How To Use HSA for a Massage in 2024


Justin Mares

Published Date:

January 31, 2024


There are so many non-invasive ways to manage discomfort and support the body’s healing process without prescription drugs. Massage is proven to be highly effective for the management of chronic physical and mental health conditions. A massage isn’t always a luxury — sometimes it’s healthcare. If you’re interested in using HSA funds for massage therapy treatment, here’s what you need to know about getting approval.

How Does an HSA Work?

An HSA, or health savings account, is a specially designated savings account used for storing pre-tax money to be spent on eligible healthcare-related purchases and expenses. The idea behind an HSA is to make healthcare more affordable by providing a tax break on necessary expenses. 

An HSA works similarly to other types of savings accounts. You choose how much money you want to deposit and when you want to deposit it. Unlike with an FSA (flexible spending account), the account isn’t overseen by an employer. The funds you deposit grow interest with time and will never expire if you don’t use them. 

Many people prefer HSAs to FSAs because of the freedom and control they offer. HSA accounts empower you to take control of your own healthcare needs on your own terms, allowing you to save money and budget effectively throughout the process. 

What Does HSA Cover?

Since HSA funds are tax-free, the IRS gets to decide what they can and cannot be used for. Thankfully, the list of eligible expenses is quite lengthy. HSA funds cover essential medical costs like prescription co-pays and medical appointment costs, as well as many over-the-counter healthcare necessities. 

Your HSA funds can be used to cover things like over-the-counter pain relievers, allergy medicine, and cold medicine. HSA money can also be used to pay for first aid kits, wound care supplies, diabetes supplies, and prescription medical devices. 

Are There Medical Benefits to Massage?

HSA funds only cover medically beneficial purchases, which brings us to massage. There are numerous medical benefits of a massage, and there are many circumstances under which a doctor may recommend or prescribe massage to treat a condition.

Massage Promotes Muscle Recovery

The primary benefit of massage is its ability to support muscle recovery. Massage encourages muscles to flush with oxygenated, nutrient-rich blood. The muscles use the nutrient content of the blood and the improved circulation to boost the healing process. This process is what makes massage especially helpful for people recovering from injuries or living with chronic pain. 

Massage Stimulates the Lymphatic System

Sore, fatigued muscles are often swollen with lymphatic fluid that the body is attempting to use to heal injuries. Lymphatic fluid tends to accumulate in the lower extremities, and it sometimes needs help to circulate and be expelled from the body through waste. Massage stimulates the lymphatic system, promoting efficient drainage and reducing swelling. 

Massage Boosts the Immune System

The combination of increased blood flow and improved lymphatic drainage works to fortify the immune system. The immune system relies on healthy lymphocyte cells and nutrients delivered by blood to strengthen itself. Massage helps your body feed its immune system, which provides it with the energy and support it needs to protect you.

Massage Can Promote Better Sleep

Discomfort and feelings of anxiety can lead to restlessness, making it difficult to fall asleep. Many people report that the relief provided by a massage significantly improves their overall quality of sleep. Massage can make it easier to fall asleep, stay asleep, and awake feeling well rested.

Massage Can Support Mental Health

Massage releases endorphins that can have a significant impact on your mental and emotional state. Feelings of emotional tension can be closely linked to feelings of physical tension. Between the endorphins released by a massage and the tension relieved by a massage, many people report experiencing an overall better mood and a greater sense of well-being. 

Can You Use HSA for Massage?

Massage is recognized as a valid medical treatment, but it isn’t covered outright by HSA funds. You can’t use your HSA to go get a leisurely massage, but you can use your HSA funds to get a doctor prescribed massage when you have a legitimate medical need for massage therapy.

Your doctor must diagnose you with a condition that is known to be improved through the use of massage. This applies to both chronic and temporary conditions. Massage can be used to treat chronic pain. There are also specific types of massage, like sports massage and prenatal massage, that can be used to treat the temporary effects of a condition.

Many massage therapists don’t accept HSA as a form of payment, but that doesn’t necessarily matter. Even if your preferred massage therapist doesn’t accept HSA, you have the option to pay for the massage with personal funds and reimburse yourself. 

How To Use HSA for Massage

In order for your massage to be covered by HSA funds, it must essentially be prescribed by a doctor. The first step is speaking to your doctor about how massage therapy can become part of your treatment plan. If your doctor agrees, they can write you a Letter of Medical Necessity.

A Letter of Medical Necessity is a medical justification for using HSA funds for something that isn’t covered by default. Your Letter of Medical Necessity acts as a justification for using your HSA to pay for a massage and will help you avoid paying a tax penalty on the money you used for your massage. 

You’ll submit a copy of your Letter of Medical Necessity to your HSA custodian and keep one for your personal records. A Letter of Medical Necessity is generally valid for a year, which means you’ll be able to use the same letter to justify massage expenses throughout that period of time. Save your receipts for every massage you buy with HSA funds. The letter and the receipts work in unison to justify the expense.

Some massage providers may accept your HSA-linked debit card as a direct form of payment, but this is less common. Truemed is working with retailers and service providers across the health and wellness industry to make HSA payment processing more accessible. If your massage therapist isn’t Truemed integrated, you’ll need to utilize reimbursement.

If your massage provider doesn’t accept HSA as a form of payment, you’ll pay for the massage with your personal funds. Save the receipt from your massage, withdraw or transfer the exact amount of the total from your HSA, and keep the cash or use it to replenish your personal bank account.

Can I Use My FSA for Massage?

The rules for FSA and HSA expenses are nearly identical. You can use your FSA for massage by following the same procedure as you would for HSA funds. Remember to submit documentation (your Letter of Medical Necessity) to your FSA custodian rather than your employer. Your employer is simply an intermediary — they aren’t responsible for maintaining FSA documentation.

Since your FSA is sponsored by your employer, it may be worth asking your human resources department if your employer partners with gyms, massage therapists, or other wellness service providers to give discounted rates to employees. You may be able to stack discounts by utilizing an employee wellness discount (usually 10% to 15%) with your employer-matched FSA contributions for substantial savings. 

What Else Can You Buy With HSA Funds?

HSA funds can be used to purchase a wide array of therapeutic services or devices with a Letter of Medical Necessity. If your doctor prescribes a wellness tool like a sauna, hot tub, or cold plunge, you’re allowed to fully or partially purchase the device with your HSA funds. Several Truemed integrated retailers offer similar home wellness equipment that you can purchase with HSA as a payment method.

In some cases, HSA funds can also be used to pay for things like gym memberships, workout equipment, supplements, vitamins, and healthy foods. Doctors can make assessments related to the treatment of their patients and determine their eligibility for purchasing things that aren’t ordinarily covered by their HSA funds. 

Empower Yourself with Truemed

Truemed’s philosophy is simple: food, exercise, and therapeutic services are medicine. We’ve partnered with a vast array of retailers and service providers in the health and wellness space to make it easier for people to use their HSA and FSA funds on the things that really matter to their health. Shop with a Truemed integrated retailer and take control of your wellness.


Flexible Spending Account (FSA) - Glossary |

Everything You Need to Know About Massage Therapy | Cleveland Clinic

Back massage intervention for improving health and sleep quality among intensive care unit patients | National Library of Medicine

Mayo Clinic explores: The role of massage therapy for mental health | Mayo Clinic

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