Pillows are typically not eligible for reimbursement with a Flexible Spending Account (FSA) or Health Savings Account (HSA). In rare cases, a specialized therapeutic pillow may qualify if prescribed by a physician to treat a diagnosed medical condition and supported by a Letter of Medical Necessity (LMN).
Why Are Pillows Not FSA/HSA Eligible?
Most pillows are considered household or personal comfort items rather than medical equipment. Under IRS Code Section 213(d), eligible medical expenses must be primarily for diagnosing, treating, or preventing a disease—not for general comfort, sleep improvement, or lifestyle enhancement.
According to IRS Publication 502, items used for general health or personal use are not reimbursable. Because pillows are commonly used by the general population for comfort and sleep, they are typically excluded from eligibility.
What’s Not Covered?
Standard bed pillows (memory foam, down, cooling, etc.)
Decorative or travel pillows
Ergonomic or contour pillows marketed for comfort
Pregnancy pillows purchased for support or positioning
Bedding accessories purchased for sleep improvement
LMN and Exceptions
A pillow may qualify only if it is considered durable medical equipment (DME) and prescribed to treat a specific diagnosed condition, such as:
Cervical spine injuries or chronic neck disorders
Post-surgical recovery requiring structured positioning
Severe sleep apnea requiring positional therapy
Documented musculoskeletal disorders that require therapeutic support
To pursue reimbursement:
Obtain a physician’s diagnosis specifying the medical condition.
Request a Letter of Medical Necessity (LMN) detailing why a specific therapeutic pillow is required as part of treatment.
Confirm eligibility with your FSA/HSA administrator before purchasing.
Submit the LMN and itemized receipt for reimbursement.
Even with documentation, approval is not guaranteed. Most standard or ergonomic pillows purchased for comfort or better sleep remain ineligible for FSA or HSA reimbursement.
Looking for something else? Check our full list of FSA and HSA eligible items and services to find out what's approved.