A mattress is typically not eligible for reimbursement with a Flexible Spending Account (FSA) or Health Savings Account (HSA). In limited cases, a mattress or mattress accessory may qualify if it is specifically prescribed by a physician to treat a diagnosed medical condition and supported by a Letter of Medical Necessity (LMN).
Why Is a Mattress Not FSA/HSA Eligible?
Mattresses are generally considered personal comfort items rather than medical equipment. Because they are used by the general population for rest and sleep—not to diagnose, treat, or prevent a specific medical condition—they do not meet the definition of medical care under IRS Code Section 213(d).
According to IRS Publication 502, personal items that promote general health or comfort are not reimbursable. This includes mattresses, bedding, and furniture, even when designed for ergonomic or orthopedic support.
What’s Not Covered?
Standard mattresses, bed frames, or bedding for comfort or home use
Orthopedic or memory foam mattresses purchased for posture or back support
Adjustable beds purchased without a medical prescription
Mattress toppers or specialty sleep products marketed for general wellness or recovery
Bedding upgrades made for convenience or luxury
LMN and Exceptions
A mattress may qualify for reimbursement in rare cases when it serves a medically necessary purpose, such as treating a diagnosed condition like:
Severe back pain or spinal disorders
Circulatory issues requiring elevation or specialized support
Sleep apnea, when part of a prescribed medical treatment setup
To pursue reimbursement, follow these steps:
Obtain a physician’s diagnosis outlining the medical condition being treated.
Request a Letter of Medical Necessity (LMN) specifying that a specialized mattress or adjustable bed is required for treatment.
Submit the LMN to your FSA/HSA administrator for pre-approval before purchasing.
Retain all documentation, including the LMN, purchase receipts, and any physician notes.
Only the additional cost of a medically necessary mattress or bed beyond a standard model may be reimbursable, and administrator approval is required.
