Employee Benefits

Can You Use Your HSA for Therapy and Other Mental Health Services?

3 min read
Jan 10, 2024

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. You can use an HSA to cover some mental health expenses, including therapy to treat a diagnosed mental condition.However, therapy that isn't specifically designed for medical or mental health needs — like marriage or family counseling — often won't qualify for HSA coverage.2

Some mental health services may require a letter of medical necessity (LMN) to qualify for HSA reimbursement.2 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 directly with HSA funds (typically with a debit card linked to your HSA), or you can get reimbursed for the cost of the service later.3

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 specific therapy sessions, you can typically use your HSA to help pay for a range of other mental-health-related services. Some common examples include:4

  • Psychiatric care: This may include consultations, assessments, and treatments used to address mental health conditions.

  • Substance abuse treatment: This may include 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 medical professional to help manage mental health conditions.

  • Alternative treatments: Non-traditional approaches to mental health — such as acupuncture, massage therapy, or holistic healing — can be eligible, though some require an LMN.

Consult with your 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 a bit differently. Review eligibility, tax benefits, and account details for FSAs and how they differ from HSAs.  

Generally, you can be reimbursed for mental health services from an HSA, traditional 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 you money on healthcare costs, it can also be used to help support your mental health.

Your employer may offer HSAs as part of your employee benefits package. If so, you can opt-in during open enrollment or after a qualifying life event (QLE). However, if an HSA plan isn’t available through your employer, you may be able to open an account on your own with an HSA provider or financial institution — if you meet eligibility requirements.

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 (HR) specialist or HSA provider.

Learn about MetLife Health Savings & Spending Accounts  

Designed to help you save

1 “Frequently asked questions about medical expenses related to nutrition, wellness, and general health,” IRS, 2023
2 “Therapy, mental health: FSA Eligibility,” FSA Store
3 “Your HSA Reimbursement Cheat Sheet,” HSA StoreⓇ
4 “The Complete HSA Eligibility List,” HSA Store