Fitness Expenses and HSA/FSA: What You Actually Can Deduct

If you’re enrolled in a high-deductible health plan (HDHP), you likely have a Health Savings Account (HSA) sitting in your name. The burning question many people ask: Can I tap into these pre-tax dollars to pay for my gym membership? The short answer is no—at least not in most cases. But there are important nuances worth understanding.

When Gym Memberships Don’t Qualify

Here’s the straightforward part: standard gym memberships are classified as personal or recreational expenses by the IRS, not medical necessities. This means withdrawing HSA funds to cover your CrossFit subscription or Planet Fitness annual fee will trigger taxes and penalties on that withdrawal amount. The same logic applies if you have an FSA (Flexible Spending Account) through your employer—gym membership costs don’t meet the qualified medical expense threshold for FSA distributions either.

The IRS is strict about this distinction. Just because exercise improves your overall health doesn’t automatically make it a deductible medical expense. Thousands of people stay fit without formal gym memberships, so the government views it as a lifestyle choice rather than a medical treatment.

The Exception: Doctor-Prescribed Fitness Programs

There is a pathway where fitness expenses can legitimately qualify. If your physician explicitly prescribes a gym membership as part of your treatment plan for a specific medical condition—such as obesity, Type 2 diabetes, cardiac rehabilitation, or post-surgical recovery—you may be able to use HSA funds for it.

The critical requirements are:

• Written prescription or documentation from your healthcare provider stating the gym membership is medically necessary
• Clear connection between your diagnosed condition and the prescribed fitness intervention
• Verification that your HSA provider will accept this as a qualified expense (policies vary)

This is where FSA participants have a slight disadvantage. Most FSA plans have stricter definitions of qualified expenses and shorter timeframes to use funds (typically use-it-or-lose-it by year-end), making it harder to accumulate documentation and receive approval for conditional expenses.

Alternative Qualified Health Expenses You Can Use HSA/FSA For

If a gym membership doesn’t work out, consider these legitimate alternatives that clearly qualify:

• Physical therapy and rehabilitation services prescribed by a doctor
• Chiropractic care and other licensed therapeutic treatments
• Medically supervised weight-loss programs with physician recommendation
• Prescription medications (including over-the-counter drugs prescribed by a provider)
• Dental work, orthodontics, eye exams, and corrective lenses
• Medical equipment like blood pressure monitors, glucose meters, or mobility aids
• Doctor visits, hospital stays, and surgical procedures, including deductibles and co-pays

Understanding HSA vs. FSA for Health Expenses

While both accounts allow pre-tax contributions for medical expenses, they have different rules:

HSA advantages: Contributions roll over indefinitely, allowing you to build substantial savings. For 2024, you can contribute up to $4,150 for individual coverage or $8,300 for family coverage (plus $1,000 catch-up for those 55+). Many HSA providers let you invest in stocks and bonds, potentially growing your balance long-term.

FSA characteristics: Money must typically be spent within the plan year—it doesn’t carry over. This “use-it-or-lose-it” structure creates urgency to identify and document qualified expenses before year-end. FSAs also have lower annual limits and don’t offer investment options.

The Bottom Line

Your HSA or FSA is a powerful tool for managing healthcare costs tax-efficiently, but gym memberships remain off-limits under standard circumstances. Unless your doctor prescribes fitness as part of a medical treatment plan with proper documentation, withdraw those funds for genuinely qualified expenses instead.

The smartest approach: maximize your HSA/FSA for legitimate medical expenses you know qualify, and pay for routine fitness activities from regular after-tax income. If your condition does require prescribed rehabilitation through a fitness facility, get everything in writing from your healthcare provider and confirm approval with your plan administrator before proceeding.