How HSA and FSA Reimbursement Works for BioFit Clients

How HSA and FSA Reimbursement Works for BioFit Clients

Clients frequently ask whether they can use their HSA or FSA funds for CGM coaching and biosensors. The answer splits into two parts, and they work differently: the sensor itself, and everything else. Here is exactly how each works.

The Sensors: Already FSA/HSA Eligible

Both Dexcom Stelo and Abbott Lingo, the two over-the-counter continuous glucose monitors most relevant to BioFit clients, are sold as FSA and HSA eligible items directly at checkout. No prescription, diagnosed condition, or Letter of Medical Necessity is required for either sensor on the manufacturer side. Dexcom states plainly that Stelo is FSA and HSA eligible, and that customers can either use an FSA/HSA card directly at checkout or pay normally and submit the order invoice for reimbursement.1 Abbott's Lingo, cleared by the FDA as an over-the-counter glucose biosensor in 2024, is marketed the same way: FSA-eligible, no prescription required.2

This eligibility rests on IRS Publication 502, which treats diagnostic medical devices as qualified expenses in their own right, separate from the stricter “general wellness” category that requires proof of a diagnosed condition.3 A glucose biosensor is a diagnostic device, not a wellness gadget, which is why it clears FSA/HSA eligibility on its own.

Where It Can Still Get Held Up

Manufacturer eligibility does not guarantee a smooth reimbursement every time. Some plan administrators are more conservative than the IRS baseline and may ask for a Letter of Medical Necessity anyway, particularly for subscription purchases rather than one-time orders.4 If a client's card is declined at checkout or a claim is denied, that is almost always a plan administrator decision, not a change in the sensor's underlying eligibility. The fix is usually to pay out of pocket and submit the itemized invoice directly, which both Dexcom and Abbott make available for exactly this purpose.

What Is Different: BioFit Coaching and Certification Services

The sensor is one purchase. CGM coaching is a separate one, and it does not carry the same built-in eligibility. Coaching and certification services are evaluated under the general medical-care definition in Internal Revenue Code Section 213(d): amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease.3 That means:

• Licensed physical therapists, chiropractors, and registered dietitians providing care within their licensed scope of practice often qualify their own services directly, without a separate LMN, because the service itself is already medical care under Section 213(d).

• Personal trainers and health coaches typically do not have that direct pathway. Their coaching services usually need a Letter of Medical Necessity from a licensed provider, tied to a client's actual diagnosed condition, before the service qualifies for HSA/FSA reimbursement.

What This Means for BioFit Clients, in Practice

• The Dexcom Stelo or Abbott Lingo sensor: eligible for FSA/HSA reimbursement on its own, no diagnosed condition needed. Pay at checkout with an FSA/HSA card, or submit the invoice afterward.

• CGM coaching from a licensed PT, chiropractor, or RD: often qualifies directly through the provider's existing license.

• CGM coaching from a personal trainer or health coach: generally requires a Letter of Medical Necessity from a licensed provider, tied to a real diagnosed condition, before it qualifies.

• Every client's situation is still individual. Plan administrators vary, and eligibility can be denied even for a generally-eligible item if documentation is incomplete.

The Disclaimer That Applies Everywhere

Because eligibility is never guaranteed and always individual, every page referencing HSA/FSA reimbursement carries the same disclaimer: Eligibility varies. US only. Clients must have a qualifying HSA or FSA account and a diagnosed condition. A Letter of Medical Necessity from a licensed provider is required where applicable.

1. Dexcom. “Stelo Is FSA & HSA Eligible.” Stelo.com. Customers can use FSA/HSA funds directly at checkout or submit their order invoice for reimbursement; no prescription is required.

2. HSA Trackr. “FSA Coverage for Stelo CGM: Which Is Better? (2026).” Abbott Lingo, FDA-cleared as an over-the-counter glucose sensor in late 2024, is likewise marketed as FSA-eligible without a prescription.

3. Internal Revenue Service. “Publication 502 (2025), Medical and Dental Expenses.” IRS.gov. Diagnostic devices are treated as qualified medical expenses; general wellness items require a documented diagnosed condition to qualify.

4. HSA Trackr. “FSA Coverage for Stelo CGM: Which Is Better? (2026).” Some plan administrators request a Letter of Medical Necessity for over-the-counter CGM purchases despite manufacturer-stated eligibility, particularly for recurring subscription orders.