Employee Benefits

How to Make the Most of Your HSA: From Massages to Investments 

3 min read
Oct 06, 2023

Have you ever wondered, “Can I use my HSA for massage therapy?” Or maybe you’ve wondered if you can use it for cold medicine, eyeglasses, or renovations to make your house accessible. If you have a health savings account (HSA), you may be aware that it can be used for more than just covering copays, deductibles, and prescriptions. You can use it for holistic healthcare costs, mental healthcare, over-the-counter (OTC) medications, and more. You can even invest the balance to save for medical costs after retirement. Read on to learn more about putting your HSA funds to good use.

What is an HSA?

Before we jump into making the most of one, let’s define HSA. For individuals with a high-deductible health plan (HDHP), an HSA is a pre-tax savings account set up with a bank, credit union, or other financial institution. You may receive a debit card to spend your HSA saved funds on qualifying expenses, such as medical expenses for you, your dependents, or your spouse.

There are generally two categories you can spend your HSA money on: common healthcare expenses and qualified medical expenses. Common medical expenses are the more traditional expenses, like copays, medical bills, ER visits, surgery, specialists, and prescription medications.

Qualified medical expenses can include everything from holistic treatments to accessibility services.

Using your HSA for holistic treatments

Your HSA can pay for many alternative or holistic treatments if your PCP recommends them. They’ll need to write you a letter of medical necessity (LOMN) stating the condition the treatment is for, how many sessions you need, and any other details. Some of the qualifying therapies can include:

  • Massage therapy
  • Acupuncture
  • Chiropractic services
  • Yoga

Using your HSA for OTC products

You can use your HSA to pay for over-the-counter (OTC) medications and other readily available healthcare products. You won’t need to get an LOMN for these categories, since the 2020 Coronavirus Aid, Relief, and Economic Security (CARES) Act expanded the list of products you can use your HSA for.1

Some of the qualifying OTC products include:

  • OTC medication: You can use your HSA to purchase any FDA-approved medications from allergy relief to cold and flu medications. However, supplements or vitamins aren’t FDA approved and don’t qualify.
  • Feminine care: In 2020, HSA-eligible products expanded to include feminine hygiene products. This includes pads, tampons, menstrual cups, and more.
  • Family planning: You can use HSA funds to pay for condoms, birth control, fertility treatments, in vitro fertilization (IVF), erectile dysfunction medications, vasectomies, pregnancy tests, and more.
  • Nursing products: If you have a new baby, breastfeeding supplies are HSA eligible.
  • Acne medicine and skincare: Acne is a medical condition and isn’t considered cosmetic, so you can use your HSA to purchase acne-fighting products.

Using your HSA for accessibility

Your HSA provides tax benefits on accessibility products and services. This can help people with limited mobility, vision and hearing problems, or other disabilities afford the services they need.

Some of the qualifying accessibility products include:

  • Hearing aids: Your HSA can help cover hearing aids, hearing aid batteries, and repair costs.
  • Glasses or contacts: This includes all kinds of lenses, even prescription swim goggles, prescription sunglasses, blue-light glasses, or anti-fatigue glasses, as well as repair costs.
  • Mobility aids: Your HSA can help purchase walkers, canes, crutches, mobility scooters, and any other mobility aids you may need.
  • Home improvements: Home improvements for accessibility — such as a ramp, rails, or a stairs chair lift — are all HSA eligible. You’ll likely need an LOMN from your doctor, but once you’ve got that, you can start on improvements.
  • Service dogs: Service dogs can help you navigate the world, feel safer, and communicate your needs. You can use your HSA to pay for a seeing-eye dog or other service dog costs.
  • Transportation and travel for medical care: No matter your mode of transportation, you can use your HSA to pay a portion of your travel expenses. This may include gas mileage, parking, tolls, tickets, hotel stays, and more. You can even use your HSA to help pay an ambulance bill.2

Using your HSA for mental health treatment

Your mental health is just as important as your physical health. HSA accounts let you spend funds on mental health treatments like in-patient programs, therapy, and prescription medications. This can help by giving you a tax break on already expensive treatment bills.

Using your HSA for addiction treatment

If you or someone on your insurance needs treatment for an addiction, you can likely pay those bills with your HSA. A drug or alcohol treatment center, smoking cessation program, and costs associated with quitting — like nicotine patches — are all HSA-eligible expenses.

Using your HSA for weight loss treatment

If your doctor recommends a weight loss program to treat a medical condition, like heart disease or obesity, they can write an LOMN for the associated costs. This often won’t cover gym fees or special food, but it will cover other weight loss treatment costs — such as a dietitian, weight loss programs, or weight loss surgery.

Using your HSA to invest

You can use HSAs for current medical costs and to invest for future medical costs.3 Much like a brokerage account or an individual retirement account (IRA), your HSA may let you invest! If you enroll in an HSA through your workplace, see if they offer any investment options.

Money in HSAs rolls over year to year, so you don’t have to use it in a specific period of time. Instead, you can leave it to grow, whether that means a few years down the road or during your retirement.3

Investing in your HSA unlocks the triple tax benefit. Your HSA contributions are tax-deductible, any market growth is tax-free, and when you withdraw for any qualified medical expenses, that’s tax-free, too.3

Considering an HSA?

Open enrollment is the perfect time for high deductible health plan (HDHP) policyholders to set up a HSA. Whether you want to set aside money for general healthcare costs, OTC products, accessibility products, an HSA may be right for you.

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1 “IRS outlines changes to health care spending available under CARES Act,” Accessed 9/22/23
2 “Travel or Transportation for Medical Care: HSA Eligibility,” FSA Store Inc., 2023
3 “How to Invest With Your HSA, and Why,” Nerdwallet, 2022

This article is intended to provide general information about insurance. It does not describe any MetLife product or feature.