In today’s world, massage therapy is finally being recognized as a medical service as
opposed to a luxury. Yes, there are patients who do seek out massage for the sole
purpose of having a spa day, and there is nothing wrong with that. But the majority of
patients, at least in my experience as a massage therapist, receive massage for healing
purposes. And while most who need a corrective approach are treated for muscle pain or
emotional stress, some patients are prescribed massage for injuries or medical conditions.
When it’s a medical necessity for a specific condition, massage may be eligible for
reimbursement. The service can be covered by a health savings account (HSA),
or a flexible spending account (FSA).
Health Savings Accounts and Flexible Spending Accounts are similar, with both allowing you to put aside tax-advantaged funds specifically for medical costs. But depending on your unique situation, one of these accounts may be more ideal than the other.
Client Resources //
Question about your bill //
HSAs vs FSAs : What Are They?
HSAs and FSAs. These are both special healthcare arrangements that allow you to set aside money for medical costs, such as deductibles, monthly prescriptions, copayments, and coinsurance. You don’t pay taxes on this money.
For a detailed list of what costs are considered “medical expenses,” start with fact sheet from the IRS. In some cases, your employer will contribute money to your HSA or FSA each year as well. Both of these plans have a lot of fine print you’ll need to consider, so talk to your HR department if you have questions.
These healthcare plans usually come with a debit card that includes your (and your employer’s) contributions. In most cases, you won’t have to worry about being reimbursed, as your funds will already be on the flex debit card. You can spend this on any of the above medical costs.
Can I use an HSA or FSA for Massage?
In many cases, a massage will be covered by your insurance plan, whether you use an HSA or FSA. Follow these steps to make sure you’re qualified.
1. Start with HR
Before you do anything else, reach out to your HR department or your medical insurance carrier and ask if massage therapy is considered a covered treatment. In some situations, an insurance policy won’t cover massages, even if you get a prescription from a doctor.
2. Doctor visit
Once you’ve gotten the go-ahead from your insurance carrier, schedule an appointment with your primary care physician. Pro tip for this step of the process: Don’t start by just saying you want a massage. You’ll need to first explain your specific symptoms.
There are a wide variety of mental and physical conditions that could qualify for a massage. Stress-related symptoms, circulation issues caused by diabetes or hypertension, sciatica, arthritis, tinnitus, fibromyalgia, anxiety, depression and chronic back pain are all examples that could qualify for massage therapy.
Preparation is key to this discussion. Don’t be afraid to bring case studies of people who’ve alleviated similar symptoms through the power of massage therapy. You could also suggest specific massage therapy options, which can help you illustrate the legitimacy of this type of care.
3. Get a prescription
Once you and your doctor have talked it over, you’ll need them to write a prescription for a massage. In your insurance’s eyes, this acts as proof that you actually need an HSA or FSA massage.
Your prescription will need to include the following:
A reason you need massage therapy, such as a medical condition or injury.
The number of sessions you’ll require each month. Do you need a massage every month? Or once every 1-2 weeks?
The duration of the treatment. How long are you going to need this treatment? Should they be 60-minute or 90-minute massages? Your doctor will be able to guide you in the right direction on this one. You can also change the length, time of day, and cadence as needed.
Getting a prescription is easier than it sounds, so there’s no need to stress. Healthcare providers often write prescriptions for things like massage or acupuncture without requiring an in-person doctor visit. Your prescription can practically be as on-demand as your massage.
4. Use Your FSA or HSA for Massage
Once you have your prescription, you’ll need to book an appointment with a massage therapy provider, such as Certified/Licensed Massage Therapists. Planned ahead the days in advance. In order to pay for your massage, you’ll just need to have your HSA or FSA debit card.
When paying your massage therapist for the service, use the card in accordance with the terms made in the prescription. (For example, don’t use the debit card for eight massages in a month if the prescription-only permits four per month. It’s easy!)
Things to keep in mind
When requesting a massage therapy prescription from a doctor, make sure you’re coming at it with the right intentions. The purpose of your health insurance is to cover medical expenses, and massage therapy can be a great way to benefit your wellness and healing. Be honest when speaking with your doctor regarding your symptoms.
In the same way, make sure you only use your HSA or FSA cards for massage therapy expenses if you have a prescription from your doctor. It’s also important that you keep track of your records for tax time.
Getting the most from your insurance
When it comes down to it, your insurance is there to keep you healthy. A massage can be a good remedy for many types of injuries and conditions. Take these steps to pay for medical massage with your FSA or HSA plan.
Steps for Massage Reimbursement
Speak to your employer about opening an FSA account. Explain why you believe massage is medically necessary for your condition. Note that emotional stress and muscle pain alone isn’t likely to qualify. (A list of conditions commonly covered by FSA will be listed towards the end of this page.)
Discuss a set amount of money to be transferred from your paychecks to your FSA. This contribution amount, unlike in the case of an HSA, cannot be changed or withdrawn from the account. Think this one through carefully.
Some employers will make their own contributions to their employee’s FSA, but they’re not required to.
After you determine the recurring transfer amount, set up an appointment with your physician. You’ll have to reiterate the reasons for seeking medical massage and why FSA is being used to cover it. In order for the massage prescription to go through, your doctor will have to provide the following information:
The reason for massage therapy treatments
How frequently massage will be received
The duration time for each treatment
How long the treatments will be provided (months, weeks, etc.)
After receiving an FSA debit card, use it to pay for your following massage appointments. Use the card in accordance with the terms made in the prescription. It’s advisable to purchase a massage membership to lower the cost of each treatment.
Conditions Commonly Covered by FSA
Both HSAs and FSAs can be used to cover the following conditions:
Injury – Car accidents, workplace injuries, etc.
Carpal tunnel syndrome
Chronic back pain
Health plans //
A type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses. By using untaxed dollars in a Health Savings Account (HSA) to pay for deductibles, copayments, coinsurance, and some other expenses, you may be able to lower your overall health care costs. HSA funds generally may not be used to pay premiums.
While you can use the funds in an HSA at any time to pay for qualified medical expenses, you may contribute to an HSA only if you have a High Deductible Health Plan (HDHP) — generally a health plan (including a Marketplace plan) that only covers preventive services before the deductible. For plan year 2019, the minimum deductible is $1,350 for an individual and $2,700 for a family. For plan year 2020, the minimum deductible for an HDHP is $1,400 for an individual and $2,800 for a family. When you view plans in the Marketplace, you can see if they’re "HSA-eligible."
For 2019, if you have an HDHP, you can contribute up to $3,500 for self-only coverage and up to $7,000 for family coverage into an HSA. For 2020, if you have an HDHP, you can contribute up to $3,550 for self-only coverage and up to $7,100 for family coverage into an HSA. HSA funds roll over year to year if you don't spend them. An HSA may earn interest or other earnings, which are not taxable.
Some health insurance companies offer HSAs for their HDHPs. Check with your company. You can also open an HSA through some banks and other financial institutions.
If you have a health plan through a job, you can use a Flexible Spending Account (FSA) to pay for copayments, deductibles, some drugs, and some other health care costs. Using an FSA can reduce your taxes.
A Flexible Spending Account (also known as a flexible spending arrangement) is a special account you put money into that you use to pay for certain out-of-pocket health care costs.
You don’t pay taxes on this money. This means you’ll save an amount equal to the taxes you would have paid on the money you set aside.
Employers may make contributions to your FSA, but aren’t required to.
The Role of Massage in Healthcare and Medical Centers
Massage can be much more than a way to de-stress or relax. While it certainly fulfills that function, massage therapy is increasingly viewed as a very beneficial complement to traditional healthcare. In fact, massage therapists now play a role in high-profile medical centers across the country and serve as official employees at many hospitals. It’s important to note that we don’t recommend massage as an alternative to traditional healthcare or as a cure for any illnesses, but rather as one part of an overall treatment program.
So what is medical massage?
Medical Massage - There’s no one official method of massage known as medical massage. Rather, medical massage is broadly defined as massage therapy prescribed or recommended by a medical doctor with a health-based outcome in mind. Of course, this could mean many different things, but it’s important to understand because massage wasn’t always a widely accepted or prescribed aspect of health care. While massage has been around as an aspect of medical practice for centuries, Western medicine has not always embraced it. Nowadays, many health insurance plans cover massage therapy if recommended and referred by doctors. Medical massage can be used to help assist in treatment and recovery for disease, injury, and pain resulting from chronic conditions. Here are a few specific ways massage can be incorporated into medical treatments at hospitals and other medical centers:
Hospital Massage - Massage therapists can play a strong role in many types of recovery onsite at hospitals. In the past, nurses often provided massages to their patients to ease muscle tension, promote relaxation, and undo knotted muscles caused by lying in bed. Now, hospitals often keep full time massage therapists on staff to help when massage is an important part of patient treatment. Hospital massage therapists are often on call during their shift and travel throughout the hospital to wherever they’re needed. The conditions massage therapists treat in hospitals are varied, but they can help medical professionals with concentrations in cardiology, sports medicine, and surgery.
Oncology Massage - Oncology massage uses traditional massage therapy techniques that are modified to work safely with patients who are undergoing (or have undergone) cancer treatment. There are training and certifications devoted solely to oncology massage, as oncology massage therapists need to understand how cancer and its treatment affect the body. Oncology massage therapists must be able to adjust their massage techniques to adapt to the symptoms and side effects of cancer and treatment, and they must be proficient enough to make these adjustments from patient-to-patient if necessary. For instance, deep-tissue massage may be ruled out for many oncology patients, but gentle massage could help patients relax, sleep, and relieve pain or anxiety.
Hospice Massage - For patients in hospice care, the focus of massage therapists is usually to provide comfort during the patients’ final days. Usually, this does not come in the form of a traditional table massage. Instead it could include very light massage and gentle touch, with patients clothed and remaining in bed or a chair. For hospice patients, massage therapy can be a pain reliever, promote healthy sleep and bodily functions, reduce swelling, and relieve anxiety. While this can be a very difficult and emotional function for massage therapists, it can also be very rewarding and meaningful to help someone pass away in the most comfortable way possible.