HSA & Flex Accounts

Using FSA and HSA for Massage Therapy

With open enrollment just around the corner, many people are thinking about their health insurance options. We won’t sugar coat it – there’s a lot to consider when picking out an insurance plan for you and your family. A common question we receive is about massage coverage on different insurance plans, specifically when it comes to paying for massages with a Health Savings Account (HSA) or Flexible Spending Account (FSA).

There’s often some confusion around claiming a massage as a medical expense. Can something that feels so relaxing actually be considered part of your health care coverage? In many cases, it absolutely can.

There are countless benefits of massage therapy. Massages can improve circulation, decrease pain and inflammation, reduce stress, as well as provide numerous benefits to your heart. Let’s take a leap into the world of healthcare to explain how you can pay for massage therapy through your health insurance plan with pre-tax dollars.

Before we discuss the process of getting a massage with your insurance plan, let’s do a quick overview on HSAs and FSAs. These are both special healthcare arrangements that allow you to set aside money for medical costs, such as deductibles, monthly prescriptions, copayments, and coinsurance. You don’t pay taxes on this money.

For a detailed list of what costs are considered “medical expenses,” start with this fact sheet from the IRS. In some cases, your employer will contribute money to your HSA or FSA each year as well. Both of these plans have a lot of fine print you’ll need to consider, so talk to your HR department if you have questions.

These healthcare plans usually come with a debit card that includes your (and your employer’s) contributions. In most cases, you won’t have to worry about being reimbursed, as your funds will already be on the flex debit card. You can spend this on any of the above medical costs.

There are a wide variety of benefits to these health accounts. First, HSAs and FSAs help you automate your savings for medical expenses. People rarely expect a medical emergency to happen, so these plans help you prepare without having to think about it.

And then there are the tax benefits. For both HSA and FSA, any contributions you make are pre-tax, so you end up saving a lot of money in the long run.

HSAs also roll over, meaning you can take any savings you’ve made for the year and apply them to the next year. FSAs, on the other hand, do not roll over. The set amount you put aside will go away if it’s not spent before December 31.

There are a few differences between FSA and HSA overall, but as it pertains to paying for a massage, they work the same.

In many cases, a massage will be covered by your insurance plan, whether you use an HSA or FSA. Follow these steps to make sure you’re qualified.

  1. Start with HR
    Before you do anything else, reach out to your HR department or your medical insurance carrier and ask if massage therapy is considered a covered treatment. In some situations, an insurance policy won’t cover massages, even if you get a prescription from a doctor.
    That said, at ABW we’ve found that the majority of customers who have an FSA or HSA had no trouble covering their massages.
  2. Doctor visit
    Once you’ve gotten the go-ahead from your insurance carrier, schedule an appointment with your primary care physician. Pro tip for this step of the process: Don’t start by just saying you want a massage. You’ll need to first explain your specific symptoms.
    There are a wide variety of mental and physical conditions that could qualify for a massage. Stress-related symptoms, circulation issues caused by diabetes or hypertension, sciatica, arthritis, tinnitus, fibromyalgia, anxiety, depression and chronic back pain are all examples that could qualify for massage therapy.
    Preparation is key to this discussion. Don’t be afraid to bring case studies of people who’ve alleviated similar symptoms through the power of massage therapy. You could also suggest specific massage therapy options, which can help you illustrate the legitimacy of this type of care.
  3. Get a prescription
    Once you and your doctor have talked it over, you’ll need them to write a prescription for a massage. In your insurance’s eyes, this acts as proof that you actually need an HSA or FSA massage.
    Your prescription will need to include the following:
    A reason you need massage therapy, such as a medical condition or injury.
    The number of sessions you’ll require each month. Do you need a massage every month? Or once every 1-2 weeks? For regular massages, you should consider getting a massage membership to lower the cost of each session.
    The duration of the treatment. How long are you going to need this treatment? Should they be 60-minute, 75-minute or 90-minute massages? Your doctor will be able to guide you in the right direction on this one. You can also change the length, time of day, and cadence as needed.
    Getting a prescription is easier than it sounds, so there’s no need to stress. Healthcare providers often write prescriptions for things like massage or acupuncture without requiring an in-person doctor visit. Your prescription can practically be as on-demand as your massage.

So how much can you save on a massage with an FSA? Using an FSA for massage therapy can save you 30-40% a year on out-of-pocket expenses.

Things to keep in mind
When requesting a massage therapy prescription from a doctor, make sure you’re coming at it with the right intentions. The purpose of your health insurance is to cover medical expenses, and massage therapy can be a great way to benefit your wellness and healing. Be honest when speaking with your doctor regarding your symptoms.

In the same way, make sure you only use your HSA or FSA cards for massage therapy expenses if you have a prescription from your doctor. It’s also important that you keep track of your records for tax season.

Getting the most from your insurance
When it comes down to it, your insurance is there to keep you healthy. A massage can be a good remedy for many types of injuries and conditions. Take these steps to pay for medical massage with your FSA or HSA plan.