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Is Melatonin FSA/HSA eligible?

Conditionally eligible

Only with a Letter of Medical Necessity. Melatonin is sold as a dietary supplement, not an over-the-counter drug, so FSA and HSA plans do not cover it on its own.

Melatonin can qualify with a Letter of Medical Necessity from a provider who recommends it for a diagnosed sleep disorder.

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Why

What the IRS rules say

The CARES Act made over-the-counter drugs eligible with no prescription, but melatonin is not a drug. In the US it is sold as a dietary supplement with a Supplement Facts label, and IRS Publication 502 excludes supplements unless a medical practitioner recommends them to treat a specific diagnosed condition. That is why plan administrators ask for a Letter of Medical Necessity before they approve a melatonin claim.

Based on IRS Publication 502.

Good to know

Common questions

Isn't melatonin an over-the-counter sleep aid?

It sits on the same shelf, but the label tells the difference. Sleep aids with a Drug Facts panel, such as Unisom SleepTabs (doxylamine) or ZzzQuil Nighttime (diphenhydramine), are OTC drugs and are eligible with no paperwork. Melatonin carries a Supplement Facts panel, so it is a supplement.

What should the Letter of Medical Necessity say?

It should name a diagnosed condition, such as insomnia or a circadian rhythm disorder, state that melatonin is recommended to treat it, and include the dose, how long it is needed, and the provider's signature. A note that just says trouble sleeping is often rejected.

Is kids' melatonin treated differently?

No. Children's melatonin gummies and chewables are dietary supplements too, so the same Letter of Medical Necessity rule applies for a dependent.

Will my FSA or HSA card work for melatonin at checkout?

Usually not. Store systems that flag eligible items at the register generally treat melatonin as a supplement, so it is often declined. With a Letter of Medical Necessity on file, pay another way and submit the receipt for reimbursement.

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