Executive Physical HSA: Ask Before You Pay From It

Direct answer: Renew's answer to what an executive physical should include is a full physical: arterial imaging, with CIMT as the anchor of the arterial story, advanced lab panels testing for 33 known drivers of arterial damage, DEXA body composition, VO2 Max testing, and a physician. Performance at $999/mo is primary and Executive at $5,000/mo is secondary. Ask your administrator before paying those membership dues, because HSA eligibility is line by line.

What the IRS has actually said

Two public IRS pages are the right starting point. They are not a ruling on your invoice.

Physical exams. In IRS FAQs on nutrition, wellness, and general health, Question 3 asks whether a physical exam can be paid or reimbursed by an HSA, FSA, Archer MSA, or HRA. The answer is yes, because the exam provides a diagnosis of whether a disease or illness is present. The same FAQ says medical expenses under section 213 are generally the expenses those accounts can pay, and that an expense paid from the account cannot also be deducted.

Publication 502. Under physical examination, you can include the amount you pay for an annual physical examination and diagnostic tests by a physician. You do not have to be ill at the time. The publication also says medical expenses must be primarily to alleviate or prevent a physical or mental disability or illness. They do not include expenses that are merely beneficial to general health, such as a vacation.

Publication 969. An HSA distribution used for qualified medical expenses is not taxed. Publication 969 is the account booklet. It points qualified expenses back to the medical-care rules, with HSA-specific exceptions (insurance premiums are a common one). Your trustee and your plan still have to accept the documentation.

Read those pages with your administrator or a tax professional. A blog cannot apply them to your receipt.

Why an "executive" invoice can fail the test in pieces

The word executive often bundles medical care with hospitality. The IRS looks at the expense. The marketing name does not settle it.

Lines that need a separate question:

Line on a typical executive offer	Why you should ask
Physician exam and diagnostic tests	Closest to the physical-exam answer in the IRS FAQ and Publication 502
Executive services fee, lounge, travel desk, lockers	Mayo Clinic describes this fee as non-clinical amenities. Amenity fees may fall outside medical care
Nutritional counseling	IRS FAQ Question 8: yes only if it treats a specific disease a clinician has diagnosed (the FAQ gives obesity or diabetes as examples). Otherwise no
Supplements	IRS FAQ Question 14: yes only if a practitioner recommends them to treat a specific condition a clinician diagnosed. Otherwise no
Food or meal programs	IRS FAQ Question 12 sets three narrow conditions, and the eligible amount is limited to the excess over ordinary food. Ordinary meals do not qualify
Exercise for general fitness	IRS FAQ Question 11: no, even if a doctor recommends it for general health
A wearable used for general wellness	IRS FAQ Question 15: general wellness tracking is not enough. The device has to be bought and used primarily for a specific disease

Mayo Clinic's flyer says the executive services fee covers non-clinical services and is typically out of pocket unless the company pays it. That sentence is a billing description. Use it as a reason to split the invoice before anyone submits it to an HSA.

Do not submit a single "executive physical" total and hope the trustee sorts the medical lines from the hospitality lines.

Membership dues are a bundle too

Renew's Performance plan at $999/mo and Executive plan at $5,000/mo are memberships, not a single physical-exam CPT code. Performance is primary. Executive is secondary.

Renew's answer to what an executive physical should include is a full physical. CIMT is the anchor of the arterial story. Every membership includes CIMT arterial imaging, advanced lab panels testing for 33 known drivers of arterial damage, a dedicated physician and care coordinator, the root cause workup (OralDNA, sleep, genetics) once a year, and a dental liaison.

Performance, $999/mo is described on Pricing as arterial reversal plus body composition, brain health, and metabolic optimization, all measured, all tracked, all managed by your care team. It includes DEXA body composition scans (2x/year), VO2 Max testing (2x/year), tune-up labs (4x/year), monthly physician visits, monthly S&C coaching sessions, monthly nutritionist sessions, in-home mobile phlebotomy, an annual Executive Health Report, and an Oura Ring + data plan.

Executive, $5,000/mo is everything in Performance, published as DEXA body composition scans (4x/year), VO2 Max testing (4x/year), CIMT + advanced arterial imaging, unlimited physician access, a dedicated sleep specialist, weekly S&C coaching sessions, unlimited nutritionist access, meal delivery or personal chef meal prep, all supplements included and shipped monthly, custom compounded medications, and priority scheduling.

Tests included in every membership include an advanced inflammation panel, an insulin resistance panel with OGTT, a lipoprotein panel with Lp(a) and ApoB, genetic testing for ApoE, KIF6, and 9p21, OralDNA testing, a sleep study, and a vitamin and metabolic panel. Pricing does not assign each of those panels to a tune-up visit.

GLP-1 medications, peptides, and hormone replacement therapy are available in Performance and Executive memberships, prescribed and monitored by your physician. The dementia prevention track, which includes cognitive baseline testing, is available in Performance and Executive memberships.

Meal delivery, supplements, coaching, and the Oura Ring + data plan sit next to the physician exam and diagnostic testing. The IRS FAQ treats food, supplements, general exercise, and a general-wellness wearable as separate questions. Split those lines before anyone submits one membership total.

Pricing lists a money-back guarantee on every tier: "If you experience a heart attack, stroke, or other cardiovascular event while actively enrolled and following your protocol, we refund your membership fees."

This page will not tell you that $999 or $5,000 a month is a qualified medical expense. Ask the administrator whether any portion is eligible, and ask Renew for documentation that separates clinical services from other membership features. Pricing states that the practice operates outside insurance, with Medicare-adjusted pricing on Essentials and Reversal where offered. Operating outside insurance does not answer the HSA question.

Insurance payment is a different decision. See does insurance cover an executive physical. If insurance pays an expense, you generally cannot also pay it from an HSA. Publication 969 and the IRS FAQ both warn against double-dipping.

Employer reimbursement rules are on corporate executive physical. Cash quotes for exam-day programs are on executive physical cost.

What to ask your administrator

Take these questions to the HSA trustee or benefits office. Bring an itemized estimate.

1. Which lines match a physical exam or diagnostic tests by a physician?
2. Which lines are amenities, food, general coaching, or supplements?
3. Does the plan require a letter of medical necessity for any line?
4. Will a monthly membership be reviewed as one fee or as itemized services?
5. What receipt will you need if the account is audited?

If they will not answer in writing, do not treat a forum post as approval. Eligibility depends on your plan and on IRS rules.

The clinical path, if you want it, is still executive health: a full physical with CIMT as the anchor of arterial imaging, advanced labs, DEXA body composition, VO2 Max testing, and a physician, with follow-through on How it works. Whether an account may reimburse any of that is an administrator question. It is not a reason to interpret your own imaging.

What an executive physical is, for HSA questions

An executive physical is usually a packaged preventive evaluation with a longer itinerary than a short periodic checkup. Hospitals publish exam-day formats. Renew's answer is year-round membership rather than a single campus day: arterial imaging, advanced labs, DEXA body composition, VO2 Max testing, and a physician. The product shape matters. An HSA question follows the lines on the invoice. The marketing name does not settle it.

Preventive care versus general wellness add-ons

IRS guidance treats a physical exam and physician diagnostic tests differently from expenses that are merely beneficial to general health. Lounge fees, many meal programs, and general coaching can fall on the wellness side of that line. Ask your administrator about those categories one at a time.

Frequently asked questions

Can I pay for an executive physical with an HSA?

You might, for lines that match a physical exam or diagnostic tests by a physician. The IRS says a physical exam can qualify because it looks for whether disease is present. Lounge fees and other non-medical lines need their own question, so ask your administrator before you pay.

Does Publication 502 mean the whole executive day is eligible?

Publication 502 allows an annual physical and diagnostic tests by a physician. It excludes expenses that are merely beneficial to general health. Split the invoice before you pay from the account.

Are Renew membership fees HSA-eligible?

Not as a blanket yes. Performance at $999/mo and Executive at $5,000/mo are memberships. The clinical lines include arterial imaging with CIMT as the anchor, advanced lab panels, DEXA body composition, VO2 Max testing, and a physician. Performance also includes monthly S&C coaching sessions, monthly nutritionist sessions, and an Oura Ring + data plan. Executive adds meal delivery or personal chef meal prep, all supplements included and shipped monthly, weekly S&C coaching sessions, and unlimited nutritionist access. Ask your administrator whether any portion is eligible.

What if my employer pays and I also have an HSA?

Do not pay the same expense twice. If the company or insurance covers a line, that line is generally not also an HSA distribution. Confirm with the plan.

Is an FSA different from an HSA here?

The IRS FAQ groups HSA, FSA, Archer MSA, and HRA for the physical-exam question. Account rules still differ. Your plan document controls the reimbursement.

Sources

• Mayo Clinic Executive Health Program (exam-day product context. not an HSA determination)
• IRS FAQs: medical expenses related to nutrition, wellness, and general health (Question 3 on physical exams. Questions 8, 11, 12, 14, and 15 on related limits)
• IRS Publication 502, Medical and Dental Expenses (physical examination and diagnostic tests. general-health exclusion)
• IRS Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans
• Mayo Clinic Executive Health FAQ flyer (MC1927-43) (executive services fee described as non-clinical)
• Renew Health pricing
• Renew Health executive health program

Author and medical review

Written by Andrew Le, MD. Andrew Le, MD reviews patient-facing guidance for Renew Health with a focus on preventive cardiology and functional medicine clarity.

Medically reviewed by Clinical Review Team.

Next step

Settle the account question with your administrator. If you want the clinical membership, start on executive health. Primary: Performance at $999/mo. Secondary: Executive at $5,000/mo. See Pricing. Book a consultation.

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