Non-traditional treatments - a worthwhile use of HSA funds?

Alternative medicine made a huge impact in the last few years, and continues to take an effect through 2019. From homeopathic treatments to alkaline diets, people are questioning commonly held wisdom more, and seeking their own path to wellness.

But as popular as these treatments are, they're less popular with insurance providers. Getting something like massage, acupuncture or chiropractic covered under your plan is a long shot, so you'll want to look into using your HSA.

Here's a little more about some things to know about non-traditional treatments and HSA eligibility.


HSAs only cover massage therapists if they're deemed medically necessary by your doctor. If a physical therapist recommends massage for a lingering injury, then you can pay for it with an HSA. If you decide that you'd like a massage to help you feel more relaxed, you won't be able to reimburse yourself with an HSA.

In order to use your HSA for your massage you should ask your doctor to write you a letter of medical necessity, which you can then use to file a claim with your HSA provider (or keep on file in the event you were ever audited by the IRS). The letter should detail the existence of a medical condition that can be treated with massage, among other requirements.


Acupuncture is an ancient form of Chinese medicine that has been found to alleviate all sorts of pain and discomfort, including nausea related to chemotherapy and migraines. As with most treatments, you'll need to prove you need it for the diagnosis, cure, mitigation, prevention or treatment of a disease or illness for it to be HSA-eligible.

If a doctor recommends acupuncture as a treatment, you might be able to use your HSA to pay for it. This is another example where it might be a good idea to have your doctor fill out a letter of medical necessity, detailing how many acupuncture sessions you'll need and why they will help. If you use acupuncture for overall wellness, it won't be eligible to use with your HSA.

Chiropractor treatments

Like massage, many people find significant benefit in seeing a chiropractor for back pain. If you have chronic pain or a high school injury that flares up every now and then, a chiropractor can adjust your musculoskeletal structure.

Many chiropractic visits will not require a letter of medical necessity, but if you have any doubts be sure to get one to keep on file. Like other alternative forms of medicine, you can only get chiropractor visits reimbursed if you're using them for a specific reason.

Essential oils

Essential oils have recently become a popular home remedy, purporting to cure everything from stress to allergies - but the IRS isn't so easily convinced. Essential oils and aromatherapy are not eligible for reimbursement with an HSA. Even if a doctor agrees to write a letter of medical necessity for your essential oils, you likely still can't use your HSA card to pay for them.

How to pay for non-traditional treatments with your HSA

You can pay directly with your HSA card at the chiropractor or acupuncture office, or submit a claim to your HSA at a later time. Be sure to have your letter of medical necessity in case the HSA provider asks for one or just to keep on file in the event that you are ever audited by the IRS.

Alternative medicine is still a grey area for HSAs, so don't be surprised if your provider is unfamiliar with certain procedures. But a few minutes with your HSA administrator will probably clear any confusion, so you can start your journey with full understanding of how far your HSA funds can take you.

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