Can You Use Your FSA or HSA at Fulcrum? Probably.

Most people assume their FSA or HSA is limited to doctor visits, prescriptions, and the occasional pair of glasses. What most people don't know is that structured fitness programs — the kind with assessments, professional coaching, and individualized programming — can qualify for reimbursement when a licensed medical professional says it's part of your treatment plan.

At Fulcrum, we've been operating at the intersection of fitness and healthcare for 30 years. We have a chiropractor on staff. We do movement assessments before anyone touches a weight. We build individualized programs around diagnosed conditions, injury histories, and medical realities. This isn't a regular gym membership — and that distinction matters when it comes to your FSA or HSA.

How It Works (The Short Version)

1. A licensed healthcare provider determines that a structured exercise program is medically necessary for a diagnosed condition you have

2. They write a Letter of Medical Necessity (LMN) — a document that says "this person needs this program for this reason"

3. You enroll in a qualifying program at Fulcrum

4. You pay with your FSA/HSA card or submit receipts for reimbursement

That's it. No loopholes. No gray areas. Just a medical professional saying what the research has been saying for decades: structured exercise is healthcare.

What Conditions Qualify?

If you're dealing with any of the following, there's a good chance a provider would support an LMN:

- Chronic back, neck, or joint pain

- Post-injury or post-surgical recovery

- Obesity or metabolic conditions

- Hypertension or cardiovascular disease

- Type 2 diabetes

- Osteoporosis or age-related mobility decline

The key requirement: the program can't be for "general wellness." It has to be tied to a specific diagnosis and a specific treatment plan. Which brings us to why Fulcrum is different from the gym down the street.

Why Fulcrum Qualifies When Most Gyms Don't

A standard gym membership — here's a key card, good luck — doesn't meet the threshold for medical necessity. There's no assessment. No professional oversight. No individualized programming. No one is tracking your progress against a diagnosis.

Fulcrum operates differently.

**Every client starts with an assessment.** Before you do anything, a coach evaluates your movement, mobility, strength, and medical history. If you're coming in with a diagnosis from a doctor or physical therapist, we build around it.

**Your program is individualized.** Whether you're in Return to Fitness, Small Group, or personal training, your coach knows your limitations and designs accordingly. This isn't a class where everyone does the same thing and hopes for the best.

**We have medical professionals in-house.** Dr. Bryen Bell, our staff chiropractor, can evaluate your condition and issue a Letter of Medical Necessity directly. You don't have to chase down your primary care doctor and explain what an LMN is.

**Integrated services under one roof.** Chiropractic care, stretch therapy, myofascial release, nutrition coaching, and fitness programming — all coordinated. This is the kind of comprehensive approach that FSA/HSA administrators are looking for.

The Letter of Medical Necessity — What You Need to Know

An LMN is just a letter from a licensed provider that says three things:

1. **What you have.** A specific diagnosis — not "I want to get in shape," but "lumbar disc herniation" or "type 2 diabetes" or "post-ACL reconstruction"

2. **What you need.** A specific exercise prescription — "strength training 3x/week for 6 months, focusing on core stability and lower body mechanics"

3. **Why it matters.** How the program treats, manages, or prevents worsening of the condition

The provider signs it, dates it, and includes their license number. You submit it with your receipts. Done.

**Important timing note:** The letter needs to be issued *before* you start the program. Most plan administrators won't reimburse retroactively — so get this in place first.

Who Can Write the Letter?

Any licensed healthcare provider actively involved in your care:

- Physicians (MD, DO)

- Physical therapists (DPT, PT)

- Chiropractors (DC) — including Dr. Bell at Fulcrum

- Occupational therapists (OT)

- Nurse practitioners (NP)

- Physician assistants (PA)

If you already have a provider who knows your condition, ask them. If you'd rather handle it through Fulcrum, Dr. Bell can evaluate you and issue the letter if you qualify.

What Programs Apply?

Depending on your condition and your provider's recommendation, any of these could qualify:

- **Return to Fitness** — our program specifically designed for people recovering from injury, managing chronic conditions, or rebuilding after a long break. This is the most natural fit for FSA/HSA use.

- **Small Group Training** — 4 people, one coach, individualized programming within a group setting

- **Personal Training** — 1-on-1 coaching for complex medical situations that require close attention

- **Chiropractic care and stretch therapy** — these often qualify on their own, and they integrate directly with your fitness programming

- **Nutrition coaching** — when tied to a metabolic or dietary condition

The Math

Here's where it gets interesting. FSA and HSA funds are pre-tax. Depending on your tax bracket, using these accounts effectively gives you a 20-40% discount on your program.

If you're spending $300/month on training and recovery services at Fulcrum, and your tax bracket is 30%, you're saving about $90/month — or over $1,000 a year — by running it through your FSA/HSA instead of paying with after-tax dollars.

That's real money. And you're spending it on something a medical professional has already told you that you need.

Next Steps

1. **Schedule an assessment at Fulcrum.** We'll evaluate where you are and which program fits your situation.

2. **Talk to your provider — or ours.** If you have an existing diagnosis, your doctor or PT can write the LMN. Or meet with Dr. Bryen Bell at Fulcrum for an evaluation.

3. **Get your letter before you start.** Timing matters for reimbursement.

4. **Pay with your FSA/HSA card or submit receipts.** Keep copies of everything for your records.

If you've been sitting on FSA/HSA funds that expire at the end of the year — or if you've been paying out of pocket for something a medical professional already recommended — this is worth a conversation.

[Schedule a Return to Fitness Assessment →]

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*Fulcrum Fitness — 30 years, 5,000+ clients, 10+ year average member retention. Two locations in Portland: Hawthorne and MLK. Integrated fitness, chiropractic, nutrition, and recovery services under one roof.*