Truemed: How to Buy Clinical Equipment with HSA or FSA Funds
Unlock your pre-tax health dollars to purchase clinical-grade equipment through Truemed's seamless HSA and FSA eligibility platform.
Truemed lets you use HSA or FSA funds for clinical equipment by connecting you to a licensed clinician who reviews your intake form and, where appropriate, issues a letter of medical necessity, effectively reducing your out-of-pocket cost by 20 to 37 percent depending on your tax bracket.
- 20 to 37 Percent Savings: HSA and FSA funds are pre-tax money, so depending on your income bracket, using them can cut a purchase price by 20 to 37 percent.
- The IRS requires that an expense diagnose, treat, or prevent a specific disease, so vague goals like feeling better or reducing stress will not qualify.
- Start with a clear, specific description of your condition before opening any intake form, because the clinician needs that context to make a sound determination.
- Most denials come down to a vague condition, an equipment choice that does not map to it, or an incomplete form, all of which are avoidable with preparation.
- If you are equipping a practice rather than buying for personal use, the HSA and FSA pathway does not apply, but the equipment is typically fully deductible as a business expense.
Where to start
Chattanooga Intelect Focus Shockwave Set includes standard accessories
DioWave Class IV 60W Therapeutic Laser System
What Truemed Actually Does for Health Equipment Purchases
Truemed is a platform that connects HSA and FSA account holders with a licensed healthcare provider who can issue a letter of medical necessity, allowing eligible wellness and clinical equipment purchases to be paid for with pre-tax dollars. The short version: instead of paying out of pocket, you submit a brief intake form, a clinician reviews your situation, and if appropriate, they issue documentation that unlocks HSA or FSA payment for equipment that would otherwise sit outside the standard eligible-items list.
This matters because HSA and FSA funds are pre-tax money. Depending on your income bracket, using them can effectively cut a purchase price by 20 to 37 percent. On a piece of clinical equipment priced at several thousand dollars, that is a real and meaningful saving. Truemed does not sell equipment and does not issue the letter itself. It connects you to an independent licensed clinician who makes the medical determination. The platform handles the paperwork workflow; the clinician handles the professional judgment.
Peak Primal Wellness supports HSA and FSA purchasing for qualifying clinical equipment. If you see an HSA/FSA option during checkout or on a collection page, that pathway is what the process described in this article is designed to support. Whether the exact platform shown is Truemed or a comparable letter-of-medical-necessity service, the steps, the eligibility logic, and the documentation requirements work the same way.
HSA and FSA Basics: Why Clinical Equipment Is Tricky
Health Savings Accounts and Flexible Spending Accounts both let you set aside pre-tax income to cover qualified medical expenses. The IRS defines what qualifies under Section 213(d), and that definition is broader than most people realize. It covers diagnosis, treatment, and the prevention of a specific disease or condition, not general health maintenance. That distinction is where clinical equipment gets complicated.
A TENS unit prescribed to manage chronic nerve pain is a qualified expense. The same device bought to "feel better" generally is not. A therapeutic laser used in a treatment plan for a documented musculoskeletal condition sits in a different category than one purchased speculatively. The equipment itself is not automatically in or out. What determines eligibility is the purpose, and whether that purpose is supported by a healthcare provider's recommendation.
HSAs belong to you and roll over indefinitely. FSAs are employer-administered and typically must be used within the plan year, though some plans offer a grace period or limited rollover. Both accept the same qualifying expense logic. If you have an HSA through a high-deductible health plan, you generally have more flexibility, but the eligibility rules for what counts as a medical expense apply equally to both account types.
What You Will Need Before You Begin
Getting through the process smoothly is mostly a matter of having the right information ready before you open the intake form. Clinical equipment purchases at this price point involve real documentation, and the clinician reviewing your file will need enough context to make a sound determination.
- A clear description of your condition or the condition you are treating, using specific terms where possible (for example, "chronic plantar fasciitis with heel spur" rather than "foot pain")
- Any existing diagnosis documentation, referral notes, or prior treatment records from your own physician or physical therapist
- The name and price of the specific equipment you intend to purchase
- Your HSA or FSA account details, including the name of the account administrator and the type of account
- A valid email address and the ability to receive and store PDF documents, since the letter of medical necessity will be issued digitally
- Payment method for the Truemed or LMN service fee, which is separate from the equipment cost and is typically a flat fee in the range of $30 to $75
You do not need to have already purchased the equipment. In most cases, you go through the letter process first, then use the resulting documentation to pay via your HSA or FSA card at checkout. Some platforms allow you to submit for reimbursement after the fact, but going in order avoids any question about timing.
Step-by-Step: Using Truemed or an LMN Service for Clinical Equipment
Identify the equipment and confirm HSA/FSA support
Start at the product page or collection page on Peak Primal Wellness. Look for the HSA/FSA indicator near the price or in the checkout flow. Not every product in the catalogue carries this designation. If you are browsing the clinical equipment collection, eligible products will generally be marked. Confirm the specific model before starting the intake process, because the letter of medical necessity will reference the equipment by name and intended use.
Open the Truemed or LMN intake form
The intake link appears during checkout or on the product page where HSA/FSA purchasing is supported. Clicking it opens a short form asking about your health history, the condition being treated, and why you believe this equipment is medically appropriate for your situation. Answer specifically. Vague answers like "general wellness" are less likely to result in an approved letter than documented conditions with clear treatment rationale.
Pay the clinician consultation fee
The platform charges a flat fee for the licensed clinician review. This fee is not refunded if the clinician determines your situation does not qualify, because you are paying for the professional review, not the outcome. The fee itself may be eligible as a medical expense through your HSA or FSA, though that depends on your plan administrator. Check your plan documents or contact your HSA/FSA administrator directly.
Wait for the clinician's review and letter
Turnaround is typically one to three business days, though some platforms offer expedited review. If the clinician approves the request, you receive a PDF letter of medical necessity. This document names the equipment, describes the condition being treated, and provides the clinical rationale for the recommendation. Store this letter carefully. Your HSA or FSA administrator may ask for it if a purchase is audited.
Use your HSA or FSA card at checkout
Return to Peak Primal Wellness and complete your purchase. At checkout, select the HSA or FSA card option and pay with your benefits card. The transaction should process the same way a standard debit card transaction does. If the card is declined (which occasionally happens because the merchant category code does not automatically signal "medical"), you can pay by another method and submit for reimbursement using the letter as supporting documentation.
File the documentation and keep your records
Save the letter of medical necessity, your purchase receipt, and any correspondence in one place. IRS rules require you to be able to substantiate HSA and FSA withdrawals as qualified medical expenses. The audit window for HSA distributions is the same as the general income tax statute of limitations, typically three years from the filing date. A clearly organized folder with the letter, receipt, and account statement is enough to satisfy that requirement.
Which Clinical Equipment Is Most Likely to Qualify
The IRS does not publish a comprehensive equipment list, which is why the letter-of-medical-necessity process exists in the first place. What the IRS does say is that an expense qualifies if it is primarily for diagnosing, treating, mitigating, or preventing a specific disease or condition. Clinical equipment that maps clearly onto a documented condition is generally where approvals happen.
Shockwave therapy devices are a strong example. The Chattanooga Intelect Focus Shockwave is cleared specifically for the non-invasive treatment of chronic proximal plantar fasciitis, a diagnosable condition with established ICD codes. When a patient has documented heel pain due to plantar fasciitis and a clinician recommends focused shockwave as part of the treatment plan, the connection between the condition and the equipment is direct and documentable. That is exactly the kind of case where a letter of medical necessity is well-supported.
Therapeutic laser systems follow similar logic. The Diowave Class IV platform, available in 45W and 60W configurations, is designed to address neuromusculoskeletal pain, including conditions like spinal stenosis, degenerative arthritis, and disc herniations. These are specific, diagnosable conditions. A patient managing one of them, whose clinician has recommended high-power laser therapy as a treatment modality, has a straightforward case for HSA or FSA qualification. The 45W system is priced at $29,260 and the 60W at $33,150, making the pre-tax saving on either substantial. Both models also include a software upgrade path from 30 or 45W to 60W, so a practice investing in the lower tier does not necessarily have to replace the unit if needs change.
Performance assessment tools like the Kinvent 3D Deltas force plate system occupy a somewhat grayer area. Force plates are used for balance testing, strength assessment, and movement analysis, all of which have clinical applications in rehabilitation and injury prevention. Whether a specific purchase qualifies depends heavily on how the use case is framed and documented. If the device is used within a rehabilitation or physical therapy context to evaluate a patient's recovery from a musculoskeletal injury, the clinical rationale is present. If it is purchased primarily for athletic performance monitoring, the connection is weaker. This is precisely the kind of nuanced case where a clinician's independent judgment, through the Truemed process, is what resolves the question.
| Model | Type | Price | Primary clinical use |
|---|---|---|---|
| Chattanooga Intelect Focus Shockwave Set |
Focused shockwave | $50,176.02 | Chronic plantar fasciitis, heel spur |
| DioWave Class IV 60W Therapeutic Laser System |
Class IV laser | $33,150 | Neuromusculoskeletal pain, neuropathy, stenosis |
 DioWave Class IV 45W Therapeutic Laser System |
Class IV laser | $29,260 | Neuromusculoskeletal pain, upgradeable to 60W |
 Kinvent 3D Deltas Multi-Axis Force Plate System |
Force plate | $28,000 | Balance, strength assessment, rehab evaluation |
The table above covers the main products in this category that may be eligible for HSA or FSA purchasing with appropriate documentation. Prices reflect what PPW carries as an authorized dealer. The "primary clinical use" column reflects the manufacturers' own stated applications, which is also the framing a clinician will use when drafting the letter of medical necessity.
Common Reasons a Letter of Medical Necessity Gets Denied
The clinician reviewing your intake is making a genuine professional determination, not rubber-stamping a form. Denials happen, and they tend to cluster around a few predictable issues.
- The condition described is general (fatigue, stress, low energy) rather than a specific diagnosable condition. These do not meet the IRS treatment or mitigation standard.
- The equipment does not have a clear clinical application to the stated condition. Requesting a letter for a force plate to treat plantar fasciitis, for example, would be difficult to support.
- The intake form is incomplete or inconsistent. A clinician reviewing a file cannot infer information that was not provided.
- The purchase is for a business or practice rather than for the individual account holder. HSA and FSA funds cover expenses for the account holder, their spouse, and qualifying dependents. A clinic purchasing equipment for patient use cannot use an individual's HSA to fund that purchase.
- The same condition has already been resolved or treated, and the equipment is now for general maintenance rather than active treatment.
If a letter is denied, you are not barred from trying again with better documentation, or from consulting your own physician to obtain a recommendation through a different process. The Truemed platform is one pathway, not the only one. Any licensed clinician can issue a letter of medical necessity, and your own doctor may be willing to do so if they are familiar with your treatment history.
For Clinics and Practices: A Different Calculation
If you are equipping a physical therapy practice or outpatient clinic rather than purchasing for personal use, the HSA/FSA pathway does not apply directly. Business equipment purchases follow a different tax treatment, generally as a Section 179 deduction or through standard depreciation schedules. The good news is that clinical equipment purchased for a practice is typically fully deductible as a business expense, which can achieve a comparable or greater tax benefit depending on the practice's structure and income.
The distinction matters because the products involved, shockwave systems, therapeutic lasers, force plates, are high-cost and the tax savings on each approach can be significant. Understanding which applies to your situation before you purchase avoids both an improper HSA withdrawal (which is taxed and penalized) and an underused business deduction. A tax professional familiar with medical practice finances is worth consulting before a five-figure equipment purchase. For context on how clinical purchases interact with deduction rules, the IRS treatment of business medical equipment costs works differently from the individual HSA pathway described in this guide.
Practices that are just getting started should also think about the full equipment picture. A shockwave device or therapeutic laser is often one component of a broader clinical setup. The choices made early, about which modalities to prioritize and how much space and power capacity the facility has, shape every subsequent purchase. Reading through a structured checklist for new clinic equipment before finalizing a purchase list can surface gaps that are easier to address before the room is built out than after.
Home Rehab Use Cases: When Personal HSA Purchases Make Sense
The clearest use case for the Truemed pathway is an individual managing a chronic condition who wants to extend treatment beyond what they can access in a clinic setting. Physical therapy visits are limited by scheduling, cost, and geography. Someone recovering from a lumbar disc herniation, managing chronic neuropathy, or dealing with a recurring plantar fasciitis flare may find that having access to therapeutic modalities at home meaningfully changes their recovery trajectory.
Research on home use of therapeutic modalities generally supports this for patients who have already been trained in their use. Compliance tends to be higher when treatment is accessible without a commute, and outcomes for chronic pain conditions often improve when patients can treat at the onset of symptoms rather than waiting for an appointment. The clinical equipment designed for home rehabilitation setups is covered in more detail for anyone weighing home rehab equipment options alongside professional models.
The equipment at this tier, Class IV lasers, focused shockwave devices, is professional-grade. These are not consumer wellness gadgets. The Diowave's stealth micro-pulsed technology, which pulses output at intervals as short as five millionths of a second, requires a trained operator to use safely and effectively. Any individual purchasing this equipment for home use should have received hands-on instruction, either through a clinician, the manufacturer's training materials, or both. That training context also strengthens the letter-of-medical-necessity case, since it demonstrates the purchase is part of an active, supervised treatment plan rather than a speculative wellness investment.
HSA and FSA Funds for Ongoing Equipment Costs
The letter of medical necessity covers the equipment purchase. It does not automatically extend to consumables, accessories, or maintenance contracts, though some of these may also qualify with separate documentation. For shockwave equipment, items like the water bag and silicone oil included with the Chattanooga Intelect Focus Shockwave are supplies necessary for the device's operation. Whether they qualify as HSA/FSA expenses depends on whether they are consumed in the course of the medical treatment the device was approved for.
Extended warranties and maintenance contracts are generally not eligible medical expenses. Software upgrades, such as the Diowave's power upgrade from 45W to 60W via a software key, sit in an ambiguous position. If the upgrade is necessary to achieve the therapeutic outcome the original letter described, there is an argument for eligibility. If it is a performance enhancement beyond the original treatment need, it probably is not. These are edge cases worth confirming with your HSA administrator before assuming coverage.
For anyone with an FSA, timing is critical. FSA funds must be used within the plan year in most cases. If you are approaching the end of a plan year with unspent FSA funds, a qualifying clinical equipment purchase with an approved letter of medical necessity can be a legitimate way to use those funds rather than forfeit them. The key phrase is "qualifying." The equipment must genuinely fit the clinical rationale. Using a letter-of-medical-necessity service to manufacture a justification for a purchase that does not have a real medical basis is not a gray area; it is an improper distribution with real tax and legal consequences.
Finding the Right Equipment for Your Condition and Budget
The pre-tax saving from HSA or FSA purchasing can shift which equipment tier is realistic. At a 30 percent effective tax rate, a $29,260 laser system costs roughly $20,480 in after-tax dollars when paid with HSA funds, compared to paying out of pocket. That difference can move an otherwise out-of-reach piece of equipment into realistic range, or allow a practice owner to choose a higher-specification model than they might otherwise budget for.
The right starting point is the condition, not the equipment. Identify what you or your patient needs to treat, then find the equipment that addresses it most directly. Shockwave and laser therapy each have specific strength areas and documented evidence bases. Shockwave is particularly well-studied for tendinopathy and calcific conditions. Laser therapy has a broader range of documented musculoskeletal applications. Force plates serve a different purpose entirely, sitting at the assessment and rehabilitation measurement side of the clinical workflow rather than the treatment side.
PPW carries a range of options across these modalities. Browsing clinical equipment by category gives you a practical way to see what is available at each price point. For practices that also work with upper-extremity rehabilitation, the electrotherapy equipment collection covers complementary modalities that pair well with the shockwave and laser systems discussed here. Understanding which products other outpatient clinics typically prioritize is also useful context, and the breakdown of what clinics actually stock reflects real purchasing patterns rather than theoretical ideals.
More clinical equipment worth a look
DioWave Class IV 45W Therapeutic Laser System
Kinvent 3D Deltas Multi-Axis Force Plate System
Frequently asked questions
What is Truemed and why does it matter for buying clinical equipment?▾
Truemed is a platform that connects you with a licensed clinician who can issue a letter of medical necessity, allowing HSA or FSA funds to cover equipment that would not normally qualify under the standard eligible-items list. Because HSA and FSA money is pre-tax, using it effectively cuts your purchase price by 20 to 37 percent depending on your income bracket. On clinical equipment priced at tens of thousands of dollars, that saving is substantial and worth the extra steps.
Is all clinical equipment automatically eligible for HSA or FSA payment?▾
No, and this is the part most people get wrong. The IRS definition under Section 213(d) covers expenses tied to the diagnosis, treatment, or prevention of a specific condition, not general wellness purchases. A Class IV therapeutic laser used in a documented treatment plan for a neuromusculoskeletal condition sits in a different category than one bought speculatively, even if the device is identical. The purpose and the supporting clinical rationale determine eligibility, not the equipment itself.
What does the Truemed process cost, and is that fee refundable?▾
The clinician consultation fee is typically a flat fee in the range of 30 to 75 dollars, paid separately from the equipment cost. That fee covers the licensed clinician's professional review, not a guaranteed outcome, so it is not refunded if your situation does not qualify. The fee itself may be eligible as a qualified medical expense, which offsets some of the sting if you are paying from an HSA or FSA account.
What information should you prepare before starting the intake form?▾
The process goes much faster if you have a specific clinical description of your condition ready, using precise terms rather than vague ones. For example, describing chronic proximal plantar fasciitis is more useful to a reviewing clinician than just saying foot pain. You should also gather any existing diagnosis notes or referral records from your physician, the exact model name and price of the equipment you intend to buy, and your HSA or FSA account administrator details. Having all of this before you open the form avoids delays.
How do you actually complete the purchase once you have the letter of medical necessity?▾
In most cases you complete the letter process first, then use your HSA or FSA card at checkout using the documentation you received. Going in that order avoids any timing questions about whether the letter predates the purchase. Some platforms do allow post-purchase reimbursement submissions, but starting with the letter in hand is the cleaner approach and reduces the chance of a rejected claim.
What kinds of clinical conditions are most likely to support an approved letter for equipment like therapeutic lasers or shockwave systems?▾
Conditions with documented clinical histories tend to review well, particularly those involving chronic or treatment-resistant musculoskeletal pain. The Diowave Class IV laser systems, for instance, are specifically designed for conditions such as burning neuropathy, spinal stenosis, severe degenerative arthritis, and disc herniations with leg pain. A shockwave device like the Chattanooga Intelect Focus Shockwave is a non-invasive treatment option for heel pain due to chronic proximal plantar fasciitis. These are the kinds of specific, documented diagnoses that give a reviewing clinician enough to work with.
How should a clinic or practice think about the cost of equipment relative to the HSA/FSA savings?▾
At the price points involved here, the math is significant. The Diowave 60W system is priced at 33,150 dollars and the Chattanooga Intelect Focus Shockwave set at 50,176.02 dollars. A 20 to 37 percent pre-tax saving on figures like those represents thousands of dollars in real purchasing power. For a practice owner who qualifies, running that purchase through an HSA rather than post-tax income is one of the more straightforward ways to reduce the effective cost of adding clinical equipment.
What is the most common mistake people make when using an LMN service for clinical equipment?▾
The most common mistake is being too vague on the intake form. Describing a condition as general wellness or something nonspecific gives the reviewing clinician very little to support a determination. The IRS standard requires a connection to diagnosing, treating, or preventing a specific disease, so your intake answers need to reflect that. A second frequent mistake is purchasing the equipment before obtaining the letter, which can create timing complications during reimbursement or HSA card validation.
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