Are nutritional shakes HSA eligible? A guide to IRS rules

December 6, 2025 •

3 min read

According to the IRS, nutritional supplements are generally not eligible for HSA reimbursement when used for general health purposes. This causes confusion for many HSA holders who want to know: are nutritional shakes HSA eligible?.

Quick Summary

Nutritional shakes are only HSA-eligible if a healthcare provider recommends them to treat a specific medical condition, requiring a Letter of Medical Necessity, not for general wellness or weight loss.

Key Points

Medical Necessity is Key: Nutritional shakes are only HSA eligible if prescribed by a healthcare provider for a specific medical condition, not for general wellness.
Letter of Medical Necessity (LMN): You must get an LMN from a licensed provider documenting the diagnosis and the need for the shake.
Documentation is Crucial: Keep all receipts, the LMN, and other relevant medical records for potential audits.
General Products Are Not Covered: Shakes for weight loss or athletic performance are not considered qualified medical expenses.
Reimbursement Process: Pay with a regular card and then submit a claim to your HSA administrator with the required documentation.
Penalties for Misuse: Using HSA funds for non-qualified expenses can lead to taxes and penalties.

Understanding HSA Eligibility for Nutritional Products

Health Savings Accounts (HSAs) offer a powerful way to pay for qualified medical expenses with pre-tax dollars. However, the IRS maintains strict rules regarding what qualifies as a legitimate medical expense. For products like nutritional shakes, the distinction rests on the 'medical purpose' rule: is the shake being used to treat or prevent a specific medical condition, or is it for general health and wellness?

The core principle is that items for general health, such as daily multivitamins or protein powder for athletic performance, are not eligible. In contrast, a medical food or supplement prescribed by a physician to manage a diagnosed disease is considered a qualified medical expense. This is the critical factor when determining if your nutritional shakes are HSA eligible.

The Role of a Letter of Medical Necessity (LMN)

For a nutritional shake to qualify as an HSA-eligible expense, you must obtain a Letter of Medical Necessity (LMN) from a licensed healthcare provider. This written documentation serves as proof that the nutritional supplement is required to treat, cure, mitigate, or prevent a specific illness or condition, and is not for general well-being.

What an LMN Must Include

To be valid, an LMN for nutritional shakes should contain several key pieces of information:

The patient's name and date of birth.
The specific, diagnosed medical condition requiring the supplement (e.g., metabolic disorder, Crohn's disease).
The exact nutritional shake or medical food being prescribed.
A clear statement that the shake is medically necessary for the diagnosed condition.
The specific dosage instructions and treatment duration.
The healthcare provider's signature, credentials, and contact information.

Conditions That May Warrant a Nutritional Shake

While shakes for general weight loss or fitness are not covered, there are specific medical conditions where a nutritional shake may be deemed medically necessary. These often include:

Malnutrition due to chronic illness or recovery from surgery.
Severe digestive issues, like Crohn's disease, that prevent nutrient absorption.
Inherited metabolic disorders, such as methylmalonic acidemia, which require specialized formulas.
Difficulty swallowing (dysphagia) or other issues where liquid nutrition is essential.

Submitting a Claim for HSA Reimbursement

Once you have your LMN and have purchased the nutritional shakes, you can submit a claim for reimbursement from your HSA. The process typically involves logging into your HSA provider's online portal.

Purchase the product: Use a regular credit or debit card for the purchase. If you use your HSA debit card for a non-eligible item, you may need to return the funds to your account.
Gather documentation: Keep your original receipts and the LMN from your healthcare provider.
Log the expense: Go to your HSA provider's website and enter the expense details, including the amount, date, and expense type.
Upload documents: Upload the receipt and LMN to your account for auditing purposes.
Choose reimbursement method: Select how you want to receive the funds, such as direct deposit or a paper check.

This robust documentation is crucial, as the IRS can audit HSA accounts to ensure all withdrawals were for qualified medical expenses. Failure to provide proper documentation can result in taxes and penalties on the non-qualified withdrawal.

A Comparison of HSA Eligibility


Feature	General Wellness Shakes	Medically Necessary Shakes
Purpose	Athletic performance, diet, general nutrition	Treatment of a specific disease or illness
HSA Eligibility	No	Yes, with proper documentation
Documentation Needed	None	Letter of Medical Necessity (LMN) from a healthcare provider
Example	Protein powder for muscle building	Specialized formula for a metabolic disorder
IRS View	Personal expense	Qualified medical expense

Conclusion: Navigating the Rules for Nutritional Shakes

Determining if your nutritional shakes are HSA eligible boils down to a single, critical factor: medical necessity. Shakes used for general health, weight management, or athletic performance are not covered. However, if a licensed healthcare provider prescribes a specific nutritional shake to treat or prevent a diagnosed medical condition, it becomes an eligible expense. The key to successful reimbursement is obtaining a comprehensive Letter of Medical Necessity (LMN) and maintaining thorough records of all purchases and documentation in case of an IRS audit. By following these clear guidelines, you can confidently use your HSA to cover these necessary medical expenses.

For a complete list of qualified medical expenses, consult IRS Publication 502, or speak to your HSA administrator for specific plan details.

Frequently Asked Questions

No, you cannot use your HSA card for any protein powder or nutritional shake. It must be a specific medical food recommended by a healthcare provider to treat a diagnosed medical condition, and you need a Letter of Medical Necessity.

An LMN is a document from a licensed healthcare provider that certifies a nutritional shake is medically necessary for treating a specific condition. It proves to your HSA administrator and the IRS that the expense is qualified, not for general wellness.

Not necessarily. A Letter of Medical Necessity can be provided by any licensed healthcare practitioner, which may include a doctor, registered dietitian, or other qualified professional.

No, nutritional shakes used for general purposes like weight loss or muscle gain are not considered eligible medical expenses by the IRS and therefore cannot be reimbursed through your HSA.

If you mistakenly use your HSA card for a non-eligible item, you should contact your HSA administrator to return the funds. Using HSA funds for non-qualified expenses can result in taxes and penalties.

You will typically log into your HSA account online, submit a claim with the expense details and date, and upload your receipt along with the Letter of Medical Necessity.

Yes, specialized baby formulas for infants with medical conditions, such as severe allergies or digestive issues, are generally considered HSA eligible, often requiring an LMN from a pediatrician.

You can find comprehensive guidance on eligible expenses by consulting official IRS sources, such as IRS Publication 502, or by contacting your specific HSA plan administrator.