Is Chiropractic Care an HSA Eligible Expense?

Health Savings Accounts (HSAs) offer a tax-advantaged method for individuals to save and pay for healthcare expenses. These accounts provide a way to manage medical costs with notable financial benefits. Understanding the scope of eligible expenses is important for maximizing the utility of an HSA.

Understanding Health Savings Accounts

HSAs are personal savings accounts for healthcare costs, offering significant tax advantages. To qualify for an HSA, an individual must be enrolled in a high-deductible health plan (HDHP). These plans typically feature lower monthly premiums but require the account holder to pay more out-of-pocket for healthcare services before insurance coverage begins.

The financial benefits of an HSA are often referred to as “triple tax-advantaged.” Contributions made to the account are tax-deductible, or pre-tax if made through payroll deductions. The funds within the HSA grow tax-free, and withdrawals are also tax-free, provided they are used for qualified medical expenses. Funds in an HSA do not expire and can be carried over year to year, allowing for long-term savings.

Defining Qualified Medical Expenses

The Internal Revenue Service (IRS) outlines specific criteria for “qualified medical expenses” in IRS Publication 502. These expenses must primarily be for the diagnosis, cure, mitigation, treatment, or prevention of disease. They can also be for affecting any structure or function of the body.

Expenses that are merely beneficial to general health, such as vitamins or a vacation, are generally not considered qualified medical expenses. The focus remains on medical necessity rather than general wellness.

HSA Eligibility for Chiropractic Care

Chiropractic care is generally considered an eligible expense for Health Savings Accounts. It is important that the chiropractic treatment addresses a health issue rather than being solely for general health maintenance or cosmetic purposes.

For instance, chiropractic adjustments and related therapies for conditions like back pain, neck pain, or headaches stemming from a diagnosed medical condition typically qualify. However, routine massages or adjustments without a specific medical diagnosis, intended purely for wellness or general upkeep, may not be eligible. In some cases, a Letter of Medical Necessity from a healthcare provider may be required to substantiate the medical necessity of the treatment for HSA reimbursement.

Documentation and Record-Keeping for Chiropractic Expenses

Thorough documentation for chiropractic expenses paid with HSA funds is important. The IRS requires substantiation that expenses were qualified medical expenses, especially during an audit. Proper records prove HSA distributions were used appropriately, avoiding taxes and penalties on non-qualified withdrawals.

Key documents include detailed receipts or invoices from the chiropractor, specifying date of service, services rendered, and amount charged. Proof of payment, such as bank statements or credit card receipts, should also be kept. Additionally, an Explanation of Benefits (EOB) from your health insurance carrier can provide valuable corroboration of services received and amounts paid. These records should be kept for at least three years, aligning with the typical tax audit period, or longer if the HSA account remains open.