💡 Quick Answer: Apple Watch is HSA/FSA eligible because it helps prevent, manage, and reverse a variety of health conditions including cardiovascular disease, diabetes, sleep disorders, atrial fibrillation, and anxiety, and many others. According to IRS Publication 502, all you need is a Letter of Medical Necessity.
Luckily, we make it ridiculously simple. Crates Health is the easiest way to get your personalized and compliant letter for Apple Watch and thousands of other wellness products, plus we handle your reimbursements directly through our platform with just one click.
What is Apple Watch
Apple Watch is the most popular smartwatch in the world, but most people don’t realize it’s also one of the most advanced health monitoring devices you can buy. While competitors focus on fitness tracking or sleep data, Apple Watch combines everything into a single device that your doctor can actually use.
The health features are clinical-grade. FDA-cleared ECG that can detect atrial fibrillation. Blood oxygen monitoring for respiratory conditions. Fall detection that automatically calls emergency services. Crash detection for car accidents. Sleep stage tracking validated against polysomnography. Irregular heart rhythm notifications that the American Heart Association validates as clinically useful. Temperature sensing for cycle tracking and illness detection.
This isn’t just marketing. Apple partners with Stanford Medicine, the American Heart Association, and major health systems to validate what Apple Watch can do. The Apple Heart Study with Stanford enrolled over 400,000 participants and found that irregular heart rhythm notifications led to atrial fibrillation diagnoses in 84% of cases where participants sought medical attention. That along with the fact that it can be used to help prevent, manage or reverse health conditions is why Apple Watch and other fitness trackers qualify for HSA and FSA reimbursement.
Why Apple Watch Qualifies for HSA/FSA Eligibility
IRS Publication 502 states that medical expenses are “the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and for the purpose of affecting any part or function of the body,” but “must be primarily to alleviate or prevent a physical or mental condition or illness.”
This means Apple Watch can qualify for HSA/FSA reimbursement when used for prevention or treatment of:
- Cardiovascular conditions – FDA-cleared ECG, irregular heart rhythm notifications, heart rate monitoring, and cardio fitness tracking (VO2 max estimation)
- Atrial fibrillation – The only consumer wearable with FDA clearance to detect AFib through ECG and irregular rhythm notifications
- Diabetes and pre-diabetes – Activity tracking for blood sugar management, medication reminders, and glucose monitor integration (Dexcom G7)
- Sleep disorders – Clinical-grade sleep stage analysis, respiratory rate monitoring, and blood oxygen tracking during sleep
- Obesity and weight management – Comprehensive activity tracking, calorie monitoring, exercise ring completion, and standing reminders
- Hypertension – Stress management through Mindfulness app, breathing exercises, heart rate variability, and activity goals for blood pressure control
- Mental health conditions – Mindfulness app, breathing exercises, heart rate variability for anxiety management, and mood tracking via third-party apps
- Fall risk and elderly care – Fall detection with automatic emergency calling, walking steadiness metrics, and medication reminders
The key requirement is that your healthcare provider must note the health monitoring device as medically necessary for managing your specific health condition, not just for general wellness. This documentation comes in the form of a Letter of Medical Necessity (LMN).
How to Get Your Apple Watch Approved
Traditional Route: Schedule an appointment with your primary care physician, discuss your health conditions and monitoring needs, and request a Letter of Medical Necessity if continuous health tracking is recommended as part of your treatment plan. This typically requires an office visit, potential wait times, and can cost $50-100+ depending on your insurance.
Faster, Smarter Route: Use Crates Health to get your Letter of Medical Necessity online in just a few minutes. Our platform connects you with licensed healthcare providers who can evaluate your conditions remotely and issue the appropriate documentation if you qualify. No office visits, no waiting weeks for appointments, and no surprise medical bills.
Which Apple Watch Models Are HSA/FSA Eligible
Every Apple Watch with health monitoring features qualifies for HSA/FSA reimbursement with proper documentation. Here’s what’s currently available:
Current Apple Watch Models (2024-2025)
| Model | Price | Key Health Features | Best For |
|---|---|---|---|
| Apple Watch SE (2nd gen) | $249 | Heart rate, fall detection, crash detection, sleep tracking | Budget-conscious health monitoring |
| Apple Watch Series 10 | $399-$499 | ECG, blood oxygen, temperature sensing, all SE features | Complete health tracking |
| Apple Watch Ultra 2 | $799 | All Series 10 features, extreme durability, longer battery, depth gauge | Serious athletes and outdoor health monitoring |
Important Note: Even older models (Series 6, 7, 8, 9) with health features qualify for HSA/FSA reimbursement. The IRS doesn’t require you to buy the latest model.
All current models include: 24/7 heart rate monitoring, irregular heart rhythm notifications, high and low heart rate alerts, cardio fitness (VO2 max), sleep tracking with stages, fall detection, crash detection, noise monitoring, and menstrual cycle tracking.
Series 10 and Ultra 2 add: FDA-cleared ECG app, blood oxygen monitoring, skin temperature sensing, and AFib history (with watchOS 9+).
Frequently Asked Questions
Are other smartwatches HSA/FSA eligible?
Yes. With proper medical documentation, you can use HSA/FSA funds for Garmin watches, Samsung Galaxy Watch, Fitbit, Whoop, Oura Ring, Ultrahuman Ring and other health-tracking wearables when they’re recommended for treating specific medical conditions.
How does the reimbursement process work?
Apple doesn’t accept HSA/FSA cards directly in their stores or online. You’ll purchase with your personal card, save your receipt, then submit the receipt and LMN for reimbursement through your HSA/FSA administrator. With Crates Health, we simplify this process: upload your receipt and get one-click reimbursements directly through our platform.
What is a Letter of Medical Necessity?
A Letter of Medical Necessity (LMN) is documentation from a licensed healthcare provider explaining why Apple Watch is medically necessary for preventing or treating a diagnosed condition. It’s the official paperwork proving your smartwatch isn’t just for general fitness. Each LMN typically remains valid for 12 months.
Will my HSA/FSA claim get denied?
With Crates, it rarely happens. That said, every HSA/FSA administrator is different, and some may initially deny claims due to receipt format, LMN documentation, or unclear medical necessity. Crates Health supports you through any denials and make sure you get reimbursed.
Can I use my HSA/FSA for Apple Watch bands and accessories?
Generally, no. HSA/FSA funds cover the device itself when it’s medically necessary, but accessories like bands, cases, and chargers typically don’t qualify unless they’re essential to the medical function (like a specialized heart rate chest strap). However, many other wellness products qualify such as saunas & cold plunges, supplements, gyms & fitness, health tech, mental health, and sleep tech.
Does Apple Watch SE qualify for HSA even without ECG?
Yes. While the SE lacks ECG and blood oxygen features, it still includes 24/7 heart rate monitoring, irregular rhythm notifications, fall detection, crash detection, and sleep tracking. These features alone can justify medical necessity for many conditions.
Why is Apple Watch HSA eligible but some other wearables aren’t?
Apple Watch qualifies because it has FDA-cleared features (ECG, irregular rhythm notifications) and clinically validated health monitoring capabilities. Not all wearables have this level of medical validation. However, many other devices like Garmin watches, Samsung Galaxy Watch, Fitbit, Whoop, Oura Ring, Ultrahuman Ring and other health-tracking wearables can also qualify with proper medical documentation.
Can I buy Apple Watch with my FSA even though FSA funds expire?
Yes. Apple Watch is FSA eligible just like it’s HSA eligible. Just be mindful of your FSA plan year and use-it-or-lose-it deadline. If you’re approaching your FSA expiration date, Apple Watch can be a smart way to use remaining funds on something that genuinely improves your health.
