Does HSA cover orthotics?
Orthotics and orthopedic shoe inserts used to treat a medical condition are qualified HSA expenses — both custom-prescribed devices and eligible over-the-counter arch supports generally qualify.
What flips the answer
- Covered when
A podiatrist prescribes custom orthotics for a diagnosed foot or gait condition.
- Covered when
OTC arch supports or insoles are used to treat a diagnosed condition, with a Letter of Medical Necessity where the plan requires one.
- Not covered when
The purchase is ordinary comfort or fashion footwear with no underlying medical condition.
IRS Publication 502 treats devices that treat a physical defect or medical condition as qualified medical care. Custom orthotics a podiatrist prescribes for a diagnosed foot or gait problem clearly qualify, and their fitting and casting costs come along with them.
Over-the-counter insoles and arch supports are commonly listed as eligible by HSA and FSA administrators when they serve a therapeutic purpose — supporting a diagnosed condition like plantar fasciitis — rather than general comfort. Some administrators ask for a Letter of Medical Necessity for OTC inserts, so keeping documentation of the condition helps.
Ordinary shoes bought for comfort or fashion aren't covered, and the extra cost of orthopedic footwear is only eligible to the extent it exceeds the cost of ordinary shoes and is tied to a medical need.
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