If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), you're sitting on money that was set aside for exactly one purpose: your health. And if you're managing diabetes, some of the most useful tools for daily foot and circulation care — including compression therapy — can typically be paid for with those pre-tax dollars.
Yet every year, billions of dollars in FSA funds are forfeited because account holders don't spend them before the deadline. This guide covers what qualifies, how to pay, and the dates you need to know.
HSA vs. FSA: The 60-Second Version
- HSA (Health Savings Account) — Available if you have a high-deductible health plan. The money is yours forever: it rolls over year to year and moves with you between jobs.
- FSA (Flexible Spending Account) — Offered through an employer. The critical difference: most FSA money expires at the end of the plan year, usually December 31. Some plans offer a small carryover or a short grace period, but the default is use it or lose it.
Both work the same way at checkout: the account issues you a debit card that draws from pre-tax money. Because you never paid income tax on those dollars, spending them is effectively a 20–30% discount compared to paying out of pocket.
What Diabetic Foot Care Items Typically Qualify
Eligibility is defined by IRS rules (and your plan administrator has the final say), but items commonly eligible include:
- Compression therapy devices and compression garments used for a medical purpose such as poor circulation, swelling, or neuropathy symptoms
- Blood glucose monitors, test strips, and CGM supplies
- Diabetic footwear and orthotic inserts (often with a prescription)
- First-aid supplies for daily foot care and wound management
- Moisturizers and skin treatments that are medically necessary
A note on Letters of Medical Necessity (LMN)
Some plan administrators approve compression devices automatically; others ask for a short Letter of Medical Necessity from your doctor stating the item helps manage a medical condition (for example, diabetic circulation problems or leg swelling). It's usually a one-paragraph form your doctor's office completes in minutes. If your card is declined or a purchase is questioned, an LMN almost always resolves it — and you can submit the receipt for reimbursement instead.
How to Pay: 3 Steps
- Check your balance. Log in to your HSA/FSA provider's site or app. Note your plan-year deadline while you're there.
- Pay with the card. At checkout on betterwithbetics.com, enter your HSA/FSA debit card exactly like a regular credit card.
- Save the receipt. Keep your order confirmation. If your administrator asks you to substantiate the purchase, the receipt (plus an LMN if requested) is all you need.
If your card doesn't work for any reason, there's a second path: pay with a normal card, then submit the receipt to your plan for reimbursement. Most providers process claims in a few days.
"An FSA is the only account where doing nothing costs you money. If the funds expire December 31, spending them on your health in November is simply getting your own money back."
The December 31 Deadline
For most FSA holders, unspent money is forfeited at year-end. If you're managing diabetes, the end of the year is the natural time to ask: what would actually improve my daily routine next year? For many people with circulation problems, swelling, or neuropathy discomfort, a home compression therapy system is one of the most-used purchases they make — something that gets pulled out every evening, not put in a drawer.
Check your balance now, note your deadline, and don't leave your own money on the table.
This article is for general information only and is not tax or medical advice. Eligibility rules vary by plan — confirm with your plan administrator, and talk to your doctor about what's right for your care.