What is FSA / HSA eligibility?
A Flexible Spending Account (FSA) and Health Savings Account (HSA) are pre-tax accounts you can use to pay for qualified medical expenses. The IRS lists "medical care" as expenses that diagnose, cure, mitigate, treat, or prevent disease — including over-the-counter braces and compression apparel intended to relieve a medical condition.
Compression sleeves for joint support, like the Pivot Sleeve, generally qualify as a medical expense under IRS Publication 502 when used to treat or mitigate a specific condition (osteoarthritis, patellofemoral pain, post-surgical recovery, chronic instability). Most FSA / HSA providers accept compression apparel; some require a Letter of Medical Necessity (LMN) for reimbursement.
The two ways to pay
1. Pay directly with FSA / HSA card
If your card is from a major issuer (HealthEquity, Optum, WEX, Navia, Further, etc.), it works at checkout exactly like a regular credit card. Enter the number as your payment method. The transaction codes through as a medical purchase.
2. Pay with a regular card, submit for reimbursement
Order with any credit card. After delivery, request a Letter of Medical Necessity by emailing lmn@pivotknee.com with your order number. Submit the LMN + your receipt to your FSA / HSA provider; reimbursement typically lands in your bank account within 7–10 business days of submission.
The Letter of Medical Necessity
If your provider requires an LMN, we'll provide one free of charge for any order. The letter includes:
- Description of the Pivot Sleeve and its compression profile.
- Reference to relevant compression-apparel categories under IRS Publication 502 and the SIGIS Eligibility List.
- Statement that the product is a medical-grade compression garment.
- Your order date, the SKU(s), and the total amount paid.
Email lmn@pivotknee.com with your order number to request. Turnaround is 1–2 business days.
A small number of FSA / HSA issuers run additional verification on compression purchases — the transaction may pend rather than approve instantly. If your card declines at checkout, contact your benefits administrator with the order amount and the SIGIS category code "compression sleeve" for verification, then try again. Or use option 2: pay with a regular card and submit for reimbursement.
What you'll need from your doctor
For straightforward over-the-counter compression use, no prescription is needed; the IRS eligibility is built into the product category. If your plan requires a doctor's note for any over-the-counter medical purchase, ask your physician for a brief letter on their letterhead stating: (a) you have a knee condition that benefits from compression, (b) a compression sleeve is recommended for symptom management, (c) the recommendation date. Most physicians can produce this in a routine visit or via patient portal request.
Tax records — keep your paperwork
The IRS requires you to keep records of FSA / HSA purchases for the period of your return + any applicable amendment window. Save (a) your order confirmation email, (b) the shipping confirmation, (c) the Letter of Medical Necessity if requested, and (d) any reimbursement paperwork from your provider. We retain order records indefinitely on our side; you can request a re-send of any past order's documentation at any time.
The fine print
This page is general information, not tax advice. Your specific plan's eligibility, documentation requirements, and reimbursement procedures are governed by your benefits administrator. For binding guidance, consult your plan's summary plan description or call your benefits administrator.
Questions
For FSA / HSA-specific questions: fsa@pivotknee.com. For general support: support@pivotknee.com.