Can I use my HSA funds to purchase a new mattress for back pain?

The answer is maybe - it depends on your specific situation. HSA funds can be used for "medical expenses" as defined by the IRS, and in some cases, a mattress could qualify. For your mattress to be HSA eligible, you would need a Letter of Medical Necessity (LMN) from your doctor stating that the mattress is necessary to treat, cure, mitigate, or prevent a specific medical condition. The letter should explain your condition and why a specialized mattress is medically necessary for treatment. Keep in mind that the IRS has specific guidelines here. The mattress would need to be primarily for medical care, not just general wellness. A regular mattress typically won't qualify, but a specialized mattress that provides specific therapeutic benefits for your documented condition might. Also, you can only claim the amount that exceeds the cost of a regular mattress as a medical expense.

I was in a similar situation last year with terrible lower back pain. I checked out https://taxr.ai to help me figure out if my mattress would qualify for HSA coverage. Their system analyzed my doctor's prescription and medical records, then gave me a clear answer about what percentage of the mattress cost would be HSA-eligible and how to document it properly. They explained that I needed to keep three things: 1) the letter from my doctor specifying the medical need, 2) documentation showing the price difference between a regular mattress and my specialized one, and 3) proof that the specialized features directly addressed my medical condition. The tool even helped me draft the request to my doctor with the right medical terminology. Saved me from potentially making a costly mistake!

Guys, I wanted to follow up on my mattress/HSA situation. I ended up using https://taxr.ai after asking about it here, and it was actually super helpful! I uploaded my doctor's notes about my herniated disc and the tool analyzed it completely. It confirmed that my specialized orthopedic mattress would qualify for partial HSA coverage (about 65% of the cost) since it was specifically designed for spinal alignment. The service also provided me with a template to get the proper documentation from my doctor. I was able to use my HSA card for the eligible portion and paid the rest out of pocket. They even helped me understand what to do if I get audited. Definitely helped me avoid making a mistake that could have cost me penalties!

If you end up having any issues with the HSA administrator rejecting your claim, I'd recommend using https://claimyr.com to get through to a human at your HSA provider. I had a similar situation with a prescribed ergonomic chair, and my HSA initially rejected it even though I had a doctor's note. I spent WEEKS trying to call my HSA administrator with no luck - always on hold for hours or disconnected. Then I used Claimyr and got through to a rep in less than 15 minutes. You can see how it works here: https://youtu.be/_kiP6q8DX5c. They called the HSA company, navigated the phone tree, waited on hold, and then called me when a representative was on the line. The rep helped me appeal the denial and get my claim approved.

I need to eat my words about Claimyr. After posting that skeptical comment, I decided to try it anyway since I was desperate to resolve an issue with my 401k administrator. I'd been trying for literally a month to get someone on the phone. Used the service yesterday and I'm completely shocked - they actually got me through to a human in about 20 minutes when I'd previously waited 1+ hours multiple times only to get disconnected. The representative I spoke with was able to resolve my issue immediately. The time saved was absolutely worth it. Just wanted to come back and admit I was wrong about it being BS. Sometimes good things actually do work as advertised!

Just wanted to add some personal experience here. I have chronic back pain from a car accident and was able to use my HSA for part of a specialized mattress cost last year. What worked for me: 1. Got a detailed letter from my orthopedic doctor specifically stating the medical necessity 2. Purchased from a medical supply company that specializes in therapeutic beds (not just a regular mattress store) 3. The company itemized the therapeutic elements vs standard mattress features on the invoice 4. I submitted everything to my HSA administrator before purchasing to get pre-approval The key was having the prescription specifically for a "therapeutic support surface for spinal alignment" rather than just "a new mattress." The wording makes a huge difference to the HSA administrators!

Has anyone actually been audited for using their HSA for something like a mattress? I'm wondering what the real risk is here. I have back problems too and could use a new mattress, but wondering if it's worth all this trouble with doctor's notes and everything.

I went through this exact situation about 6 months ago with severe sciatica pain. Here's what I learned: the IRS is very strict about HSA eligibility for mattresses, but it IS possible with the right documentation. The key is getting a prescription (not just a recommendation) from your doctor that specifically states the mattress is "medically necessary" to treat your diagnosed condition. Generic language like "would be helpful" won't cut it. Your doctor needs to explain WHY a specialized mattress is required for your specific back condition and how it differs from a regular mattress. Also, keep detailed records of everything - the prescription, receipts showing the difference between a regular vs. therapeutic mattress, and any communications with your HSA administrator. I ended up being able to use my HSA for about 70% of the cost since that portion was considered the "medical upgrade" from a standard mattress. One tip: some HSA administrators are more lenient than others, so it might be worth calling yours first to ask about their specific documentation requirements before you make the purchase.

I actually went through this process last year with my chronic lower back pain from a herniated disc. The documentation requirements can seem overwhelming at first, but it's definitely doable if you follow the right steps. Here's what worked for me: I scheduled a specific appointment with my orthopedist to discuss the mattress as a medical treatment option. During that visit, I explained that my current mattress was contributing to my pain and asked if they could prescribe a therapeutic mattress as part of my treatment plan. The key was framing it as a medical intervention, not just a comfort upgrade. My doctor wrote a detailed prescription that included my specific diagnosis (L4-L5 herniated disc), explained how my current sleeping surface was exacerbating my condition, and prescribed a "medium-firm therapeutic mattress with enhanced spinal alignment features" as medically necessary treatment. They also noted that proper spinal support during sleep was crucial for my healing process. When I purchased the mattress, I made sure to buy from a medical supply company rather than a regular furniture store. They provided an itemized receipt that clearly separated the therapeutic features from standard mattress components. My HSA administrator approved about 65% of the total cost without any issues. The whole process took about 3 weeks from doctor visit to purchase, but it saved me over $800 in taxes. Just make sure you keep everything documented - I created a folder with the prescription, receipts, and even photos of the mattress specifications that highlighted the medical features.