Can I use FSA and HSA to pay for my massage?

Massage therapy isn’t just about relaxation – it can be a powerful tool for managing stress, pain, and muscle tension. But did you know that you can potentially use your Flexible Spending Account (FSA) or Health Savings Account (HSA) to pay for massage therapy? Both FSAs and HSAs allow you to pay for certain health-related expenses with pre-tax dollars, saving you money. Here’s how you can make massage therapy more affordable using these accounts.

What Are FSAs and HSAs?

• FSA (Flexible Spending Account): An FSA is a special account where you contribute pre-tax dollars to cover medical expenses. FSAs are offered through employers and typically have an annual use-it-or-lose-it policy, meaning you need to spend the funds within the plan year.
• HSA (Health Savings Account): An HSA is a savings account that you can use for qualified medical expenses if you are enrolled in a high-deductible health plan (HDHP). Unlike FSAs, the funds roll over year to year and are not subject to the use-it-or-lose-it rule. HSAs also provide tax advantages: contributions are pre-tax, and withdrawals for qualified medical expenses are tax-free

Is Massage Therapy Covered by FSA and HSA?

Massage therapy can be covered by both an FSA and an HSA, but it must be deemed medically necessary. This means that it needs to be prescribed by a doctor for the treatment of a specific medical condition, such as:

• Chronic pain (e.g., long-term back pain, fibromyalgia)
• Acute Muscle Strain
  • A sudden impact or awkward movement could result in muscle fibers being overstretched or torn
  • Examples:
    • Lifting something heavy without bending your knees; putting all the strain on your lower back.
    • Reaching or twisting awkwardly to grab something or falling and twisting your body can strain muscles in the back or sides.
    • Slipping or falling
    • Not warming up property before physical activity
    • swinging a tennis racket or a golf club repetitively leading to a strain in the shoulder or arm muscles
    • sleeping in an awkward position
    • sudden movement after inactivity
• Soft Tissue Injury
  • Damage to muscles, ligaments, or tendons that can happen due to trauma or an accident.
  • Examples:
    • sprained ankle from tripping or falling
    • whiplash from a car accident
    • tennis elbow
    • lifting heavy objects above the head repeatedly, leading to a rotator cuff injury
    • pulled hamstring during sports
    • strained lower back from lifting improperly
    • strained wrist from repetitive motions like typing at a keyboard
    • torn Achilles tendon from a sudden jump
• Anxiety or stress-related disorders
• Arthritis
• Migraines
• Sciatica
• Post-Surgical Recovery
• Carpal Tunnel Syndrome

The key point here is medically necessary. If you’re getting a massage simply for relaxation or general wellness without a prescription, it won’t be eligible for reimbursement through FSA or HSA.

Steps to Use Your FSA or HSA for Massage Therapy

1. Get a Doctor’s Prescription: To qualify for FSA or HSA reimbursement, you’ll need a doctor to write a prescription or a “Letter of Medical Necessity (LMN)”, which includes

   • Your diagnosis and date

   • Reason why the product or service is needed

   • Duration of treatment

   • Their relationship to you, contact information, and signature

2. Pay with Your FSA or HSA: Once you have the prescription, you can pay for your massage therapy directly with your FSA or HSA debit card. If your provider doesn’t accept these cards, you can pay out of pocket and submit a claim for reimbursement.
3. Keep Records: Make sure you keep a copy of the prescription and all receipts related to your massage therapy. Some FSA and HSA administrators may require these documents when you submit a claim.
4. Submit Claims for Reimbursement: If you don’t use your FSA or HSA card to pay directly, you’ll need to submit the receipts and a copy of the prescription to your account provider for reimbursement. Be sure to check the deadlines for claim submissions for FSAs, especially if you’re nearing the end of your plan year.

Typical massage therapies prescribed by physicians include

• Deep tissue massage
• Trigger point therapy
• Sports massage
• Myofascial release
• Lymphatic drainage massage
• Neuromuscular therapy
• Prenatal massage
• Reflexology

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