Can You Pay for a Massage With Your HSA?
Navigate HSA rules to determine if your massage therapy is a qualified medical expense. Understand eligibility criteria and necessary documentation.
Health Savings Accounts (HSAs) offer a tax-advantaged way for individuals to save and pay for eligible medical expenses. Designed to complement high-deductible health plans, HSAs provide financial benefits. Contributions are tax-deductible, funds grow tax-free, and withdrawals for qualified medical expenses are also tax-free, creating a triple tax advantage.
Understanding Qualified Medical Expenses
The Internal Revenue Service (IRS) defines a “qualified medical expense” as the costs associated with the diagnosis, cure, mitigation, treatment, or prevention of disease, along with expenses for treatments affecting any part or function of the body. This broad definition, outlined in IRS Publication 502, guides what can be paid for with HSA funds. For an expense to be qualified, it must be primarily for medical care and not merely for general health or wellness. Items such as over-the-counter medications and menstrual care products are also considered qualified medical expenses.
Specific Requirements for Massage Therapy
Massage therapy can be considered a qualified medical expense, but only under specific conditions. It must be medically necessary and prescribed by a licensed healthcare provider to treat a diagnosed medical condition. This means the massage cannot be for general well-being, relaxation, or stress relief alone. The therapy must aim to cure, treat, mitigate, or prevent a specific illness or injury.
A doctor’s note or a Letter of Medical Necessity (LMN) is required to substantiate the medical need for massage therapy. This documentation should clearly state the specific diagnosis for which the massage is prescribed. It must also outline how massage therapy will serve as a part of the treatment plan, including the recommended frequency and duration of the sessions. If the treatment extends beyond a specified period, a new LMN may be necessary.
Required Documentation and Record Keeping
Maintaining thorough documentation is crucial when using HSA funds for massage therapy, especially in the event of an IRS audit. Individuals should obtain a Letter of Medical Necessity (LMN) from their healthcare provider, which specifies the medical condition, the necessity of the massage for treatment, and the recommended frequency and duration. This letter serves as evidence that the expense is not for general wellness but for a legitimate medical purpose.
Beyond the LMN, detailed receipts from the massage therapist are essential. These receipts should include the date of service, a description of the service provided, the amount charged, and the provider’s information. It is also advisable to keep any supporting medical records that corroborate the diagnosis and the treatment plan. These records must be retained for as long as a tax return remains open to audit.
Using Your HSA Funds for Massage
Once the medical necessity for massage therapy is established and proper documentation is secured, there are common methods for using HSA funds. Many HSA providers issue a debit card, which can be used directly at the time of service, similar to a regular debit card. It is important to ensure the provider accepts HSA debit cards for such transactions.
Alternatively, individuals can pay for the massage therapy out-of-pocket and then seek reimbursement from their HSA administrator. This process typically involves submitting a claim to the HSA provider, often through an online portal, along with the required documentation. If audited by the IRS, presenting the previously gathered LMN and detailed receipts will substantiate the legitimacy of the expense.