Can You Use an HSA or FSA for Medspa and Wellness Treatments?

Tax rules define medical care as costs for diagnosing, treating or preventing disease, or affecting a structure or function of the body. Cosmetic procedures whose only purpose is to improve appearance are generally excluded, unless they correct a deformity from a congenital condition, an accident or a disease. The IRS explains the boundaries in its medical-expense publication.

Treatments chosen for appearance, such as fillers for volume, most laser skin rejuvenation or a lash lift, are normally on the excluded side. Treatments prescribed for a diagnosed condition may be on the eligible side, for example care for a medical skin condition, a headache or migraine condition, or hormone or weight-related care directed by a licensed clinician.

Whether a particular treatment counts depends on the reason it is given and on documentation, not on the name of the treatment. Two patients can receive the same service for different reasons.

Plan administrators sometimes ask for a letter from a licensed provider stating the diagnosis and why the treatment is needed. A letter does not make a cosmetic treatment eligible, and each plan decides what it will reimburse, so ask the administrator before you spend.

Ask your clinic whether the service is billed under a diagnosis. Ask your plan administrator whether that expense type qualifies and what paperwork they need. Keep itemised receipts. If the answer is no, financing or a payment plan is the usual route.

The calculator on this site estimates the tax you would save if an eligible expense is paid from pre-tax money. It uses the tax rate you enter and is only a rough guide.

Many integrative and wellness services sit in a grey area, because they are chosen for general health rather than for a named diagnosis. Check with the administrator and the provider before assuming a plan will pay.