The idea to question
Anything described as wellness qualifies for a health spending account.
The short answer
The Internal Revenue Service, or IRS, distinguishes treatment for a diagnosed disease from spending that merely supports general health. That is the rule reflected in September 2026. IRS guidance on medical expenses
Ask what makes this expense eligible
For weight-loss costs, IRS guidance links eligibility to treatment for a specific disease diagnosed by a physician, rather than weight loss alone. IRS guidance on medical expenses
Ask the office that runs your account what paperwork it needs for this expense. Keep the written answer and receipts.
A letter is part of the paperwork question
Ask the office that runs your account whether it needs a “letter of medical necessity.” This is a note from the health professional treating you, explaining why you need the medical expense. IRS information on expense records
As of September 2026, the IRS materials ask for proof of medical expenses without naming that letter as a requirement. Your account office may still ask for the letter. What the expense is for still decides whether it qualifies.
For a device or tracker, the IRS’s September 2026 guidance says general health monitoring alone is not enough; its main purchase and use must serve a specific disease-related purpose. IRS wellness-expense answers
Ask about the actual charge, rather than assuming a whole bundle receives the same treatment.