Does an HSA or FSA Cover Massages, Acupuncture, and Other Natural Therapies for Menopause?
Key takeaways:
Alternative treatments like acupuncture and hypnotherapy may be used to treat menopause symptoms. But they’re typically not covered by health insurance.
You can use money in your health savings account (HSA) or flexible spending account (FSA) to help you pay for eligible alternative menopause treatments. Some menopause treatments may require a letter of medical necessity (LOMN) to be eligible.
Natural remedies like aromatherapy and herbal supplements for general well-being are typically not considered HSA- or FSA-eligible expenses.
Table of contents
Are you experiencing hot flashes, night sweats, and mood changes? If so, you may be starting menopause, which can begin between the ages of 40 and 58.
Hormone replacement therapy (HRT) — also known as menopausal hormone therapy — can help with menopause symptoms. But some people may prefer to seek out alternative or natural remedies.
Health insurance typically doesn’t cover alternative menopause treatments. But a tax-advantaged account like a health savings account (HSA) or flexible spending account (FSA) may be able to help you save money.
Prescription Savings Are Just the Beginning
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Keep in mind that there are mixed opinions about the benefits of some alternative therapies for menopause.
Can you use an HSA or FSA for massages and other natural menopause therapies?
Yes, you can use HSA or FSA funds to pay for natural menopause therapies that are considered qualified medical expenses. The IRS defines qualified medical expenses as “costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and for the purpose of affecting any part or function of the body.”
You may need to provide a letter of medical necessity (LOMN) from your healthcare professional for certain expenses to be FSA or HSA eligible. For instance, massages and yoga aren't usually eligible expenses. But they may qualify if your healthcare professional recommends them for the treatment of osteoporosis due to menopause-related bone loss and writes you a LOMN.
If you use your HSA or FSA to pay for non-eligible medical expenses, you will lose tax savings and incur a 20% tax penalty.
Also, you can’t seek reimbursement through an FSA or HSA for any menopause-related expenses covered by your health insurance. You can only use your account to cover out-of-pocket costs that aren’t reimbursed by your insurance company or another plan.
Can your HSA or FSA cover acupuncture for menopause symptoms?
You can likely use your HSA or FSA to pay for acupuncture treatments. However, you’ll want to confirm with your HSA or FSA provider that acupuncture treatments for menopause symptoms are considered a qualified medical expense. Research shows acupuncture may be helpful for reducing menopausal symptoms like hot flashes and sleeplessness.
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Acupuncture is a type of alternative therapy that comes from traditional Chinese medicine. Tiny needles are inserted at points across the body. This therapy is used to help treat various chronic conditions like:
The cost of acupuncture varies depending on the condition being treated, where the provider is located, and the number and types of sessions needed. An initial visit averages $112 and follow-up visits average $80, according to a 2019 study.
How does an FSA or HSA work?
Before using an HSA or FSA, it’s important to understand how each works. Although they are both tax-advantaged accounts, there are key differences between an HSA and FSA that may impact how you use the accounts.
HSA (health saving account) | FSA (flexible spending account) | |
Eligibility | You must enroll in a high-deductible health plan (HDHP) to make account contributions. | This is an employer-sponsored account that can be used with an HMO, PPO, or other qualifying health plan. |
Ownership | These accounts are owned by individuals instead of employers. If you switch health plans or jobs, you can take your HSA with you. | FSAs are set up and owned by employers. So you will lose access to your account if you change jobs. |
Rollover | Your HSA funds never expire and can roll over into the next year. | This account is known for its “use it or lose it” feature, which means you have to spend the funds by the end of the year unless your employer offers a grace period or carryover option. |
You can reach out to your FSA or HSA custodian to learn more about your account and eligible expenses. Any expenses you incurred before setting up your HSA or FSA do not qualify for reimbursement.
The custodian can also let you know if an LOMN is required to use your FSA or HSA funds on a particular expense. They may provide you with an HSA or FSA debit card that you can use to make qualified purchases for menopause treatments.
What other menopause treatments may be HSA or FSA eligible?
In addition to massages and acupuncture, the four menopause treatments below may be HSA or FSA eligible. Note that your healthcare professional may need to write an LOMN for a treatment to be eligible.
1.Yoga
Yoga is a type of movement practice that incorporates breathing exercises, meditation, and poses (asanas). A short-term study found that yoga and other natural interventions can reduce hot flashes by 35% to 40%. Yoga may also help with other menopause symptoms like insomnia, mood changes, and fatigue.
If your healthcare professional recommends yoga to reduce menopausal symptoms or to treat a medical condition, it may be FSA or HSA eligible. But you may need a LOMN from your healthcare professional. Yoga used solely for general health purposes does not count as a qualified medical expense.
2. Hypnosis/hypnotherapy
Hypnotherapy, or hypnosis, is typically provided by a trained therapist or other mental health professional. The idea is to help you reach a state of openness and relaxation. Sessions typically last 60 to 90 minutes and can cost an average of $75 to $125 per session, depending on where you live.
Mind-body studies show hypnotherapy may help treat menopause symptoms such as hot flashes and sleeping problems. Your HSA or FSA custodian may consider this an eligible expense if your healthcare professional recommends it for the treatment of a specific medical condition and provides an LOMN.
3. Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a type of psychotherapy (or talk therapy) that can help assess and treat menopause symptoms. Paced breathing and deep breathing exercises can be a part of this treatment approach. Studies show these techniques may help ease stress related to hot flashes and other psychological symptoms of menopause.
CBT can cost $100 or more per hour. Some therapists may offer a sliding scale payment system based on your income. Psychotherapy treatments are generally considered FSA or HSA eligible when they’re recommended for medical or mental health purposes.
4. Magnetic therapy
Magnetic therapy has been studied for its potential benefits on urinary incontinence due to stress, which can happen more often during menopause. This alternative treatment involves placing magnets on the body to treat a variety of ailments.
You may need an LOMN for magnetic therapy to be considered an eligible FSA or HSA expense. Since magnets may interfere with some medical devices, consult your healthcare professional before considering this form of alternative therapy.
Can your HSA/FSA cover massage guns and other therapeutic items?
Your healthcare professional may prescribe certain items as part of treatment. You still may need a LOMN for these items to be considered HSA or FSA eligible. Some examples include:
Foot massager or foot circulator
Heating pads
Herbs and herbal medications
Acupressure accessories
Are over-the-counter supplements for menopause HSA or FSA eligible?
Over-the-counter (OTC) medications for menopause are HSA and FSA eligible thanks to the expansion of the CARES Act. Vitamins and dietary supplements may also be covered if they’re used for a specific medical condition that’s been diagnosed by a healthcare professional, according to IRS Publication 502. Medications and supplements for general health or well-being don’t qualify.
Some natural OTC supplements for menopause that may be HSA or FSA eligible include:
Some OTC supplements can have adverse side effects, so it’s important to talk to your healthcare professional before taking any herbal or dietary supplements.
Affordable, natural menopause relief
There are some natural approaches to menopause treatment that you can do at home for little to no cost. For example, studies show that certain mindfulness and relaxation techniques can improve sleep during menopause.
Some low- and no-cost treatments for natural menopause relief include:
The bottom line
Common symptoms of menopause include hot flashes, trouble sleeping, mood changes, and fatigue. Alternative therapies can help address these symptoms, but they’re often not covered by health insurance.
You may be able to use money in your health savings account (HSA) or flexible spending account (FSA) to reduce the cost of qualified medical expenses like acupuncture, yoga, and hypnotherapy that ease menopause symptoms. Both HSAs and FSAs provide tax advantages that can save you money. But it’s important to check with your HSA or FSA account administrator to confirm which expenses are eligible.
Why trust our experts?
References
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National Alliance on Mental Illness. (n.d.). Psychotherapy.
National Center for Complementary and Integrative Health. (2021). Relaxation techniques: What you need to know.
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Norris, L. (2022). Can I use my HSA to purchase over-the-counter medications? Healthinsurance.org.
Peng, L., et al. (2019). Magnetic stimulation for female patients with stress urinary incontinence, a meta-analysis of studies with short-term follow-up. Medicine.
Sood, R., et al. (2013). Paced breathing compared with usual breathing for hot flashes. Menopause.
Steels, E., et al. (2017). Efficacy of a proprietary Trigonella foenum-graecum L. de-husked seed extract in reducing menopausal symptoms in otherwise healthy women: A double-blind, randomized, placebo-controlled study. Phytotherapy Research.
Thomas, T., et al. (2021). Effect of mind-body approaches on menopausal symptoms among women: A community-based pilot study. Journal of Health and Allied Sciences.
This article is solely for informational purposes. This article is not professional advice concerning insurance, financial, accounting, tax, or legal matters. All content herein is provided “as is” without any representations or warranties, express or implied. Always consult an appropriate professional when you have specific questions about any insurance, financial, or legal matter.
