Once considered a luxury, massage therapy is increasingly recognized as an alternative medical treatment or a complement to conventional medicine. Studies have shown health benefits when massage therapy is used for pain management, improve blood flow and circulation, decrease inflammation, or to reduce cortisol, the body’s stress hormone.
What is a Flexible Spending Account (FSA) and Health Savings Accounts (HSA)?
A flexible Spending Account and Health Savings Account (HSA) are both special healthcare arrangements where money may be set aside using pre-tax salary deductions for out-of-pocket healthcare expenses, such as deductibles, healthcare services not covered by insurance, monthly prescriptions, co-payments, and co-insurance. The money set aside is usually referred to as contributions. You do not pay taxes on this money, which means you will save an amount equal to the taxes you would have paid on the money you set aside. A debit card is usually provided with these healthcare plans that includes your contributions. For medical expenses that qualify, you will not need to submit information to get reimbursed, as your funds will already be on the flex debit card. In some cases, additional information may be requested for reimbursement such as an itemized receipt of the healthcare service or letter of medical necessity.
The Coronavirus Aid, Relief, and Economic Security (CARES) Act, signed into law March 27, 2020, has key updates on the use of HSAs and FSAs. These changes expand qualified medical expenses and access to remote care.
Telehealth Services
High-deductible health plans (HDHPs) with an HSA may provide pre-deductible coverage for teleheath and other remote care service. This provision will las until December 31, 2021 (plan year must begin prior to this date).
Coverage for over-the-counter (OTC) medications
The CARES act restores the ability to use HSAs and FSAs to purchase certain OTC medications, like aspirin and other pain medication, allergy medications, etc. without a doctor's prescription. For the first time, menstrual care products are considered qualified medical expenses for reimbursement with an HSA or FSA. Both provisions for OTC and menstrual products apply to expenses incurred on or after January 1, 2020 and will continue without an expiration date.
Helpful Link:
IRS Medical Expenses: IRS Publication 502
What is the difference between an FSA and HSA?
An HSA is an individual account designed to work together with an HSA-eligible high deductible health plan (HDHP). Eligible contributions are tax deductible, and you can use your HSA money tax free to pay for qualified medical expenses for you, your spouse, and your qualified dependents. The employee owns the account, which means you have the flexibility to take it with you if you move to a different state or change jobs. The 2021 contribution limit is $3,550 (individual coverage) and $7,100 (family coverage).
Employers offer Flexible Spending Accounts (FSA) during the annual open enrollment period, usually in the last quarter of the year. All employees are eligible regardless of whether they have insurance or not. The employer owns the account, so the funds may not be transferred if you leave your job. The contribution limit for 2021 is $2,750.
Main Differences:
To be eligible for an HSA, you must have a qualified high deductible health plan (HDHP). Unlike FSAs, HSAs are not “use-it-or-lose-it” and they generally cover a broader range of qualified medical expenses than flexible spending accounts (FSAs). Unused contributions may be rolled over to the next year.
(Video) HSA vs FSA: Which One Should You Get?Unused contributions for an FSA are lost at the end of the year if you do not spend it by the deadline. They do not rollover to the following tax year, and you cannot change the contribution amount once you have elected it during open enrollment.
Helpful Links:
https://www.investopedia.com/best-health-savings-account-providers-5079652
https://www.investopedia.com/terms/f/flexiblespendingaccount.asp
Can I Use FSA or HSA for Massage Therapy?
Massage therapy can be a qualified medical expense if a medical condition is diagnosed by a physician or a chiropractor for which massage therapy may be incorporated into the treatment plan, whether it is a chronic condition or temporary, such as an injury or pre- and post natal discomfort. Medical expenses are the costs of diagnosis, cure, mitigating, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body. The IRS ruling states that medical care expenses must be primarily to alleviate or prevent a physical or mental disability or ailment. Examples of illnesses that qualify include carpal tunnel syndrome, stress, arthritis, diabetes, hypertension, fibromyalgia, chronic fatigue, anxiety, depression, and pain management.
Take these steps to pay for medical massage with your FSA or HSA plan:
1. Start with Your Benefits Plan Administrator in Human Resources.
Every company that administers FSA or HSA benefits may have different documentation requirements. Ask your benefits administrator what information is needed to cover medical massage under your FSA or HSA.
2. Get a Prescription from Your Physician or a Medical Letter from Your Chiropractor
Explain to your primary care physician or chiropractor, the symptoms you have for your
condition and how medical massage may be incorporated into your treatment plan.
There are a wide variety of mental and physical conditions that could qualify for a medical massage. Stress related symptoms, circulation issues caused by diabetes or hypertension, sciatica, arthritis, tinnitus, fibromyalgia, anxiety, depression, and chronic back pain are all examples of conditions that could qualify for massage therapy with a medical diagnosis that your doctor or chiropractor has identified.
The plan administrator will need this information as proof that massage therapy is part of your preventive health or treatment plan.
The prescription or letter will need to include the following information:
A reason you need massage therapy, such as to help manage a medical condition, manage the symptoms of a condition for preventive, or injury rehabilitation.
How often will you need massage therapy? Is it a few times a week, every week, or once a month?
How often you get a massage depends on your preventive health goals, medical
condition or injury, or stress level. You will get the most health benefits when you get
massages regularly. While it may be relaxing to get a massage at a full service spa,
going once or twice a year will not undo recurring muscle tension. Integrative health
centers, independent practitioners, and day spas may offer affordable options that will
allow you to incorporate massage therapy into your wellness plan more routinely.
Massage once every week or two is ideal for keeping tension and knots from forming
in your muscle tissues. If you have chronic pain or a medical condition, you may need
massage twice a week until you feel better.
The duration of the treatment. How long are you going to need this treatment? Routine massage is recommended to continue until the condition or injury improves. Once you are feeling good, once a month is the recommended minimum for maintaining health of your tissue. When medical massage is approved, it is usually covered for up to 12 months.
Including the medical diagnosis code is also very helpful in the prescription or letter. Diagnostic coding is used to translate written descriptions of diseases, medical services, and equipment into universal medical alphanumeric codes. These codes are part of the medical billing process to submit claims to be paid by insurance carriers.
“What you do every day, matters more than what you do once in a while.” -Gretchen Rubin
Start a routine and stay consistent to maintain a healthy lifestyle!
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FAQs
Can an FSA be used for massage? ›
If you have a Flex Spending Account (FSA), you may not be aware that Massage Therapy can qualify as a medical expense. If massage therapy services are prescribed by your physician then you can use your FSA account to pay for these services.
Can HSA be used for massage? ›Massage Therapy is eligible for reimbursement with a Letter of Medical Necessity (LMN) with flexible spending accounts (FSA), health savings accounts (HSA) and health reimbursement arrangements (HRA).
How do I get a medical necessity letter for massage therapy? ›Talk to your primary care provider.
In many HMOs and other health plans, this doctor is the one who must authorize the referral. Discuss medical necessity with the doctor. Figure out how that medical professional will diagnose a condition that can formally necessitate medical massage.
Chiropractic is a Qualified FSA Expense
Chiropractic is covered by a 'standard' FSA and not by a limited-purpose FSA (a limited purpose FSA can only be used for vision and dental expenses). A standard FSA covers all eligible medical expenses, including chiropractic treatments.
Massage therapy CAN be a qualified medical expense, if you meet all of the criteria below. The IRS ruling states: “Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body.
Can I write off massage therapy? ›Medically necessary massages
The rule states that anything that your doctor prescribes as "medically necessary" can be deducted from your taxes. That means that if your doctor tells you to get therapeutic massages you can keep the receipts and knock that expense off as deductible.
Can I use my HSA for a gym membership? Typically no. Unless you have a letter from your doctor stating that the membership is necessary to treat an injury or underlying health condition, such as obesity, a gym membership isn't a qualifying medical expense.
How do you prove medical necessity? ›- “Be safe and effective;
- Have a duration and frequency that are appropriate based on standard practices for the diagnosis or treatment;
- Meet the medical needs of the patient; and.
- Require a therapist's skill.”
To give you a fast and simple answer, you can expect to pay anywhere from $50 to $150 per hour for a massage.
Is massage therapy covered by insurance? ›For a massage to be covered by insurance, your best bet is to get a prescription or referral from your doctor. Even then, the insurance company doesn't have to agree to pay for it. Medicare, for example, doesn't cover massage therapy at all, so you would have to pay for 100% of the costs.
Can you use FSA for gym membership? ›
Key Takeaways
Generally, gym and health club memberships, along with exercise classes (like Pilates or spinning), cannot be covered by FSA funds.
Electric toothbrushes are not eligible for reimbursement with flexible spending accounts (FSA), health savings accounts (HSA), health reimbursement accounts (HRA), dependent care flexible spending accounts, and limited-purpose flexible spending accounts (LPFSA) because they are general health products.
Can you use FSA for Botox? ›You can use your FSAs (Flexible Spending Account) to cover Botox! Symptoms such as dry eyes or headaches can be treated with Botox.
What can I spend my FSA money on? ›You can spend FSA funds to pay deductibles and copayments, but not for insurance premiums. You can spend FSA funds on prescription medications, as well as over-the-counter medicines with a doctor's prescription. Reimbursements for insulin are allowed without a prescription.
Is massage therapy covered by insurance? ›For a massage to be covered by insurance, your best bet is to get a prescription or referral from your doctor. Even then, the insurance company doesn't have to agree to pay for it. Medicare, for example, doesn't cover massage therapy at all, so you would have to pay for 100% of the costs.
Can you use FSA for Botox? ›You can use your FSAs (Flexible Spending Account) to cover Botox! Symptoms such as dry eyes or headaches can be treated with Botox.
Can I use FSA for physical therapy? ›Yes, you can.
Since physical therapy services, like the ones provided at Natural Fit Therapy, fall under a medical expense that treats structures and functions of the body, you are able to use your FSA funds to pay for treatment from a physical therapist for yourself, your spouse, or your dependents.
A pedicure is not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).
Does FSA cover electric toothbrushes? ›Electric toothbrushes are not eligible for reimbursement with flexible spending accounts (FSA), health savings accounts (HSA), health reimbursement accounts (HRA), dependent care flexible spending accounts, and limited-purpose flexible spending accounts (LPFSA) because they are general health products.
Is Apple Watch FSA eligible? ›While fitness trackers such as an Apple Watch, Fitbit or Garmin aren't eligible expenses, medical devices that monitor, screen, or test for certain diseases or medical conditions may be eligible. These include items like blood pressure and heart-rate monitors.
How much does a massage cost? ›
To give you a fast and simple answer, you can expect to pay anywhere from $50 to $150 per hour for a massage.
Does physical therapy include massage? ›Do Physical Therapists Do Massage? Yes — Physical therapists perform a variety of massage techniques including: Active Release therapy. Trigger point release.
Do you tip a chiropractor massage therapist? ›Tipping about 20% is customary in the "spa realm," says Taelour Wagler, a licensed massage therapist and owner of The Middle Wellness Center in Grand Junction, Colorado. (That's about how much to tip a hairdresser, too.)
Can you use FSA for tummy tuck? ›FSA eligible with prescription products designated with this symbol require a prescription to be reimbursed by an FSA. Abdominoplasty, more commonly referred to as a tummy tuck, is not an eligible expense as it is for cosmetic purposes.
Can you use FSA for toilet paper? ›Toiletries are not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). What are toiletries?
What can FSA be used for 2022? ›expenses. Your 2022 FSAs can only be used to reimburse eligible expenses for care provided from the effective date of your enrollment through March 15, 2023. Different rules apply to Health Care and Dependent Care eligible expenses if your participa- tion in the plan ends before December 31, 2023.
Can I buy a treadmill with my FSA? ›A treadmill can be eligible for reimbursement with a Letter of Medical Necessity (LMN) with a flexible spending account (FSA), health savings account (HSA) and health reimbursement arrangement (HRA).
Can I use my HSA for YMCA membership? ›Gym memberships are not eligible in a Health Spending Account. However, a gym membership would be eligible in a Wellness Spending Account since it is a taxable spending account.
Can you use FSA for weight loss? ›Like any other health care product, you're only able to use your FSA funds for a weight loss program if the purpose is to treat, mitigate, cure, diagnose or prevent a specific illness. This condition needs to be diagnosed by a physician and may include conditions such as obesity, heart disease and hypertension.