How to use your HSA or FSA to buy a sauna

A traditional sauna can qualify as an HSA/FSA-eligible medical expense — meaning you can pay with pre-tax dollars and effectively save 20-35% off your purchase. Here's exactly how to qualify, what your doctor needs to write, and how to submit for reimbursement.

June 3, 2026 · 7 minute read

If you've been pricing out a cedar sauna for your home, you've probably already noticed they're not cheap. A custom-built cedar sauna typically runs $5,000 to $15,000 by the time you include the heater, delivery, and installation. What most buyers don't realize is that a meaningful chunk of that cost can come straight out of your HSA or FSA — essentially paid for with money you've never been taxed on.

This guide walks through exactly how it works, what you need to do, and the most common questions buyers ask us.

The short version

Yes, you can use your HSA or FSA to buy a sauna. To qualify, you need a Letter of Medical Necessity (LMN) from a licensed medical provider stating that the sauna is recommended to treat or prevent a specific medical condition. Once you have that letter, you can either pay directly with your HSA/FSA card or pay out of pocket and submit for reimbursement.

If your tax bracket is around 24% federal plus state, a $10,000 sauna purchase saves you roughly $2,400 to $3,500 in taxes. Real money.

What is a Letter of Medical Necessity (LMN)?

An LMN is a short letter from a licensed healthcare provider — usually a primary care physician, but it can also come from a chiropractor, naturopath, physical therapist, or other licensed practitioner depending on your plan. The letter states three things:

1. The medical condition being treated (chronic pain, cardiovascular health, recovery from injury, autoimmune symptoms, etc.)
2. That a sauna is recommended as part of the treatment plan
3. The duration the treatment is expected to be necessary (often 12 months, sometimes longer)

That's it. There's no special form, no government registration, no waiting period. A doctor who agrees that sauna therapy will help your condition can write one in five minutes.

Medical conditions saunas commonly address

This isn't medical advice — it's a list of conditions for which there's published research supporting regular sauna use as part of treatment. Discuss your specific situation with your doctor:

• Cardiovascular health — regular sauna use is associated with lower blood pressure and reduced cardiovascular event risk (Finnish studies on 2,300+ men over 20 years)
• Chronic pain — fibromyalgia, lower back pain, arthritis, and post-injury recovery
• Muscle recovery — particularly for athletes or active adults dealing with overuse
• Stress and anxiety — heat therapy raises endorphins and lowers cortisol
• Sleep disorders — body temperature regulation supports deeper sleep
• Autoimmune conditions — Lyme, chronic fatigue, and similar conditions where detoxification protocols are recommended
• Depression and mood disorders — emerging research on heat therapy as an antidepressant adjunct

Sample Letter of Medical Necessity

Here's a template your doctor can adapt. Many doctors will just sign a version of this if you bring it in — it saves them from writing it from scratch:

Step-by-step: how to actually buy a sauna with your HSA

Step 1 — Talk to your doctor

Schedule a visit (or include this in your next annual physical). Tell your doctor you're interested in sauna therapy for [your condition] and ask whether they'd be willing to write an LMN. Bring the template above. Most doctors won't have an issue with this for legitimate conditions.

Step 2 — Get the LMN in writing

Make sure it's signed, dated, on letterhead, and includes the doctor's NPI number. Keep both digital and paper copies. Your HSA/FSA administrator may ask for it at any time.

Step 3 — Decide how to pay

You have two options:

• Pay directly with HSA/FSA card. Some buyers do this, but be aware: large purchases on HSA cards sometimes get flagged for review. You may be asked to submit the LMN within 30-90 days to substantiate the expense.
• Pay out-of-pocket and submit for reimbursement. This is what we recommend for larger sauna purchases. You pay with a credit card or via financing, then submit our itemized invoice plus your LMN to your HSA administrator. They reimburse you back into your bank account, usually within 1-2 weeks.

Step 4 — Save everything

Keep your LMN, our itemized invoice, the receipt of payment, and any reimbursement confirmation. If you're ever audited by the IRS, this is your paper trail. We recommend keeping copies for at least 7 years.

Common questions we get

Does Cedar Built or Pulse Wellness handle the HSA paperwork for me?

We don't write the LMN — that has to come from your doctor. But we do provide a detailed itemized invoice that clearly shows the sauna purchase, components, installation, and delivery as separate line items. This is exactly what HSA administrators want to see.

What if I'm financing the sauna?

You can still use your HSA. Pay your monthly financing payments out-of-pocket, then submit the invoice and LMN to your HSA administrator for reimbursement of the full purchase amount. The reimbursement money is then yours to use however you want — including paying down the financing balance.

Do infrared saunas qualify too?

Generally yes, though some HSA administrators are more conservative about infrared specifically. A traditional cedar sauna with a Harvia or HUUM heater is the most universally accepted option. If you want infrared, double-check with your plan administrator first.

What about the heater, delivery, and installation costs?

These are typically all eligible since they're necessary components of the medical equipment. We invoice everything as a single medical-equipment purchase with itemized line items, which is what most administrators want to see.

Can I get reimbursed for a sauna I already own?

Typically no — the LMN needs to predate the purchase. The IRS considers expenses incurred before the doctor's recommendation to be personal expenses, not medical expenses. If you're planning to buy, get the LMN first.

What you'll actually save

Quick math on what HSA dollars are actually worth. If you're in a typical income bracket:

• Federal tax savings: roughly 22-24%
• State tax savings: roughly 4-7% depending on state (Utah is around 5%)
• FICA savings (only on HSA contributions through payroll): 7.65%

For most working professionals, a dollar contributed to your HSA buys what would otherwise take roughly $1.30 to $1.45 of after-tax money. On a $10,000 sauna, you're effectively getting it for $7,000 to $7,700 net out-of-pocket.

Disclaimer: Pulse Wellness Co. is not a tax advisor, financial advisor, or medical provider. The information in this guide is general in nature and reflects common IRS interpretations and HSA administrator practices as of June 2026. Tax laws, IRS rules, and HSA/FSA plan rules change. Always confirm eligibility with your plan administrator and consult a CPA before making purchase decisions based on tax considerations.