Does FSA cover weight-loss medication?
An FSA covers weight-loss medication when a doctor prescribes it to treat a diagnosed disease like obesity — but not when weight loss is for general health or appearance.
What flips the answer
- Covered when
A doctor prescribes the medication to treat a diagnosed disease — obesity, hypertension, heart disease, or type 2 diabetes.
- Covered when
You have a Letter of Medical Necessity documenting the diagnosis the medication treats.
- Not covered when
The weight loss is for general health or appearance with no diagnosed disease.
- Not covered when
The item is an OTC diet aid, meal replacement, or gym membership rather than a prescribed drug for a diagnosed condition.
IRS Publication 502 sets the same rule for FSAs as for HSAs: the cost of a prescribed weight-loss drug or program is a qualified expense when a physician directs it as treatment for a specific disease they've diagnosed — obesity, hypertension, heart disease, or type 2 diabetes.
Weight loss pursued to improve general health or appearance, without a diagnosed condition, is a personal expense the IRS excludes. With no qualifying diagnosis, the medication isn't FSA-eligible.
OTC diet products, meal-replacement foods, and gym memberships generally stay outside FSA eligibility even with a diagnosis, since the IRS treats food and fitness as personal. The reimbursable case is a prescription tied to a documented condition, and an FSA administrator may request a Letter of Medical Necessity.
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