HSA and FSA Eligible Blood Tests (2026): 16 Services Checked

A card being accepted at checkout and a test being a qualified medical expense are two different things. The first is the seller's payment setup; the second is decided by your plan administrator under IRS rules. Below: what each service says, in its own words, what the IRS says counts, and how to keep the paperwork that gets a claim paid. Every service is ranked on the best blood tests page and priced per year on our cost page.

What each service says about HSA and FSA

Quoted from each provider's own page, read October 31, 2026. "Eligible" is the seller's claim, not a tax ruling.

None of these services bills insurance for the test itself. The full price, lab and state facts for each are on its review page, for example Function, Superpower and Quest.

What the IRS says counts

The starting point is IRS Publication 502: "You can include in medical expenses the amounts you pay for laboratory fees that are part of medical care." (IRS Publication 502). The phrase that matters is "part of medical care".

The IRS's own FAQ on wellness spending draws the line: "Medical expenses must be primarily to alleviate or prevent a physical or mental disability or illness. They don't include expenses that are merely beneficial to general health." (IRS FAQ). The same page treats a physical exam as a medical expense, and it treats a gym membership bought for general health as not one. A lab test ordered by a clinician sits closer to the first; a membership sold for general health optimization invites a closer look from your plan.

For a health FSA, the paperwork rule is explicit: "You must provide the health FSA with a written statement from an independent third party stating that the medical expense has been incurred and the amount of the expense." (IRS Publication 969). That is why an itemized receipt matters more than a logo at checkout.

Card at checkout vs reimbursement

There are two ways to use the account.

1. Pay with the HSA or FSA debit card. Most of the services above accept it. Your administrator can still ask for proof later, so keep the receipt.
2. Pay with your own card and claim it back. You submit an itemized receipt. Quest says "the order lookup and confirmation email should provide what most plans require" (Quest help center). Rythm says you can download the receipt from your dashboard (Rythm FAQ).

A receipt that helps a claim names the test or service, the date, the amount and the seller. A line that says only "membership" is the one most likely to be questioned.

Do you need a letter of medical necessity?

Sometimes. A letter of medical necessity is a clinician's note saying why a service treats or prevents a specific condition. Plans ask for one when a purchase could be general wellness, which is how many longevity memberships market themselves. Some sellers route HSA payments through a partner that arranges this step: InsideTracker uses Truemed, and Mito uses Flex. Whether your plan accepts that letter is up to the plan.

If you want to avoid the question, buy the specific tests your own clinician asked for at a lab store. Our guide to ordering your own blood test explains how those orders work, and our blood test cost without insurance guide prices common tests one by one.

The cheapest way to spend HSA money on blood work

Pre-tax money stretches further on a plan with a low cost per measured marker. Superpower at $3.69, Empirical Health at $2.88 and Function at $3.69 per measured marker are among the lowest we track; all three state HSA or FSA eligibility. For a handful of single tests, a lab store such as Ulta Lab Tests or Labcorp OnDemand can cost less overall. Our biomarker table shows which plan covers which marker, and the Function Health alternatives guide compares the memberships.