Can You Use Your HSA for Massages?
Explore when therapeutic massages qualify as an HSA-eligible expense. Understand the medical necessity and documentation needed for IRS compliance.
Health Savings Accounts (HSAs) offer a tax-advantaged way for individuals to save and pay for qualified medical expenses. These accounts allow for pre-tax contributions, tax-free growth of funds, and tax-free withdrawals when used for eligible healthcare costs. Many people wonder if specific wellness or therapeutic services, such as massages, can be covered by these accounts.
Understanding HSA Eligibility
To be considered an HSA-eligible expense, a service or product must meet the Internal Revenue Service (IRS) definition of “medical care,” as outlined in Internal Revenue Code Section 213. This section broadly defines medical care as amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body. The primary intent of the expense must be to alleviate a physical or mental defect or illness, rather than for general health improvement or cosmetic purposes. Expenses that are merely beneficial to general health are typically not eligible. Many non-traditional treatments often require a specific, diagnosed medical condition to qualify.
When Massages Qualify
Massages are generally not considered qualified medical expenses if their sole purpose is for general well-being, relaxation, or stress reduction without a specific medical indication. However, therapeutic massages can qualify for HSA reimbursement if prescribed by a licensed healthcare provider to treat a specific medical condition. For instance, a massage might be eligible if recommended for chronic back pain, recovery from a muscle injury, or to address conditions like temporomandibular joint disorders (TMJ) or certain neurological conditions. The specific type of massage itself is less important than the documented medical necessity and the purpose for which it is received.
Required Documentation
To substantiate a massage as a qualified medical expense for HSA purposes, specific documentation is necessary. This typically includes a Letter of Medical Necessity (LMN) or a formal prescription from a licensed healthcare provider, such as a physician, chiropractor, or physical therapist. The LMN should explicitly state the specific medical condition being treated, explain why massage therapy is medically necessary for that condition, and outline the recommended frequency and duration of the treatment.
In addition to the LMN, detailed receipts from the massage therapist or facility are crucial. These receipts must clearly show the date of service, a description of the service that reflects its therapeutic purpose (e.g., “therapeutic massage for chronic low back pain”), the cost of the treatment, and the provider’s information and credentials. Maintaining meticulous records of both the LMN and all related receipts is important for tax purposes, as the IRS may request this documentation during an audit. Using HSA funds for non-eligible expenses can result in penalties.