Hi, I'm Shubhi. GLP-1 medications are the most-asked-about prescription category on Burst since 2024 because the eligibility framework changed substantially with the obesity and weight management coverage expansions.

Short answer. GLP-1 medications (Wegovy, Ozempic, Mounjaro, Zepbound, Rybelsus, Saxenda) are FSA and HSA eligible by default when prescribed for type 2 diabetes — they're prescription medications, which fall into the default-eligible category under IRS Publication 502. When prescribed for weight management without a diabetes diagnosis, eligibility depends on plan-administrator interpretation: most plan admins now approve them as default-eligible since obesity is recognized as a medical condition under updated guidance, but some still require a Letter of Medical Necessity documenting the specific medical context (BMI threshold, comorbidities, prior weight management attempts). Below is the framework.

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Default-eligible contexts (no LMN needed)

• Ozempic, Mounjaro, Trulicity, Rybelsus prescribed for type 2 diabetes. Default-eligible — these are diabetes medications.

• Wegovy or Zepbound prescribed for documented obesity at most plan administrators in 2025-2026.

• Saxenda for weight management. Same framework as Wegovy.

Contexts that may need an LMN

• GLP-1 prescribed for weight management without a documented obesity diagnosis (BMI under 30 without comorbidity)

• GLP-1 prescribed off-label for conditions like PCOS or insulin resistance

• Compounded semaglutide or tirzepatide from non-FDA-approved sources

• GLP-1 dosed off-label outside the approved indication

What's eligible with the prescription or LMN

• The medication itself

• Injection supplies (needles, sharps containers, alcohol pads) when bundled

• Continuous glucose monitors when paired with the GLP-1 (especially in T2D contexts)

• Telehealth consultation fees that lead to the prescription

What's not eligible

• Compounded GLP-1 from non-FDA-approved sources without strong clinical justification. Plan admins are increasingly cautious here.

• GLP-1 ordered without a US-licensed clinician's oversight. Online pharmacies that bypass clinician review don't reimburse.

How to handle the eligibility ambiguity

If your GLP-1 is for weight management and you're unsure whether your plan admin approves it as default-eligible, two paths:

• Submit the prescription receipt first. Most plan admins approve. If denied, the LMN is your fallback.

• Get the LMN proactively. Burst can issue an LMN documenting the obesity diagnosis and prior weight management attempts. This pre-empts denials.

GLP-1 FSA/HSA FAQ

Is Wegovy FSA eligible?
Yes — for documented obesity, default-eligible at most plan admins. For BMI under 30 without comorbidity, an LMN strengthens the claim.

Is Ozempic HSA eligible?
Yes — Ozempic prescribed for type 2 diabetes is default-eligible.

Is Mounjaro covered?
When prescribed for type 2 diabetes (its FDA-approved indication), default-eligible. Off-label for weight loss may need an LMN at some plans.

Is Zepbound HSA eligible?
Yes — Zepbound is FDA-approved for chronic weight management. Default-eligible at most plan admins.

Are compounded GLP-1s covered?
Plan admin response varies. Plans are increasingly cautious about non-FDA-approved compounded versions. An LMN strengthens the claim significantly.

Is the LMN fee itself FSA/HSA eligible?
Yes.

Get an LMN for ambiguous GLP-1 contexts

If your GLP-1 is in a borderline approval zone (off-label, BMI between 27-30, compounded, no comorbidity), an LMN is the cleanest path to reimbursement.

Request my LMN →

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,
Shubhi
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.