands of dollars annually while investing in your health.

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Disclaimer: This information is for educational purposes only and does not constitute tax, legal, or medical advice. HSA/FSA rules vary by administrator and employer. Always consult with your benefits administrator and healthcare provider for specific guidance on your situation.