Health Savings Account

Can I Use My Health Savings or Flexible Spending Account for Massage Therapy?

We get this question often and the answer is; it depends on your insurance carrier along specific IRS guidelines.

In general, Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSA) cover massages for certain medical conditions. It has been determined that the medical care MUST be primarily to alleviate or prevent a physical or mental ailment. The Internal Revenue Service (IRS) has ruled that massage therapy for the sole purpose of tension and stress relief does not qualify as an eligible expense.

The treatment must be approved and prescribed by a physician. Examples of medical conditions that qualify include carpal tunnel, back pain, arthritis, fibromyalgia, anxiety, depression and pain management.

How to Use an FSA/HSA for Massage

You must ensure you have obtained prior approval for the massage from your doctor, insurance provider and ensure that your HSA/FSA will cover the massage session. Once you obtain your prescription, keep it with your tax documents, should you need it to verify the expense at tax time.

Before scheduling the massage session, visit your primary care doctor or local physician. Let him or her know that you have an FSA or HSA and you’d like to use some of your funds toward massage for treatment or prevention of your condition. Once the evaluation is concluded, if you qualify, the physician will write a prescription for your massage, as a medical necessity.

Once qualified, the physician must provide three pieces of information on your prescription:

  • First, the doctor must detail why it is medically necessary. (Example: to relieve back pain, reduce stress/anxiety; prevent carpal tunnel syndrome, etc.)
  • Second, the number of sessions per month or frequency of your visits should be listed. (Example: Two (2) 60-minute sessions per month.)
  • Third, the length of the treatment period should be provided. (Example: 3 months, 6 months, 12 months, etc.)

How do you pay?

Once approved you may contact a service provider to reserve your massage session(s) For example Oasis Day Spa.  Make the provider aware that you have HSA/FSA approval for your sessions. You must provide your service provider (the organization performing your massage session) a copy of your prescription for their records to show approval and the number of sessions.

Some providers will require you to pay upfront and be reimbursed for your sessions from your insurance company.  Maintain your receipts from each session for your records, as proof of treatment to submit for reimbursement.  Note: Your service provider is not responsible for any denials for reimbursement once a service is provided, so ensure you have all proper approvals.

At Oasis Day Spa you pay us directly, as your service provider, and maintain your receipts for reimbursement by your insurance company.  Advise if you will be paying with a Visa or MasterCard Flex Spending Card (you cannot include a tip on your Health Savings Card.) Your payment will be processed upon arrival, to confirm approval prior to your massage session.  If the Health Savings Card will not process in our system, you will be required to pay for the session and seek reimbursement from your insurance company. Oasis will provide you with a receipt to submit for reimbursement.

To recap, you must obtain approval prior to a massage session as outlined above, with written permission from your doctor, and approval from your insurance company. Only certain conditions are covered, so do your research and have all your approvals before making your massage appointment. Massages for a spouse and even a dependent under the age of 27, if he or she has a qualifying medical condition, may be covered.

Most accounts are “Use it or Lose it,” so use your HSA/FSA accounts before the end of the year if you have a medical condition that qualifies you for a massage!

For more IRS information go to: