Answers based on IRS guidance, Truemed documentation, and real-world HSA/FSA administrator practices.
Eligibility & Qualification
How do I know if I qualify to use HSA/FSA?
Eligibility is determined on a per-customer basis, not by product. During checkout, you'll complete a short health assessment through Truemed. An independent licensed practitioner reviews your responses and, if your health situation qualifies, issues a Letter of Medical Necessity (LMN). Not every customer will qualify — the practitioner makes the final determination based on clinical criteria. If you don't qualify, you can still purchase using standard payment methods.
What health conditions typically qualify?
Common qualifying conditions include chronic pain, arthritis, cardiovascular concerns, muscle recovery needs, stress/anxiety management, sleep disorders, chronic inflammation, and metabolic conditions. The key requirement under IRS rules is that the purchase must be primarily for treating, preventing, or mitigating a specific diagnosed medical condition. General wellness, relaxation, or athletic performance goals do not qualify. The licensed practitioner makes the final determination based on your individual health assessment.
What products are eligible for HSA/FSA checkout?
Truemed reviews and approves individual products through its compliance team — merchants cannot self-designate products as eligible. Currently, our eligible categories include complete sauna units (traditional and infrared) and FDA-cleared red light therapy devices. Accessories such as buckets, ladles, thermometers, and hats are not eligible. If you check out with a mix of eligible and ineligible items, your entire claim could be denied. We recommend purchasing eligible and ineligible items in separate orders.
What about sauna heaters, controllers, and stones purchased separately?
Components required for a medically-prescribed sauna to function — such as heaters, controllers, and stones — have a legal basis for eligibility under IRS regulations covering the operation and maintenance of medical equipment. However, Truemed must independently approve each product SKU through its compliance team before it can be purchased with HSA/FSA funds. A heater purchased as a replacement for a prescribed sauna has a stronger case than one purchased speculatively.
Contact us before checkout if you plan to use HSA/FSA for standalone components — we can confirm which specific products are approved.
Are red light therapy devices eligible?
Yes. Our red light therapy devices are FDA-cleared Class II medical devices, which provides a strong foundation for HSA/FSA eligibility. The same checkout process applies — select "Truemed - Pay with HSA/FSA" and complete the health assessment.
How to Pay
Can I use my HSA debit card directly?
Yes. HSA debit cards work at most merchant categories with minimal scrutiny at the point of sale. Your HSA administrator processes the charge like any debit transaction — they see the merchant name and total amount, but not individual line items. Select "Truemed - Pay with HSA/FSA" at checkout and enter your HSA card details. Keep your Letter of Medical Necessity on file in case of an IRS audit.
Can I use my FSA debit card directly?
We recommend paying with a regular credit card and submitting for reimbursement instead. FSA cards frequently decline at non-medical merchant categories, and FSA administrators are required by law to substantiate every claim — unlike HSA administrators, they actively review whether each purchase qualifies. The most reliable process for FSA holders: pay with your regular credit card at Truemed checkout, receive your LMN, then submit your receipt and LMN to your FSA administrator for reimbursement.
Can I split payment between HSA/FSA and a regular card?
Yes. Truemed supports split payments. You can pay part of the purchase with your HSA/FSA card and the remainder with a regular credit or debit card. You can also pay the full amount with a credit card and submit for partial reimbursement — for example, reimburse $3,400 from your FSA and pay the rest out of pocket. This is especially useful when your account balance is lower than the product price.
How does the reimbursement process work?
If you pay with a regular credit or debit card: complete the Truemed checkout and health survey, receive your Letter of Medical Necessity (usually within 24-48 hours), then submit your purchase receipt along with the LMN to your HSA/FSA administrator. Most administrators process claims within a few days. The specific steps and timeline vary by plan — check with your HR department or plan provider for their submission process.
HSA vs FSA: Key Differences
What's the difference between HSA and FSA for sauna purchases?
HSA (Health Savings Account): You own the account. Funds roll over year to year and never expire. Requires a high-deductible health plan. HSA administrators generally do not review individual purchases at the point of sale — the account holder is responsible for ensuring expenses qualify. In an IRS audit, you'd need to produce your LMN and purchase records.
FSA (Flexible Spending Account): Your employer sponsors the account. Funds typically expire at the end of the plan year, though some plans allow a small carryover or grace period. FSA administrators must substantiate every claim and actively review whether purchases qualify. This makes FSA claims more likely to be scrutinized.
Bottom line: HSA is generally smoother for high-ticket sauna purchases. FSA works but requires more careful documentation and the reimbursement pathway is safer than direct card use.
What are the 2026 HSA and FSA contribution limits?
HSA: $4,400 individual, $8,750 family, plus $1,000 catch-up if 55+. HSA funds roll over indefinitely.
FSA: $3,400 per year. Most FSA plans follow a use-it-or-lose-it rule — some allow a $640 carryover or a 2.5-month grace period.
If your purchase exceeds your available balance, you can split payment or pay with a credit card and submit for partial reimbursement.
My FSA funds expire soon — can I still use them?
Yes, and this is one of the smartest uses of expiring FSA dollars. If you have unused FSA funds approaching your plan year deadline, purchasing an eligible sauna or red light device puts those pre-tax dollars to work rather than forfeiting them. Check your plan's exact expiration date with your HR department. For next year, open enrollment is typically October through November — you can increase your FSA election if you're planning a larger purchase.
After Your Purchase
What is the return policy for HSA/FSA purchases?
Our standard return policy applies to all HSA/FSA purchases — there is no "final sale" restriction. No IRS rule requires HSA/FSA purchases to be final sale. If you need to return a product, the refund is processed back to your original HSA/FSA card within 3-10 business days.
For HSA holders returning a product: Once the refund hits your HSA, the original purchase is no longer a qualified medical expense. You can notify your HSA custodian to treat it as a "mistaken distribution" under IRS Notice 2004-50. Funds returned this way are not subject to income tax or the 20% penalty, and they don't count against your annual contribution limit. The deadline to report this is April 15 following the year you learned of the return. Most HSA custodians accept mistaken distributions, though they are not required to.
For FSA holders returning a product: The refund goes back to your FSA plan via the original card. If your plan year has already ended, the use-it-or-lose-it rule may apply — returned funds could be forfeited to the employer plan rather than credited back to you. FSA holders should be especially sure of their purchase before buying.
Our team is available before and after purchase to help you choose the right product.
What happens if my claim is denied by my plan administrator?
A claim denial does not affect your purchase with Sauna Republic. You already own the product and we already have your payment. The denial is a matter between you and your HSA/FSA plan — it does not create a reversal or chargeback against your order.
Step 1 — Contact Truemed. Email support@truemed.com with your denial notice, the reason given, and any codes provided. Truemed's team will work with their Medical Group to rewrite your LMN to meet your administrator's specific requirements. Truemed reports overturning the majority of denied claims through this process.
Step 2 — Resubmit. Submit the updated LMN to your administrator.
If the appeal fails: Truemed's Terms of Service include a discretionary provision where they may offer approximately 30% of the purchase price to offset your lost tax savings. This is Truemed's payment to you directly — it is not charged to or deducted from your order. This payment is at Truemed's sole discretion and is not guaranteed.
Common denial reasons: Missing or incomplete LMN, LMN dated after the purchase, a cart mixing eligible and ineligible items, or the administrator requiring a specific form.
What if my administrator asks me to repay my HSA/FSA?
This can happen if your administrator determines the purchase was not a qualified medical expense after the transaction has already processed. The administrator asks you (the account holder) to repay the plan — this does not affect the merchant or your product order.
For HSA: If you repay the amount, your HSA custodian may process it as a return of a mistaken distribution. You would not owe income tax or the 20% penalty on the repaid amount.
For FSA: Your employer or TPA will typically deduct the amount from future paychecks or require direct repayment. FSA administrators have strong enforcement incentives because the employer's entire cafeteria plan could lose its tax-favored status if it reimburses non-qualified expenses.
We recommend working through the Truemed appeal process first — most denied claims can be resolved with an updated LMN before repayment becomes necessary.
Can I use my LMN for future purchases?
Yes. Your Letter of Medical Necessity is valid for 12 months from the date of issuance. During that period, you do not need to complete the health survey again for additional eligible purchases. You still need to submit each new receipt to your HSA/FSA administrator for reimbursement. After 12 months, you would need a new health assessment through Truemed.
What if my HSA/FSA account is closed after my purchase?
If you need a refund and your HSA/FSA account has been closed, the refund still posts to that account. You'll need to work directly with your former plan administrator to retrieve the funds — Truemed cannot redirect refunds to a different payment method. This is a compliance requirement enforced by both IRS rules and the payment processor. Confirm your account is in good standing before purchasing.
Tax & IRS Considerations
What happens if the IRS audits my HSA/FSA sauna purchase?
In an audit, you would need to demonstrate that the expense was a qualified medical expense. Your key documentation: (1) your Letter of Medical Necessity, (2) your purchase receipt, and (3) any correspondence with your HSA/FSA administrator. Keep these records for at least 3 years from your tax return filing date.
For HSA purchases, the account holder bears full responsibility for ensuring expenses qualify — HSA administrators do not police purchases. For FSA purchases, your administrator has already substantiated the claim, which provides additional documentation.
The audit risk is on the account holder, not the merchant. Sauna Republic has no IRS reporting obligations related to your HSA/FSA payment.
What are the penalties for a non-qualified HSA distribution?
If an HSA distribution is determined not to be a qualified medical expense, the account holder owes income tax on the full amount plus a 20% additional tax penalty. For example, on an $8,000 non-qualified distribution at a 30% marginal rate, you would owe approximately $2,400 in income tax plus a $1,600 penalty — roughly $4,000 total. This underscores the importance of having a legitimate medical condition and a properly issued LMN. The 20% penalty does not apply if you are 65 or older, disabled, or if the distribution is returned as a mistaken distribution before the filing deadline.
Has the IRS said anything about using HSA/FSA for wellness equipment?
In March 2024, the IRS issued an alert (IR-2024-65) reminding taxpayers that general health and wellness expenses do not qualify for HSA/FSA unless prescribed to treat a specific diagnosed condition. The IRS cautioned that documentation based solely on self-reported health information may not meet legal requirements. No enforcement actions against consumers or merchants have been publicly reported, but the alert signals increased scrutiny.
This is why Truemed's health assessment involves a licensed practitioner making a clinical determination — not a rubber-stamp process. We encourage customers to be thorough and honest in the health assessment.
General Questions
How long does the Truemed approval process take?
Most health assessments are reviewed within 24-48 hours. Once approved, you'll receive your LMN via email and your order processes immediately. If you don't see it in your inbox, check spam, then contact support@truemed.com.
What if I don't qualify for an LMN?
You can still purchase any product using standard payment methods — credit card, debit card, Shop Pay, or
0% APR financing. Not qualifying for HSA/FSA does not prevent you from buying. You may reapply at a later date if your health circumstances change.
Are there any fees for using Truemed?
There is no additional fee charged to you. The cost of the health assessment and LMN is included in the transaction. You pay the same product price whether you use HSA/FSA funds or a regular payment method.
Can I still get free shipping and value stack bonuses with HSA/FSA?
Yes. All Sauna Republic promotions, free shipping, and value stack bonuses apply regardless of payment method. HSA/FSA customers receive the same benefits as every other customer.