A health savings account (HSA) is a tax-advantaged account that’s used for qualified medical expenses for those with a high-deductible health plan (HDHP). You may already know that you can use an HSA to help cover eligible medical, dental, and vision expenses for you, your spouse, and qualifying dependents. But what about using it for therapy or other mental health services? Read on to learn more.
Can I use my HSA for therapy?
Yes, an HSA can be used to cover some mental health expenses, including therapy to treat a diagnosed mental condition.1 (Note that therapy that isn’t specifically designated for medical or mental health needs — like marriage or family counseling — often won’t qualify for HSA coverage.)
Some mental health services may require a letter of medical necessity (LOMN) to qualify for HSA reimbursement. This is a formal document, provided by your doctor or healthcare provider, explaining the essential need for a specific treatment.
If you’re unsure about your HSA plan’s coverage, speak with your healthcare or HSA provider.
How do I use my HSA for therapy?
After confirming that the therapy you’re seeking qualifies as an eligible medical expense, you can use an HSA to help pay for copays, coinsurance, and deductibles associated with mental health services. When it comes to payment, you generally have two options: You can pay with a debit card linked to your HSA, or you can get reimbursed for the cost of the service.
It’s a good idea to keep track of your therapy expenses — such as invoices or receipts — so you'll have proper proof of eligibility for reimbursement.
What other mental health services can I use my HSA for?
In addition to therapy sessions, you can typically use your HSA to help pay for a range of other mental health services. Some common examples include:
Psychiatric care: This may include consultations, assessments, and treatments used to address mental health conditions.
Substance abuse treatment: These are medical and therapeutic treatments aimed at helping individuals with drug or alcohol addictions.
Prescription medications: These include any medications prescribed by a doctor, psychiatrist, or other licensed healthcare practitioner to help manage mental health conditions.
Gyms and health clubs: Memberships to a gym or health club may be eligible if exercise is a recommended treatment for your mental health condition.
Alternative treatments: Non-traditional approaches to mental health — such as acupuncture, massage therapy, or holistic healing — may be eligible with an LOMN.
Consult with your doctor or HSA provider to learn more about HSA eligibility.
What about FSAs? Can I use an FSA for therapy?
A flexible spending account (FSA) can also help cover the costs of mental health services, like therapy. However, keep in mind that FSAs and HSAs work slightly differently. Review eligibility, tax benefits, and account details for FSAs and how they differ from HSAs.
In general, you can be reimbursed for mental health services from an HSA, FSA, or a health reimbursement arrangement (HRA). However, reimbursement for therapy isn’t permitted with a dependent care FSA (DC-FSA) or limited purpose FSA (LP-FSA).2
HSA and therapy: The bottom line
An HSA can not only help support your physical well-being by saving on healthcare costs, it can also be used to help support your mental health. With an HSA, you can use pre-tax money for things like therapy, psychiatric care, recovery, and medications.
Your employer may offer HSAs as part of your employee benefits package; if so, you can opt in during open enrollment. However, if an HSA plan isn’t available through your provider, you can also open an account on your own with an HSA provider or financial institution.
As with all insurance plans, be sure to carefully read all the information associated with an HSA option to make sure it’s right for you. If you have questions, reach out to your human resources specialist or HSA provider.