What Can I Buy With My HSA or FSA for Celiac Disease?

_Note from 2026-05-31._

If you have celiac disease and a Health Savings Account (HSA) or Flexible Spending Account (FSA), you may be able to use those pre-tax dollars for far more than doctor visits. The challenge is that many celiac-related expenses look like grocery bills or supplements rather than traditional medical expenses—which means documentation matters.

## The filterable reference guide

Gluten Hero maintains a filterable reference table of 34 common celiac-related expenses at [community.glutenhero.net/hsa-fsa-guide](https://community.glutenhero.net/hsa-fsa-guide). Use the category filters to narrow by Food & Grocery, Supplements, Testing & Diagnosis, Medical Equipment, Appointments & Services, or Medications.

Each expense shows one of three eligibility states:

- **Typically Eligible** — generally accepted by plan administrators without extra paperwork
- **Requires LMN** — eligible if you have a Letter of Medical Necessity from your physician
- **Typically Not Eligible** — generally not reimbursable (e.g., gluten-free shampoo, fresh produce)

## What is a Letter of Medical Necessity?

A Letter of Medical Necessity (LMN) is a document from your physician stating that a specific item or service is medically necessary to treat your diagnosed celiac disease. Without it, your plan administrator will likely deny claims for supplements, gluten-detection devices, and specialized dietary expenses. Gluten Hero offers a free LMN template at [resources.glutenhero.net/lmn-template/](https://resources.glutenhero.net/lmn-template/).

## The price-difference rule for gluten-free food

You cannot claim the full cost of gluten-free bread or pasta. The IRS allows only the **difference** between the gluten-free item and its standard equivalent. If regular pasta costs $2.00 and the gluten-free version costs $5.00, you can potentially claim $3.00—with your LMN and detailed receipts showing both prices.

GF-only specialty ingredients (like xanthan gum, which has no conventional equivalent) may be fully claimable.

## When in doubt, ask

Rules vary by plan administrator and can change year to year. The guide is a starting point, not a guarantee. Always confirm with your plan administrator and your CPA or tax professional before submitting a claim.