Can I Use My FSA for Chiropractic Care?

A Flexible Spending Account (FSA) is an employer-sponsored benefit that allows you to set aside pre-tax money from your paycheck for out-of-pocket healthcare costs. The primary advantage is tax savings, as contributions are not subject to payroll taxes, which reduces your taxable income. While many use these accounts for copayments and prescriptions, questions often arise about services like chiropractic care.

Determining Eligibility for Chiropractic Care

According to IRS Publication 502, you can use your FSA funds for chiropractic care. The treatment must be for the diagnosis, cure, mitigation, or treatment of a specific medical condition. This means adjustments to address issues like chronic back pain, sciatica, or neck pain from an injury are eligible.

This distinction is important because care for maintaining general wellness does not qualify. For example, routine adjustments without a specific medical diagnosis would be considered a general health expense and not eligible for FSA reimbursement. Your FSA administrator may scrutinize claims to ensure they meet this standard of medical necessity.

Beyond adjustments, other prescribed services are often covered, including initial consultations, diagnostic X-rays, and certain therapeutic treatments. Transportation costs for travel to and from your appointments may also be an eligible expense.

Required Documentation

Your FSA administrator will likely require documentation to prove the expense is valid, most commonly a Letter of Medical Necessity (LOMN). This is a formal letter from your chiropractor substantiating that the treatment is required to address a specific health condition and not for general wellness.

The LOMN must state your specific medical diagnosis, such as “chronic lower back pain” or “cervicalgia.” The letter should also detail the recommended treatment plan, including the services to be rendered and their expected duration. It must include a direct statement from the chiropractor affirming that these services are medically necessary.

Obtaining this document is a straightforward process that involves requesting it from your chiropractor’s office. They are familiar with these requests and can provide a letter that meets the requirements of most FSA administrators. Having this LOMN prepared before you submit a claim can prevent delays or denials.

The Payment and Reimbursement Process

There are two methods for payment. The most direct way is to use an FSA debit card, if your plan provides one, to pay at the chiropractor’s office. Even when using a debit card, you should always keep your itemized receipts, as the administrator may still request documentation to verify the charge was for an eligible expense.

The second method involves paying out-of-pocket and then submitting a claim for reimbursement. First, you must obtain an itemized receipt from the chiropractor for each visit that details the date of service, the specific service provided, and the cost.

Next, you will complete a claim form provided by your FSA administrator. You then submit this form along with the itemized receipt and the Letter of Medical Necessity. After the administrator reviews and approves your submission, the funds will be paid out to you from your account.