Are Running Shoes HSA Eligible? The 2026 Guide
Running shoes are not default-eligible, but specialty orthopedic and prescribed orthotic shoes can be FSA/HSA reimbursable with a Letter of Medical Necessity. Here's the complete walkthrough on what works and what doesn't.
7 minute read
Hi, I'm Anthony, co-founder at Burst. Running shoes are one of the most-asked-about categories where the answer is genuinely "it depends."
Short answer. Standard running shoes are not eligible by default under FSA or HSA rules — they're consumer footwear, not medical equipment. Specialty orthopedic shoes, prescribed orthotic shoes, and shoes specifically purchased to manage a documented condition (severe plantar fasciitis, diabetic foot care, post-surgical recovery, severe pronation requiring custom support) can be FSA or HSA reimbursable with a Letter of Medical Necessity. The IRS treats this category narrowly: "shoes" alone don't reimburse, but "shoes purchased to manage a specific medical condition with documented orthopedic specifications" do. Below is the framework.
If that already describes you, the request takes about three minutes and you can skip the rest of this guide.
Brand-by-brand fit
Hoka. Maximum cushion. Strong fit for documented plantar fasciitis, post-surgical foot recovery.
Brooks. Their stability lineup (Adrenaline GTS, Beast). Strong fit for severe overpronation tied to a clinical context.
Asics. Gel Kayano, Gel Foundation lineups for stability. Same fit as Brooks stability.
Altra. Zero-drop. Niche eligibility for very specific clinical foot conditions; ask your clinician.
New Balance. Their orthopedic-specific lineup (928, 990 series with extra-wide options). Strong fit for diabetic foot care.
Vionic. Built-in orthotic support. Strong fit for documented plantar fasciitis or flat foot.
Custom orthotic shoes prescribed by a podiatrist. Always eligible with the prescription as the LMN equivalent.
What's eligible with an LMN
The shoes themselves when prescribed for a specific orthopedic condition
Custom orthotics fitted by a podiatrist
Replacement insoles when the LMN names a chronic foot condition
What's not eligible
General fitness running shoes. "For my marathon training" doesn't qualify under IRS rules.
Branded apparel. Hoka shirts, Asics merch.
Multiple pairs of the same shoe without documented rotation needs.
Common reasons people get a shoe LMN
Severe plantar fasciitis
Diabetic peripheral neuropathy
Post-surgical foot recovery (bunionectomy, plantar fasciotomy)
Severe overpronation requiring stability shoes
Charcot-Marie-Tooth and similar progressive foot conditions
Documented flat foot or fallen arches
Achilles tendinopathy requiring a specific drop or cushioning profile
A few common shoe FSA/HSA pitfalls
Buying without the orthopedic specification. An LMN that names "plantar fasciitis" should also specify the type of shoe support required.
Submitting receipts for fashion shoes. Plan admins parse the brand and model. Premium fashion sneakers don't qualify even with an LMN.
Forgetting the orthotic insole as a separate eligible item. A custom insole inside a non-prescribed shoe can still be eligible on its own.
Running shoe FSA/HSA FAQ
Are Hoka shoes HSA eligible?
With an LMN naming a specific orthopedic condition (plantar fasciitis, post-surgical foot recovery), yes.
Are running shoes default-eligible without an LMN?
No. Standard running shoes are consumer footwear under IRS rules.
Are diabetic shoes covered?
Yes — when prescribed for diabetic peripheral neuropathy, they're a recognized medical category.
Are custom orthotics FSA eligible?
Yes — orthotics prescribed by a podiatrist are default-eligible.
Is the LMN fee itself FSA/HSA eligible?
Yes.
Stop paying full price for orthopedic shoes
If you've got a documented foot condition and you're already paying for specialty shoes, the LMN turns it into pre-tax savings. Get yours from Burst in under 5 minutes.
If you're not sure whether your situation fits, hit reply on any Burst email or write to support@getburst.com. We read every email ourselves.
Thanks,
Anthony
CEO and Co-Founder at Burst
For the underlying rules, see IRS Publication 502, IRS Notice 2006-69, and IRS Notice 2007-2.
Last updated: May 2026
This guide is not medical advice. Your eligibility depends on your specific situation and your plan administrator's interpretation of IRS rules. Burst's clinicians make eligibility decisions on a case-by-case basis.
