Can You Use an HSA for Marriage Counseling?
Navigate HSA eligibility for marriage counseling. Discover when it qualifies as a medical expense and what documentation you need.
Health Savings Accounts (HSAs) provide a tax-advantaged way for individuals to save and pay for eligible healthcare expenses. These accounts help those enrolled in high-deductible health plans manage medical costs. This article explores whether marriage counseling can be considered an HSA-eligible expense.
Qualified Medical Expenses for HSAs
The Internal Revenue Service (IRS) defines qualified medical expenses in Publication 502 as costs for the diagnosis, cure, mitigation, treatment, or prevention of disease. These expenses also include treatments aimed at affecting any structure or function of the body. The primary purpose of the expense must be to alleviate a physical or mental defect or illness, not simply for general health improvement.
Common examples of qualified medical expenses include doctor visits, prescription medications, and hospital stays. Dental and vision care, as well as certain chiropractic services, also typically qualify. However, items merely beneficial to general health, like vitamins or a gym membership for general fitness, are generally not included unless prescribed for a specific medical condition.
Marriage Counseling and HSA Eligibility
Marriage counseling is typically not considered a qualified medical expense under IRS guidelines. This is because it usually addresses relationship issues or general well-being rather than a specific medical condition of an individual. Expenses for general health improvement or stress management are generally not eligible for HSA reimbursement.
However, an exception exists if the counseling is directly related to treating a diagnosed mental health condition of one of the spouses. If a licensed medical professional diagnoses an individual with a mental health condition like depression, anxiety, or PTSD and prescribes marriage counseling as an integral part of that treatment plan, it may qualify. The counseling must be considered medically necessary for the individual’s diagnosed condition, not for general relationship improvement.
Supporting Documentation for Reimbursement
Maintaining thorough documentation is important for any HSA reimbursement. If marriage counseling is deemed medically necessary for a diagnosed condition, specific records should be kept. This includes a written diagnosis from a qualified medical professional for the mental health condition affecting one of the spouses.
A letter of medical necessity (LMN) from the medical professional should state that marriage counseling is a necessary treatment for the diagnosed condition. This letter should explain how the counseling alleviates or treats the specific condition. Detailed receipts from the counseling provider showing dates of service, services rendered, and amounts paid are also needed. These documents help substantiate the expense to the HSA administrator or the IRS, especially in the event of an audit.