FSA/HSA and Massage Therapy

What is an FSA?

An FSA is a Flexible Spending Account or a Flexible Spending Arrangement. This is a healthcare plan that you receive through your employer. You set aside money from your paycheck, pre-taxed, to pay for healthcare expenses. However, not all healthcare services are qualified, so make sure to check your plan. Your employer may also contribute to your FSA, but they are not required to do so. (healthcare.gov).

Typically, you can receive a debit card that’s connected to your account, and you can use that card to pay for your services. Refer to your employer or FSA provider to see what options they offer to access your account funds. (metlife.com). 

• Requirements: Contribute pre-taxed dollars to your FSA through your employer

• Tax Benefits: Contributions are pre-taxed, and receive tax free withdrawals for eligible medical expenses 

• Contribution Limits: There are annual contribution limits, and employers can set grace periods or carryover options for unused funds. (elementsmassage.com).

What is an HSA?

An HSA is a Health Savings Account which is a type of personal savings account that lets you put aside pre-taxed money to pay for qualified healthcare services. Check your specific HSA to see what services you qualify for. You are eligible to contribute to an HSA when you are covered by an HSA-eligible plan, also referred to as a High-Deductible Health Plan [HDHP]. Anyone can contribute to your HSA, family, friends, and employers. If you have Medicare coverage or a plan that pays its share of a covered service without you having to pay a deductible or copayments first, then you are not eligible to contribute to an HSA. 

You can find HSA-eligible plans on the Health Insurance Marketplace or at some banks, credit unions, or financial institutes. (cms.gov).

• Requirements: Must be enrolled in an HSA-eligible plan or High-Deductible Health Plan (HDHP)

• Tax Benefits: Contributions are tax-free, tax-deductible, and withdrawals for qualified health expenses are tax-free

• Contribution Limits: The IRS sets annual contribution limits (elementsmassage.com).

How to Use FSA/HSA for Massage Therapy?

Massage therapy has recently been recognized more as a holistic treatment for various conditions in the healthcare field, rather than just a relaxing treat to unwind with. Massage can help with stress relief, pain management, increase joint range of motion, soft tissue injuries/ strains, or other specific health issues.

Depending on your FSA/HSA and the location you choose to receive massage from, massage therapy may be a qualified medical expense. You are likely to need a Letter of Medical Necessity (L.M.N.) from your doctor to prove to your insurance the need for this healthcare service. A L.M.N. states the condition the treatment is for the number of sessions needed, and other relevant details. Your HSA must be used for qualified medical expenses only. If your HSA funds are used for non-eligible expenses, then you may be subject to penalties. (metlife.com).

Bibliography 

“Can You Use an HSA for Massage.” MetLife, www.metlife.com/stories/benefits/can-you-use-hsa-for-massage/. Accessed 8 Apr. 2025. 

“Health Care Options, Using a Flexible Spending Account FSA.” HealthCare.Gov, www.healthcare.gov/have-job-based-coverage/flexible-spending-accounts/. Accessed 8 Apr. 2025. 

Pump, Elements Massage Short. “Using HSA/FSA for Massage Therapy.” Elements Massage - Short Pump, 19 Nov. 2023, elementsmassage.com/short-pump/blog/using-hsafsa-for-massage-therapy. 

“What Is an FSA and How Do I Use It?” MetLife, www.metlife.com/stories/benefits/flexible-spending-account/. Accessed 8 Apr. 2025. 

What’s a Health Savings Account? Fact Sheet, www.cms.gov/marketplace/outreach-and-education/health-savings-account.pdf. Accessed 8 Apr. 2025.