How to Use Your Flex Spending (FSA) or HSA on Running Gear: Watches, Gels, and Home Gym Equipment

Every December, millions of people lose money they already set aside in their flex spending account, or FSA, because they didn't spend it in time. If you're a runner, there's a good chance you can spend it on things you actually want: a new running watch, your race-day gels, or equipment for a home gym.

My wife and I have done all three. We've used our flex money on gels and supplements while training for a half marathon and a full marathon, on add-ons for our home gym rig, on a dumbbell set, and on an exercise bike. Next year I'm planning to use it on a new Garmin Forerunner.

Here's how it works, which brands take it, and what you should know before you try it.

How It Works: Truemed

The company that makes this possible is Truemed. It partners with a long list of fitness, nutrition, and wearable brands so you can pay with your FSA or HSA card right at checkout.

The process is simpler than you'd think. When you check out on a partner brand's website, you choose Truemed as your payment option and fill out a short online health questionnaire. A licensed clinician reviews your answers to see whether the purchase helps treat or manage a health condition. If you qualify, you get a Letter of Medical Necessity, and you finish checkout with your FSA or HSA debit card.

At the brands we've bought from, that was it. We paid with our flex card like any other card, with no receipts to submit and no reimbursement to wait on. It's honestly pretty slick. The process can vary by retailer, though. Some brands don't support direct checkout with an FSA or HSA card, and in that case you pay normally and submit your letter and receipt to your plan for reimbursement. Your plan administrator can also ask for documentation later, so keep your letter and receipts.

One thing to know: you have to buy direct from the brand's own website to use Truemed. It won't work through Amazon or other retailers.

Running Watches: Garmin, Coros, and Amazfit

This is the one most runners don't know about. Garmin, Coros, and Amazfit all partner with Truemed, which means you may be able to buy a new running watch with pre-tax money.

The key word is "may." A running watch isn't automatically FSA or HSA eligible just because the brand works with Truemed. Medical necessity has to be established through the health questionnaire and clinician review, and approval isn't guaranteed. If you do qualify, it's a big deal. Paying with pre-tax dollars can save you a good chunk depending on your tax bracket, and if your flex money is about to expire anyway, it's money you'd lose otherwise.

Not sure which watch to get? Our Watch Finder matches you to the right one in four questions, and our comparisons break down the most popular matchups, like the Garmin Forerunner 170 vs Forerunner 265, the Coros Pace 4 vs Garmin Forerunner 170, and the Amazfit Active 3 Premium vs Active Max. Once you've picked one, buy it from the brand's own site and choose Truemed at checkout.

Gels and Fuel: The Feed

This is where we've used it the most. My wife and I were both training for a marathon this year and ran a half marathon in the spring, and we burned through a ridiculous number of gels.

The Feed is a Truemed partner, and it carries most of the big sports nutrition brands in one place, from gels and chews to drink mixes and supplements. Same rules apply here, though. Gels and supplements aren't automatically eligible. Whether they qualify depends on medical necessity and your plan's rules, and the IRS is especially skeptical of food and supplement purchases. In our case it worked, but check before you count on it.

If you're not sure how much fuel you'll need, our guides on how to fuel long runs and races and electrolytes for long runs cover the numbers.

Home Gym Equipment: REP Fitness and Bells of Steel

Over the past couple of years, we built out a home gym, and Truemed helped a lot with it.

We bought a full rig with a pulley system from REP Fitness, then used our flex money on add-ons to build out the setup. We also bought a dumbbell set through Truemed. REP makes solid equipment, and being able to use pre-tax money on it made the whole project a lot easier to justify.

We also bought an exercise bike from Bells of Steel through Truemed. Honest review: it's okay for the money, but it's not on the level of a Peloton. If you want a Peloton bike or treadmill, Peloton also partners with Truemed.

For runners, a home gym is a great investment. Strength training is one of the best things you can do to stay healthy and run faster, and our guide to strength training for runners covers where to start. A treadmill is also a lifesaver in an Iowa winter. Our guide to treadmill running covers how to make those miles count.

What About Running Shoes?

This one's trickier. Most of the big running shoe brands, like Hoka and Brooks, aren't Truemed partners right now. Altra is one of the few that is.

Shoes may qualify but eligibility depends on the medical circumstances and applicable requirements. If that's you, it's worth checking. If not, you're better off putting your flex money toward a watch, fuel, or equipment.

What to Know Before You Buy

It has to be for a real health reason. The questionnaire asks about your health, and the clinician is deciding whether the purchase helps treat or manage a condition. It's not a loophole for free stuff. The IRS has warned that general health and wellness expenses don't qualify, even with a doctor's note based on self-reported information, and your FSA or HSA administrator always has the final say. Truemed explains how qualification works in its eligibility overview. Answer honestly and keep a copy of your Letter of Medical Necessity in case your plan ever asks for it.

Flex money usually expires December 31. Most flex spending accounts are use-it-or-lose-it at the end of the plan year. Some plans give you a grace period into the next year or let you carry over a small amount, so check your plan's rules. That deadline is why now is the time to use it.

HSA money generally doesn't expire. If you have an HSA instead of an FSA, your money generally rolls over year to year, so there's no rush. You can still use Truemed whenever you're ready to buy.

Buy direct. Truemed only works on the brand's own website, not Amazon or other retailers.

There may be a small fee. Depending on the brand, there can be a small fee for the Letter of Medical Necessity, often around $20 to $30. On a watch or a big equipment purchase, that's nothing compared to the tax savings.

The Bottom Line

If you've got flex money sitting there, don't let it expire. A running watch, a training block's worth of gels, or a piece of home gym equipment may all be options through Truemed, as long as you buy from a partner brand and a clinician agrees it fits a real health need. For us, it's paid for a big chunk of our home gym and our race fuel, and it'll pay for my next watch.

Still deciding what to spend it on? Check out our best running watches of 2026 or our breakdown of the recovery tools that actually work.

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This article is based on my own experience and is not tax or medical advice. FSA and HSA rules vary by plan, so check with your plan administrator if you have questions about what qualifies.