Consumer Resources

Where & How To Buy HSA/FSA Eligible Period Underwear

Yulia Derdemezis

Head of Marketing at Flex

HSA and FSA eligible period and menstrual underwear

Updated: March 20, 2026

🚀 Fast Facts: Is period underwear HSA and FSA eligible?

Period underwear is not automatically HSA/FSA eligible, even under the recent changes under the CARES Act
Period and menstrual underwear requires a Letter of Medical Necessity to be eligible, requiring a treatment plan for a specific medical condition

The so-called pink tax on menstrual care and period products has made it challenging for many to try out new products that increase comfort — like period underwear — because of their cost. However, thanks to regulatory changes in the 2020 CARES Act, many menstrual care products are now automatically eligible to expense through Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs), so you can pay for them using pre-tax dollars.

In this guide, you’ll learn when period underwear qualifies for HSA or FSA spending and how you can purchase eligible products easily.

Understanding these rules helps you use your healthcare funds effectively while covering real health needs. Let’s start with the most common question people ask about this product category.

Is period underwear HSA and FSA eligible?

Period underwear is HSA and FSA eligible because it’s classified by the IRS as an item used for healthcare purposes. Thanks to federal legislation passed in 2020 that recently made period care products designated as medical expenses, you can now use HSAs/FSAs and your pre-tax funds to purchase them without restrictions.

If the period underwear you are looking at functions essentially like a reusable menstrual pad with no other function, it should be automatically eligible. If the period underwear you’re looking at is used to help with some other kind of condition like pain relief or serves other purposes, you may require a Letter of Medical Necessity (LMN) to be eligible to expense it to your HSA/FSA account.

Do you always need a Letter Of Medical Necessity to buy period underwear with your HSA/FSA?

No, you don’t need a Letter of Medical Necessity (LMN) to purchase period underwear using your HSA or FSA. A Letter of Medical Necessity is typically required only for dual-purpose items — for products that may have both medical and general wellness uses — but period underwear is used only for healthcare, so it is automatically eligible.

Period underwear is categorized by the IRS as a menstrual care product, which means they are always eligible as HSA/FSA expenses. Because of that, you can purchase them with your HSA or FSA funds just like any other over-the-counter health item.

How to buy period underwear using your HSA or FSA directly or through reimbursement

There are two common ways to use your HSA or FSA funds for eligible period underwear: you can pay directly using your HSA/FSA card at a checkout, or you can pay out of pocket and submit a reimbursement claim afterward. Here’s how to do both:

1. Pay for period underwear using your HSA/FSA card directly at checkout

The easiest way to purchase eligible period underwear is to pay directly with your HSA or FSA debit card. Many online retailers that sell health products allow you to enter your benefits card at checkout just like a regular debit card. If the transaction qualifies under IRS rules, the payment processes immediately.

Here’s how the process usually works:

Find eligible products: Look for period underwear that qualifies for HSA or FSA spending. If the product requires a Letter of Medical Necessity (LMN), make sure you have the documentation ready.
Add the item to your cart: Choose the size, style, and absorbency level that works best for your needs.
Enter your HSA or FSA card at checkout: Use your benefits debit card as your payment method.
Save your receipt: Even if the payment goes through automatically, your plan administrator may request documentation later.

Check out the Women’s Health stores in the Flex Marketplace, many of which sell period underwear, as well as other period and menstrual care products. Many of these shops let you pay using your HSA/FSA account right at checkout online! No more paying out of pocket for period care. No more waiting for reimbursement. See how easy it is to do with The Period Company:

The Period Company checkout using Flex for HSA/FSA payments

2. Make a reimbursement claim for period underwear after paying out of pocket

If a retailer does not accept HSA or FSA cards directly, you can still pay out of pocket, and then submit a reimbursement claim through your HSA/FSA provider. This is what the reimbursement process typically looks like:

Purchase the period underwear normally, using any standard payment method at checkout
Save your receipt and any documentation you needed, like a Letter of Medical Necessity if the product requires one
Submit a claim to your HSA or FSA administrator, usually through an online portal or mobile app
Wait to receive reimbursement after your claim for period underwear is approved

Reimbursement works well when you purchase from retailers that do not accept HSA or FSA cards directly, but it usually takes weeks or sometimes months to receive reimbursement for the money you spent.

5 HSA & FSA approved period underwear you can buy using your plan directly

If you want to spend funds from your Health Savings Account or Flexible Spending Account on period underwear, choosing the right retailer makes the process much easier. Here are some of our top choices for HSA/FSA eligible period underwear that you can buy using your HSA/FSA right online conveniently:

5 other menstrual products that are HSA/FSA eligible

Many other traditional menstrual products qualify as automatically eligible per the IRS rules about HSAs/FSAs and menstrual products. Thanks to recent updates from the CARES Act, common menstrual care items like tampons, pads, and menstrual cups generally qualify as eligible medical expenses under IRS rules. That means you can often purchase them directly using your HSA or FSA funds.

Here are some of our top choices of other brands that offer menstrual and women’s health products that qualify for HSA or FSA spending:

Brands like Sundaze, The Period Company, and Monthly even offer absorbent options that some healthcare providers recommend for symptom management. Check out all of the women’s health shops in the Flex Marketplace to see what else you might be able to spend your HSA/FSA funds on.

In Summary

Period underwear can be a practical option for managing menstrual flow, postpartum bleeding, or light bladder leaks. If you have available funds in your HSA or FSA, you may be able to use those dollars to help cover the cost.

If you want to spend your healthcare funds on eligible products quickly, the Flex Marketplace provides an easy place to start. Instead of searching across multiple retailers, you can browse hundreds of online stores that sell HSA and FSA eligible health products and complete purchases online directly, using your HSA/FSA card right at checkout in many cases.

Shop the Flex HSA/FSA Marketplace

Discover HSA/FSA-eligible brands and products

Use your pre-tax HSA/FSA dollars at checkout

Improve your health and wellness with products you’ll love

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Product	Description
	The Period Company The Period Company focuses on affordable, reusable period underwear designed to replace disposable menstrual products. Their lineup includes high-absorbency styles and inclusive sizing across a wide range of body types.
	Monthly Monthly creates leakproof underwear designed for menstrual protection and light bladder leaks. Their styles prioritize comfort and reliable leak protection for daily wear or overnight use.
	Sundaze Sundaze offers comfortable, reusable period underwear designed for everyday menstrual protection. Their products feature soft fabrics and multiple absorbency levels, making them suitable for light to heavy flow days.
	Lola Lola offers organic cotton tampons, pads, and liners with a focus on simple, transparent ingredients. Their products are designed for comfort and convenience, with subscription options available.
	Tampon Tribe Tampon Tribe provides organic tampons, pads, and menstrual cups made with eco-conscious materials.Their products emphasize sustainability and reliable absorbency.

Product	Description
	Viv Viv produces organic cotton tampons, pads, and liners designed with sustainable materials. Their products focus on clean ingredients and environmentally conscious packaging.
	Jovi Jovi offers wearable relief patches designed to help manage menstrual cramps and pelvic discomfort. These reusable patches are worn on the lower abdomen to provide support during menstrual cycles.
	Mixhers Mixhers produces supplements designed to support hormonal balance, menstrual health, and overall wellness. Some supplements intended for specific medical conditions may qualify for HSA or FSA reimbursement when supported by a Letter of Medical Necessity.
	Kindra Kindra offers products focused on menopause and vaginal health, including moisturizers, supplements, and wellness solutions. Some of these products may qualify for HSA or FSA spending when recommended by a healthcare provider to address symptoms related to menopause or hormonal changes.
	Flex Flex offers innovative menstrual care products, including reusable menstrual discs and disposable options designed for comfort and longer wear. Their products provide an alternative to traditional tampons and pads, with designs focused on flexibility and leak protection.