Will my HSA or FSA pay for my massage?

Will my HSA or FSA pay for my massage?

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Health insurance is a must-have, as it can prevent emergency, lifesaving medical bills from crippling your finances. Beyond the essentials, an increasing number of patients are wondering, what about preventive and holistic care?


It’s no secret that natural therapies are rising in popularity. With fewer (or no) side effects and the ability to prevent or even treat health conditions by striking at their underlying causes, they can reduce healthcare costs when used appropriately.

Massage therapy can relieve pain and inflammation, reduce stress (and potentially, the illnesses it leads to), and benefit your cardiovascular health. But can you pay for treatment with a Flexible Spending Account (FSA) or Health Savings Account (HSA)?

What Are FSAs And HSAs?

First of all, what are FSAs and HSAs, and how can they help you pay for massage therapy? Both of these are special arrangements for healthcare costs, where you can reserve money for regular prescriptions, copayments, coinsurance, and deductibles.

Fortunately, this money is tax-free, but the IRS has set out criteria for eligible uses. They include legally-recognized medical services by doctors, dentists, and other practitioners in order to prevent or treat a physical or mental health condition. They don’t include expenses such as herbal teas, yoga classes or vacations, as these are classified as purchases that benefit general health. You can also ask your employer to contribute to your FSA or HSA, but both options have significant amounts of fine print detailing the criteria (this is where your HR department can come in).

Once your account is opened, you will receive a debit card with access to your (and possibly your employer’s) contributions. The money is already in your account, which removes the process of reimbursement.

Why Choose An FSA or HSA?

FSAs and HSAs have some advantages over regular health insurance, and especially over no protection at all. You don’t need to think about allocating money to an emergency medical fund, which isn’t always on our minds if healthcare expenses are usually minor or rare.

Perhaps best of all, everything you put into FSAs and HSAs is pre-tax. This is their key advantage over setting up an automatic bank transfer into an account you made for healthcare expenses: the money you transfer into a regular account is taxable.

However, there are a few differences between the two. First, money in HSAs roll over to the next year if you don’t spend it all. FSAs unfortunately don’t, so you lose any spare funds at the end of December. HSAs can follow you if you change jobs, and you can adjust your contribution at any time. Where FSAs stand out is their lack of eligibility requirements, as HSAs typically need a high-deductible health plan (HDHP), among other criteria.

Will My FSA or HSA Cover Massage?

Although there are some differences between FSAs and HSAs, the process is the same when it comes to paying for massage therapy:

1. Ask Your Workplace or Provider
The majority of customers who use an FSA or HSA find no problem when it comes to using the funds for massage therapy. However, it’s best to ask your medical insurance company or HR department first, as some won’t cover massage. It depends on whether the provider sees massage as a healthcare expense or service with general or incidental health benefits.

2. See Your Doctor
Yes, you must first be prescribed a massage for your FSA or HSA to cover it. To get a prescription, it’s best to explain why you need the massage first: think specific symptoms and conditions, not relaxation or simply wanting one.

Perhaps you have chronic, non-specific lower back pain; arthritis; a nerve pain condition such as sciatica; or poor circulation. With an increasing awareness about the importance of good mental health, a range of holistic interventions are now being recommended alongside (or in some cases, instead of) talk therapy and medication. For this reason, anxiety, depression, and stress-related illnesses such as hypertension or headache can be indications for massage.

Be prepared to present your case, too, as many doctors are still skeptical about the power of holistic therapies. Research case studies of people who benefitted from massage for your condition. The best information you can find is peer-reviewed trials and case studies. If these are out of your depth, articles written by or about experts can be useful.

3. Get A Detailed Prescription

What goes into a prescription for massage therapy? Overall, it must be comprehensive proof that you are using a medically necessary service. You may not need to see your doctor in-person to obtain or repeat it, but you need:

- The number of appointments that you need per month, or for the course of treatment. For example, you may have a prescription for one massage every two weeks, or a six-week course of weekly sessions.

- Their duration. Appointments are generally available as 60, 75, 90, or even 120-minute treatments. Some may be longer during the initial session in order to examine you.

- Perhaps most importantly, the condition you are seeking massage therapy for. A chronic condition can justify ongoing treatment, while recovery from an injury may indicate a course of massage therapy over several weeks or months.

4. Book With Our Therapist

If you have an FSA, remember that your funds are wiped on December 31, so plan ahead to make the most of them.

How Much Can I Save?

Like regular insurance, you can enjoy significant savings on out-of-pocket costs. An FSA, for example, may save you 30-40% every year. Membership programs for massage therapy may save you an extra 30%. Some companies report a total savings of 45% when you combine an FSA with a membership program. This can spare you from the risk of burning out your funds, especially if your health needs are more complex and require care from multiple practitioners.

Essential Considerations
If you need to seek out massage therapy, ensure that you are approaching your doctor with genuine intentions. Health insurance of all types is there to help you save on healthcare costs, and too many claims across the network for treatments that aren’t meant for specific conditions may affect your provider’s policies. This is also why it’s important to present your case, so your doctor can prescribe massage therapy with confidence. As for financial issues, your provider should send an itemized receipt for every treatment for tax purposes.

The Bottom Line
Most FSAs and HSAs will cover massage therapy – for healthcare purposes. If you have a health condition that can benefit from massages, such as injury recovery, chronic back pain, or even mental health issues such as depression or anxiety, you can obtain a prescription from your doctor that will allow coverage. If you are simply seeking massage for relaxation purposes, you are not covered and will need to pay out-of-pocket.

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