Using your HSA for Alternative Treatment

Alternative medicine is a term that describes medical treatments that are used instead of traditional or mainstream therapies (WebMD). Many Americans use alternative treatments to manage medical issues, but can you use your HSA funds to cover them? Let’s explore below.


Before we go any further, you can't just go and get a massage, and count it as a qualified medical expense. It needs to be used specifically to treat an actual medical condition or injury. This includes anxiety, depression, hypertension, diabetes, chronic fatigue and fibromyalgia.

Specific requirements differ with each HSA, but generally, you'll need your doctor to give you a Letter of Medical Necessity (LMN). This letter should state the actual diagnosis and how massage therapy will help to treat the issue. The doctor also needs to mention how long the treatment should be.

Acupressure and acupuncture

Acupuncture is an ancient Chinese medical technique that uses needles to help balance energy flow to treat medical conditions, most commonly pain. The needles don't typically hurt and may even help relieve muscle tension, similar to getting a massage.

Acupressure is similar to acupuncture except there are no needles involved. The practitioner will press on certain pressure points (also known as acupoints) on specific areas of the body. It's meant to help restore balance to the body.

Getting acupuncture or acupressure may count as a HSA-qualified medical expenses, and in some cases, will require an LMN. It also needs to outline how acupuncture or acupressure will be used and for how long, just like for massage therapy.

Other alternative treatments

Alternative treatments aren't clinical trials for medicine or procedures. Rather these treatments don't fall into mainstream medicine. When used on a regular basis, alternative treatments can help your body and mind relax as if you did go on a week-long vacation. (Please note: These alternative treatments will likely require a LMN to show they are primarily for the treatment or alleviation of a medical condition.)

Common alternative treatments include:

  • Reiki - This is where an alternative healer accesses your body's natural energy by placing his or her hands lightly over your body. Their hands move around, circulating energy and is meant to aid in relieving anxiety, manage pain and promote relaxation.
  • Naturopathy - Healers use various treatments such as herbal remedies, acupuncture and other kinds of noninvasive treatments to help the body heal itself.
  • Chiropractic - This is where a chiropractor puts your body back in alignment by manipulating the spine. It's meant to help treat a wide variety of conditions, such as headaches and chronic pain.
  • Energy Therapy - Similar to reiki, except practitioners use magnets to manipulate your body's energy fields.

Remember, qualified medical expenses are primarily for the treatment or mitigation of a medical condition. Even if a treatment fall outside of the “mainstream”, it still may be eligible with your HSA dollars.

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