Common HSA/FSA FAQs

The Basics

What is an HSA or FSA?

An HSA (Health Savings Account) or FSA (Flexible Spending Account) lets you use pre-tax dollars to pay for eligible health and medical expenses.

Why should I use my HSA or FSA?

Using HSA or FSA funds means you're paying for eligible health expenses with pre-tax money, which can help you save overall. Depending on your plan, HSA funds may also roll over and grow over time.

Who is eligible to use an HSA or FSA?

Eligibility for an HSA or FSA depends on your employer, health insurance plan, and location. We recommend checking with your employer or account provider to confirm your eligibility.

For product eligibility, customers can use HSA/FSA funds if they have one of the qualifying conditions listed during checkout.

Are there any limitations on using HSA or FSA funds?

Eligible products can be purchased more than once. However, limits may apply based on your HSA/FSA provider, such as account balance limits, daily spending caps, or other bank-specific rules.

Are customers in all states eligible to use HSA or FSA funds?

Most states are fully supported, however customers in Louisiana, New Mexico, and Mississippi are currently unable to use HSA/FSA funds through Flex for products requiring a Letter of Medical Necessity. These states have local laws that limit telehealth services, which Flex uses to facilitate the LMN process.

Eligible Products & Purchases

Which products are HSA/FSA eligible?

Eligible products are clearly shown during checkout. Some products require a Letter of Medical Necessity, which is completed as part of the checkout process through Flex.

Is sales tax covered by my HSA or FSA?

Yes! Sales tax on eligible items is also covered by your HSA or FSA funds. If you use split pay, the tax will be divided among payment methods.

Can I use my HSA or FSA for a reformer rental?

Yes! While reformer rentals must be paid using a personal card on file, your weekly rental payments are eligible for HSA/FSA reimbursement. Each week you will receive an email showing proof of payment — this email serves as your receipt and is what you'll need to submit to your HSA/FSA provider for reimbursement. Please note that receipts cannot be produced in PDF form. The deposit is not eligible for reimbursement as it is refunded by Your Reformer at the end of your rental once the reformer has been returned in great condition.

Paying at Checkout

How does checkout work when paying with HSA or FSA?

At checkout, select Pay with Flex as your payment method. You'll be guided through a short medical questionnaire and then redirected back to our site to complete your purchase.

Can I split my payment between my HSA/FSA and another card?

Split pay is available for qualifying conditions. If you'd like to use your HSA or FSA for part of your reformer purchase and cover the remaining balance with another card, split payment may be available. Select the split payment option on the Flex questionnaire page during checkout which will populate after the questionnaire if qualifying condition is met.

Why is my HSA or FSA card being declined?

HSA and FSA cards are debit cards, so the most common reason for a decline is insufficient funds. We recommend contacting your HSA or FSA administrator to confirm your available balance.

Letters of Medical Necessity

What is a Letter of Medical Necessity and what do I do with it?

A Letter of Medical Necessity (LMN) is documentation from a licensed healthcare provider stating that a product is necessary to treat or manage a specific medical condition. You should keep your LMN on file for at least three years in case of an IRS audit of your HSA or FSA account. Some FSA providers may also request it to confirm the eligibility of your purchase.

Do I need a Letter of Medical Necessity to rent a reformer?

Yes. Reformer rentals require a Letter of Medical Necessity (LMN). If you already have an LMN obtained prior to your rental, you can submit it during the checkout process. Please ensure your letter is from a licensed healthcare provider and clearly states the medical need for the equipment. You can also obtain a LMN through Flex at checkout.

What if I didn't receive my LMN or receipt from Flex?

Please log in to the Flex portal at withflex.com/portal using the same email address you used at checkout to download all documents related to your purchase. If you still need assistance, contact support@withflex.com and they will be able to help.

Still have questions or want to explore the details further? Visit our Payment Options article here to learn more and see how to make the most of your HSA/FSA benefits.