Are Insoles FSA or HSA Eligible? (2026 Answer)

Orthotic insoles, arch supports and heel cups are eligible FSA and HSA expenses. Comfort cushions sold for everyday wear are not. Here is where the line sits.

Aug 27, 2026

5 minute read

Burst guide cover, for shoppers: the headline "Orthotic insoles are eligible" over the line "Arch supports and orthotic inserts qualify. Comfort cushions do not." with three tags: Orthotic: yes, Comfort: no, No letter.

Short answer

Yes, when the insole does an orthopedic job. Arch supports, heel cups, orthotic inserts and custom orthotics are eligible FSA and HSA expenses with no letter of medical necessity needed. Plans treat them the same way they treat braces and supports.

What does not qualify is the cushioning insert sold for comfort or for standing all day. Same shelf, different category, and plans read the packaging. If yours is a borderline product and the claim is denied, a clinician's letter naming the foot condition is what changes the answer, and Burst can issue one for $35, refunded if the clinician declines or the plan denies. Request a letter for insoles. Related: running shoes and the arthritis and joint pain guide.

Orthotic shoe inserts and insoles with arch support are a go-to solution for alleviating foot pain, supporting a healthy gait, and treating or managing conditions like plantar fasciitis (painful heel inflammation), arthritis, and flat feet.

Podiatrists, orthopedic surgeons, and physical therapists frequently recommend them. But are insoles FSA-eligible or HSA-eligible? Yes, orthopedic insoles and shoe inserts are generally eligible to buy with FSA (flexible spending account) and HSA (health savings account) funds.

Keep reading for information about what types of insoles qualify, whether you need a letter of medical necessity (LMN), and how to buy shoe inserts with your tax-free dollars.

FSA and HSA eligibility basics

FSAs and HSAs are tax-advantaged plans. Both allow you to save pre-tax earnings and use those dollars to pay for eligible medical expenses. The IRS (Internal Revenue Service) determines what counts as a medical expense.

Foot-care devices used to treat, prevent, or manage pain or a musculoskeletal condition generally do qualify.

Are insoles FSA- and HSA-eligible?

Yes, orthopedic insoles, such as arch-support shoe inserts, are FSA- and HSA-eligible. This includes custom insoles and over-the-counter (OTC) options.

In the context of eligible medical expenses and FSA/HSA eligibility, shoe inserts and insoles, orthopedic inserts, arch supports, heel cups, and orthotics are categorized identically.

What types of insoles qualify?

Are shoe inserts FSA-eligible or HSA-eligible? It depends on the type. Orthotics and arch-support insoles are eligible.

Are shoe insoles FSA-eligible if they're for comfort only? Not automatically. An insert that provides cushioning and makes your shoes more comfortable to wear may not qualify. And if it does, it likely requires an LMN.

Do you need a letter of medical necessity for insoles?

You usually don't need a letter of medical necessity if you're using FSA or HSA funds to buy insoles for orthopedic support. As mentioned, comfort-only products might need one.

Burst's handy LMN guide has more details about what types of items require a letter of medical necessity from a healthcare provider and how to get one quickly.

If you do end up needing an LMN for a particular product, Burst handles the paperwork and emails the letter in about 12 to 24 hours, if a clinician approves your case.

How to pay for insoles with FSA or HSA

There are two ways to pay for orthotic shoe inserts or orthopedic insoles with pre-tax FSA or HSA dollars:

FSA or HSA debit card: These programs often issue debit cards to plan holders. If you have a card, you can use it just like a regular bank card to purchase insoles directly from an eligible retailer, online or at a store.
Receipt-based reimbursement: If you don't have a card or are buying from a source that doesn't take this form of payment, you can file a reimbursement claim by filling out a form and submitting an itemized receipt.

Shop FSA/HSA-eligible insoles with Burst

Are insoles HSA-eligible or FSA-eligible? In most cases, orthopedic insoles designed to alleviate pain or treat a musculoskeletal foot condition are eligible for purchase with both HSA and FSA funds.

The Burst browser extension helps you use your tax-free dollars on what you already buy and turn your FSA or HSA plan into instant cash back. Everywhere you shop. Install once, no checkout changes.

Burst's FSA/HSA shop makes it easy to find eligible products. Browse the platform to see what you can buy with your pre-tax dollars.

Frequently asked questions

Do insoles need a letter of medical necessity?

Not if they are sold as orthotic or arch-support products. A letter is only worth getting when the product is marketed for comfort and the plan has already pushed back.

Are custom orthotics from a podiatrist eligible?

Yes, and so is the fitting appointment. Keep the itemized invoice, since custom orthotics are usually the largest claim in this category.

Are drugstore inserts like Dr. Scholl's eligible?

The orthotic and arch-support lines generally are. The gel comfort inserts from the same brand generally are not. Read what the box claims the product does.