Hi, I'm Shubhi, one of the co-founders of Burst. This guide is for anyone who's pregnant or about to be, and shopping for the things you need to get through pregnancy and prepare for birth.

Pregnancy is the rare medical context where FSA/HSA rules actually work in your favor. Prenatal vitamins are eligible by default. Breast pumps are eligible by default (you can buy one before the baby arrives). Doula services and childbirth classes are eligible. The catch is that most expecting parents don't know any of this, so they pay out-of-pocket for thousands of dollars of pregnancy-related purchases that their FSA/HSA would have covered. I'd rather you not be one of them.

Below is a quick walkthrough of what qualifies during pregnancy, what's already eligible without paperwork, and what needs a Letter of Medical Necessity (LMN).

What FSA/HSA actually covers during pregnancy

Federal rules treat pregnancy as a medical context, not a lifestyle. That means a wide range of pregnancy-related products and services are FSA/HSA eligible. Some are explicitly listed as eligible (breast pumps, prenatal vitamins, birth control). Others fall under the broader "products used to treat, mitigate, or alleviate a specific medical condition" standard, which during pregnancy can mean morning sickness, back pain, swelling, sleep disruption, varicose veins, or pregnancy-related musculoskeletal pain.

For products in the broader category (pregnancy pillows, compression socks, maternity support belts, morning-sickness aids, pregnancy-safe supplements beyond a basic prenatal), reimbursement turns on documentation. An LMN is a short note from a licensed clinician naming the pregnancy-related condition being treated. With the LMN attached to your receipt, the expense is reimbursable.

Two facts worth knowing. The fee for the Burst LMN request is itself FSA/HSA eligible, so you can pay for it with your FSA/HSA card. And if our clinician decides your situation doesn't qualify, you get a full refund.

Categories already eligible without an LMN

A solid list of pregnancy categories is eligible by default. No LMN needed for:

• Prenatal vitamins. Ritual, Needed, FullWell, Garden of Life, Nature Made, Theralogix Theranatal, store brand. All eligible as OTC medical product.

• Breast pumps and accessories. Manual, electric, hospital-grade. Spectra, Medela, Elvie, Willow, Momcozy. Plus all replacement parts, flanges, valves, bottles, milk storage bags. You can buy a pump before the baby is born.

• Birth control. All forms.

• Pregnancy tests and ovulation tests. Eligible as OTC.

• Pelvic floor physical therapy. Eligible as a medical service. Many pelvic floor PTs work with pregnant clients.

• Doula services. Birth and postpartum doulas are eligible as medical services. Some administrators want a brief note from your provider; a few accept doula invoices directly.

• Childbirth classes. Lamaze, Bradley, hospital-led childbirth education classes are eligible as medical education.

• Therapy and counseling. Eligible without an LMN, including for pregnancy-related anxiety, mood concerns, or pregnancy loss.

• Prescription medications. All eligible.

• Maternity care visits and copays. All eligible.

You can buy or book most of these wherever you want. The eligibility is the same.

Categories of pregnancy products often eligible with an LMN

These are the categories I see most often in real Burst LMN requests during pregnancy. Brands are illustrative, not endorsements, not affiliate.

Pregnancy pillows

Full-body and U-shaped pregnancy pillows (PharMeDoc, Boppy, Leachco Snoogle, Momcozy, Frida Mom) are heavily used in the second and third trimester for sleep positioning, hip and back pain, and reflux relief. With an LMN naming pregnancy-related back, hip, or sleep conditions, the category is reimbursable.

You can buy these at Amazon, Target, Buy Buy Baby, or directly from the brand. The LMN works the same.

Maternity support belts and belly bands

Maternity support belts (Belly Bandit, Bao Bei, AZMED, Frida Mom) help with pelvic and lower-back pressure, especially in the third trimester. With an LMN naming pregnancy-related musculoskeletal pain, sacroiliac dysfunction, or symphysis pubis dysfunction (SPD), they're reimbursable.

Compression socks and stockings

Graduated compression socks (Bombas, Comrad, CEP, Sockwell, Vim & Vigr) are commonly used during pregnancy for swelling, varicose vein management, and DVT prevention (especially during travel). Compression socks are eligible with an LMN naming the pregnancy-related circulatory condition.

Morning sickness and nausea aids

Acupressure wristbands (Sea-Band, Reliefband), ginger products, B6 (with doctor guidance), and electrolyte mixes for hyperemesis are all common. Acupressure bands and ginger products are eligible with an LMN naming hyperemesis gravidarum or pregnancy-related nausea. B6 and electrolyte mixes (LMNT, Liquid IV, Drip Drop) need an LMN to be reimbursable as supplements.

Pregnancy-safe supplements beyond the basic prenatal

If your provider recommends additional supplementation during pregnancy (extra folate or methylfolate, additional iron, DHA/omega-3 beyond what's in your prenatal, magnesium for cramps or sleep, choline), those are eligible with an LMN. The LMN names the pregnancy-related deficiency or condition the supplement is treating.

TENS units for labor

TENS units for labor pain management (Elle TENS, MyTENS, Babycare TENS) are FSA/HSA eligible. Many TENS units are eligible without an LMN, but pregnancy-specific or labor-specific units sometimes get flagged. An LMN naming labor preparation covers any administrator question.

Birthing balls and pregnancy yoga

Birthing balls (Trideer, Live Infinitely, Hospitology), peanut balls, and pregnancy-specific yoga props are eligible with an LMN naming pregnancy-related musculoskeletal preparation or labor preparation. Pregnancy yoga classes themselves are sometimes eligible as well, depending on your administrator.

Stretch mark and belly skincare

Stretch mark creams and belly oils (Mama Mio, Earth Mama, Bio-Oil, Burt's Bees Mama, Mustela) are eligible with an LMN where they're connected to a specific pregnancy-related skin condition. The category is borderline (some administrators reject as cosmetic), so the LMN matters here more than in some other categories.

Doppler fetal monitors for high-risk pregnancies

At-home fetal Doppler monitors (Sonoline, BabyDoppler, Wusic) are typically only LMN-eligible when prescribed for a high-risk pregnancy or for medical monitoring beyond standard prenatal care. The LMN should specifically name the high-risk indication.

Mental-health tools beyond therapy

Therapy is eligible without an LMN. Adjacent mental-health tools (meditation apps like Calm or Headspace, weighted blankets for pregnancy-related anxiety, sleep wearables) qualify with an LMN naming pregnancy-related anxiety, mood concerns, or sleep disruption.

What's NOT eligible

A few things people ask about that don't qualify, even with an LMN:

• Maternity clothing. General clothing is excluded from FSA/HSA eligibility. Compression-medical-garment-style maternity wear may be borderline; standard maternity clothing is not.

• Strollers, car seats, cribs, bassinets, baby monitors, baby furniture. Consumer goods, not medical.

• Diapers, formula, baby food. Generally not eligible (some narrow exceptions exist for medically-indicated formula with an LMN).

• Most baby gear. The eligibility window is on YOU as the patient, not the baby.

How Burst gets you reimbursed (3 steps)

Step 1: Request an LMN at app.getburst.com/request-lmn

Under 5 minutes. List the products. Describe your context (which trimester, any specific conditions like SPD, hyperemesis, varicose veins, gestational diabetes, high-risk pregnancy). Submit.

Step 2: A Burst clinician reviews and signs

Most LMN requests come back in under 24 hours. A licensed clinician on our network reviews. If your situation qualifies, you get the signed LMN. If it doesn't, you get a full refund.

Step 3: File the LMN with your administrator

Log into your administrator (HealthEquity, Optum Financial, WEX, Inspira, Lively). Upload the LMN plus your receipt. Submit. Reimbursement usually lands in a week or two.

The Burst team wrote a step-by-step walkthrough for the most common administrators: How to file your LMN for reimbursement.

We don't care which brand or store you buy from. The LMN covers the product, not the storefront.

One LMN, 12 months, any store

A single LMN from Burst covers that product for 12 months. Approved during pregnancy, the LMN keeps working into the postpartum period for products that overlap (compression socks, magnesium, sleep tools, mental-health tools). For postpartum-specific recovery, you can request a follow-up LMN.

People I talk to during pregnancy are shopping everywhere: Amazon for the consumables, Target on the way home, the brand site for the bigger items, Costco for prenatals and supplements in bulk. The LMN doesn't care where you bought. It cares about the product and the context.

When the baby arrives, the postpartum guide picks up where this one leaves off: FSA/HSA Reimbursement for Postpartum Care & Recovery.

FAQ

Are prenatal vitamins FSA eligible?
Yes, without a Letter of Medical Necessity. Prenatal multivitamins are FSA/HSA eligible by default as OTC medical product.

Is a breast pump FSA eligible? Can I buy one before the baby is born?
Yes and yes. Breast pumps are FSA/HSA eligible without an LMN, and you can purchase one during pregnancy in preparation. Manual, electric, and hospital-grade pumps and their accessories are all reimbursable.

Are doula services FSA eligible?
Yes. Birth and postpartum doulas are eligible as medical services. Some administrators want a brief note from your provider; many accept doula invoices directly.

Are childbirth classes FSA eligible?
Yes. Lamaze, Bradley, hospital-led childbirth education, and similar medically-oriented classes are eligible without an LMN. Hypnobirthing courses are sometimes accepted, depending on your administrator.

Are pregnancy pillows FSA eligible?
With an LMN, yes. Pregnancy pillows (PharMeDoc, Boppy, Snoogle, Momcozy, Frida Mom) are reimbursable when the LMN names a pregnancy-related back, hip, or sleep condition.

Are maternity support belts FSA eligible?
With an LMN, yes. Maternity belts (Belly Bandit, Bao Bei, AZMED, Frida Mom) qualify when the LMN names pregnancy-related musculoskeletal pain, SPD, or sacroiliac dysfunction.

Are compression socks FSA eligible during pregnancy?
With an LMN, yes. Compression socks are reimbursable when the LMN names a pregnancy-related circulatory condition like edema, varicose veins, or DVT prevention during travel.

Is maternity clothing FSA eligible?
No. General clothing is excluded from FSA/HSA eligibility, and maternity clothing falls under that exclusion.

Are strollers, car seats, or cribs FSA eligible?
No. Consumer baby gear is not eligible. The eligibility window is on you as the patient, not the baby.

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

Stop paying out-of-pocket for pregnancy prep

If you're pregnant and shopping across multiple brands or stores for things that help, I'd rather you stop paying out-of-pocket for purchases your FSA/HSA would cover. Get an LMN from Burst in under 5 minutes. If our clinician doesn't approve it, you get a full refund.

Request my LMN →

If you're not sure whether something specific qualifies, hit reply on any Burst email or write to support@getburst.com. I read every email myself. I'd rather sanity-check for you up front than have you guess.

Thanks,
Shubhi
Co-founder at Burst