Can You Use Your HSA or FSA to Pay for Chiropractic or Massage?
Wondering if you can use your HSA or FSA to pay for your chiropractic care? What about massages? Or cupping?
You can use your HSA or FSA to pay for these treatments (and more), but it’s not as simple as swiping your card. Here’s everything you need to know about using your HSA and FSA to pay for chiropractic services, holistic care, and alternative treatments.
What Is an HSA?
A health savings account (HSA) is a special savings account that allows you to save pre-tax money to pay for a qualified medical expense. You can only contribute to an HSA if you’re in a high-deductible health plan (HDHP). However, the account is yours, and the money is always there for you to use, even after you leave your job.
What Is an FSA?
A flexible spending account (FSA) is also a special savings account funded with pre-tax dollars and used to pay for a qualified medical expense. Unlike an HSA, you can contribute to your flexible savings account without being in an HDHP, but FSAs are only available through your employer.
Flexible spending accounts are “use it or lose it.” If you don’t spend all the money you saved by the end of the year or you leave your employer before spending everything, you forfeit the money left in the account. Some employers allow for a “grace period” at the end of the year to spend the money, or they may allow you to “rollover” a certain amount of qualified medical expenses from one year to the next.
What Is a Qualified Medical Expense?
The IRS defines what a qualified medical expense is for both HSAs and FSAs. The definition applies to almost anything that’s used to diagnose, cure, treat, or prevent an illness. Some examples of a qualified medical expense are:
- Medical care, including deductibles, copayments, and doctor’s visits
- Prescription medications
- Over-the-counter items like allergy medications, pain relievers, and menstrual products. This does not include vitamins unless you have a doctor’s note.
- Dental and vision, including glasses, contacts, and dental cleaning
- Devices like crutches or CPAP machines
- Specific treatments like acupuncture or addiction treatment
Expenses for general health, wellness, cosmetic purposes, or relaxation are not qualified medical expenses.
Can I Use My HSA or FSA to Pay for Chiropractic Care?
Yes! The IRS considers chiropractic care and treatment a specific treatment, meaning it’s a qualified medical expense, and you can use your HSA or FSA to pay for it.
However, you cannot use your HSA or FSA to pay for chiropractic care when it’s for your general wellness. To be a qualified medical expense, you must be getting chiropractic adjustments to treat a specific medical condition. In some cases, especially for ongoing or maintenance care, your HSA or FSA administrator may require a prescription, also called a Letter of Medical Necessity (LMN), from your medical provider or chiropractor that explains why chiropractic is part of your treatment plan. The prescription must state what specific condition the massage is treating (herniated disc, sciatica, etc.) and how many chiropractic sessions you’ll need.
Not getting the LMN could mean the IRS penalizes you for using your HSA or FSA funds on an unapproved medical expense.
Can I Use My HSA or FSA for a Massage or Medical Massage?
You can use an HSA or FSA to pay for massage therapy or medical massage therapy when it’s used to treat a specific medical condition, like carpal tunnel or TMJ. A wide range of massage therapies will qualify, including trigger point massage, deep tissue massage, and sports massage, but you’ll likely need an LMN from your provider outlining the condition being treated and the recommended number of massage therapy sessions.
Is Cupping HSA Eligible?
Yes! Cupping may be eligible for HSA or FSA reimbursement when it’s used to treat a specific medical condition. In most cases, you’ll need an LMN to document that it’s part of a treatment plan.
Cupping for general health and wellness is not a qualified medical expense, so you won’t be able to use your HSA or FSA to pay for it.
Can My Dependents Use My HSA or FSA for Chiropractic Care?
You can pay for your IRS-qualified dependent’s chiropractic care with your HSA or FSA just as you would for any of their covered expenses. Keep in mind, they may still need an LMN that states the chiropractic adjustments are treating a specific medical condition.
Do I Need a Referral or Prescription?
While you don’t need a referral or prescription to seek chiropractic care or massage therapy, you will need an LMN to use your HSA or FSA to pay for these treatments.
Does Flourish Chiropractic Spa Accept My HSA or FSA?
Flourish Chiropractic Medical Spa accepts HSA and FSA payments. We can also write you an LMN for your massage, medical massage, chiropractic care, or other holistic treatments as long as it’s medically necessary and part of the treatment plan you and your provider agree upon.
For all massages paid for with HSAs or FSAs, we will charge your card on file at the time of your appointment. We can provide you with receipts of payment and LMNs within 10 business days of a written request.
HSAs and FSAs do not cover additional time over 60 minutes, and CBD add-ons are not eligible for HSA or FSA payment, regardless of time. Those will be charged separately at the time of your service.