Unlock the Power of Your HSA: Pay for a Chiropractor & Chiropractic Care from your Health Savings Account

Health savings accounts, or HSAs, are terrific tools for helping you pay qualified medical expenses of all kinds with pre-tax dollars.  You can use your health savings account (HSA) to pay for chiropractic care if it is medically necessary to treat a specific medical condition or injury.  Generally, this includes chiropractic care that is deemed necessary by a physician.

It’s important to note that the chiropractic care must be considered a medical expense by the IRS in order to be eligible for HSA funds. Routine chiropractic care, such as visits for general wellness or maintenance, is not considered a qualified medical expense and cannot be paid for with HSA funds.

To ensure that your chiropractic care is considered a qualified medical expense, you should obtain a Letter of Medical Necessity (LMN) from your healthcare provider. This letter should outline the specific medical condition or injury being treated and how chiropractic care is necessary to address it. Be sure to keep a copy of the LMN for your records and submit it to your HSA provider along with the receipt for the expense.

Why Use Health Savings Accounts?

HSAs have several other benefits, too: 

This combination of direct tax benefits make HSAs the most powerful savings tool in the tax code. But HSAs have other indirect benefits, too, that make them even more valuable: 

 What is an HSA?

A Health Savings Account (HSA) is a tax-advantaged account designed to help individuals with high-deductible health plans (HDHPs) save money for out-of-pocket medical expenses.

The funds in an HSA can be used to pay for any medical expenses, including alternative medicine options like chiropractic care.

Five Ways Using Your HSA to Pay for a Chiropractor Can Save You Money

Using your HSA for chiropractic care comes with four big financial benefits:

1. Tax savings.
   The money you contribute to your HSA is tax-deductible, and the funds in your account grow tax-free. You also won’t even pay taxes on withdrawals that you use to pay for eligible medical expenses, including chiropractic services.
2. Alternative medicine.
   Having pre-tax money in your HSA will make it easier to afford alternative medicine services like chiropractic care. If you can manage your condition with chiropractic care, this may help you avoid or reduce the need for more expensive medical treatments, such as surgery or prescription medications.
3. Preventative care.
   You can’t use an HSA to pay for chiropractic care you receive for general wellness purposes. But under certain circumstances, you can use your HSA to pay for chiropractic care for preventative reasons. For example, you may be able to use your HSA to pay for chiropractic care if your physician prescribes it to prevent the development or worsening of a specific medical condition. 
4. Cash-payer discounts.
   Patients who pay cash up front for medical services, including chiropractic care, can often negotiate a significant discount compared to what providers charge insured patients. Ask your provider about a cash-pay or self-pay discount. If you have a healthsharing plan, you can contact their concierge service and ask them for referrals to good chiropractors who provide attractive pricing to cash-pay patients.
5. Lower health insurance premiums.
   If you have money in an HSA, it’s much easier to afford higher deductibles. This enables you to save money in health care premiums every month. According to a report from eHealth, in 2020, the average premium for an individual HDHP was $285 per month, compared to an average premium of $456 per month for an individual plan with a lower deductible. This represents a savings of approximately 38% on average for individuals enrolled in an HDHP. For family coverage, the average premium for an HDHP was $698 per month, compared to an average premium of $1,152 per month for a family plan with a lower deductible. This represents a savings of approximately 39% on average for families enrolled in an HDHP.

Compare Pricing on the Best HSA Plans Available

How Your HSA Helps You Choose Your Own Doctor

When you use a health savings account, you have total freedom to choose your own doctor!

This is a major advantage over routing your healthcare business through most traditional commercial health insurance plans. Here’s why:

Most traditional health insurance policies sold today, and most workplace group insurance policies, are managed care plans, including health maintenance organizations (HMOs), preferred provider organizations (PPOs), and exclusive provider organizations (PPOs). These types of plans restrict benefits if you go out of network.

But everything you have in an HSA is your money, not the insurance company’s money. Even if your employer made the contribution. So when you use an HSA to pay for chiropractic care, or anything else, you aren’t limited to a managed care plan’s limited network of authorized care providers.

With your HSA, you can see any provider you want. For chiropractic care, or any other qualified healthcare expense. 

Does My Insurance Cover Chiropractic Care?

Not necessarily. 

Some plans do, but many traditional health insurance plans don’t cover chiropractic care, or provide very limited coverage for chiropractic care and other forms of alternative care. Whether your insurance covers chiropractic care or not depends on the specific terms and conditions of your insurance policy.

Understanding your health insurance plan’s coverage for chiropractic care is crucial.

To find out if your insurance covers chiropractic care, you can check your policy documents or contact your insurance provider directly. They will be able to provide you with information on what types of services are covered and any applicable copayments or deductibles.

It’s worth noting that even if your insurance does cover chiropractic care, you may still have a significant deductible or coinsurance requirement.  There may be limits on the number of visits or the types of treatments that are covered.

In this case, as long as your chiropractic care qualifies as an authorized medical expense, you can use your HSA to cover all your out-of-pocket expenses – tax free, up to the dollar amount you have in the account.

As always,  it’s best to check with your insurance provider to fully understand your coverage for chiropractic care and alternative health care.

HSA Myths: What are the Common Misconceptions and Concerns about HSAs and Chiropractic Care?

Here are some of the most common misconceptions people have about HSAs and how they apply to chiropractic care:

1. HSAs are difficult to manage.
   Contrary to popular belief, HSAs are not difficult to manage. You can easily deposit money into your account on a monthly or yearly basis and use it to pay for medical expenses. Additionally, many HSA providers offer intuitive tools and resources to help you monitor and control your account, such as web portals, mobile apps, and educational articles and videos.
2. HSAs require me to keep my money in savings accounts that provide a lousy return.
   Not true. If you have money in your HSA that you don’t expect to need right away, you can invest them in a mutual fund or other investments, using a self-directed HSA account. These may help you generate a higher return on your HSA money than you would if you left it alone in the original HSA account. Your self-directed HSA investments still receive the same tax benefits they would in a conventional HSA. Naturally, there are risks associated with these investments, as well. You should be aware of the potential risks of self-directed HSA investing as well as the reward.
3. Chiropractic care is not a valid medical expense.
   Contrary to this belief, chiropractic care is considered a qualified medical expense if used to treat a specific diagnosed medical condition and can be paid for using your HSA funds.
4. HSAs can only be used for traditional medical treatments.
   HSAs can also be used for any type of alternative medicine, including chiropractic care, acupuncture, energetic healing modalities, and even massage therapy. The catch: for it to be a qualified medical expense, you need a diagnosis of a specific medical condition. You can’t use HSA money to pay for chiropractic care or other alternative forms of care for general wellness purposes.
5. You need a referral from a primary care physician to use HSA funds for chiropractic care.
   You never need referral or permission from your insurance company, your employer, or anybody else to use your HSA funds for chiropractic care, or any other medical expense.
   
6. HSA funds can only be used for chiropractic adjustments.
   HSA funds can be used for any medical services you receive from the chiropractor, as long as they are related to a specific medical condition. This would include adjustments, X-rays and other diagnostic tests, or any other prescribed therapies and treatments.
7. HSA funds must be used by the end of the year, or they will be lost.
   Unlike flexible spending accounts (FSAs), HSA funds do not have a “use it or lose it” policy. Your HSA funds will continue to roll over from year to year, tax-deferred, allowing you to save and invest for future medical expenses. Any amounts remaining are available to supplement your retirement savings penalty-free, starting at the age of 65. You just have to pay income taxes on withdrawals, but there’s no more 20% penalty for withdrawals for purposes other than qualified healthcare expenses.
8. You cannot use your HSA for chiropractic care if you have other insurance coverage.
   You can use your HSA to pay for chiropractic care or any other qualified medical expense, even if you have other insurance coverage. HSA funds can be used to cover copayments, deductibles, or any out-of-pocket expenses related to your chiropractic care that your insurance does not cover.

Examples of Using an HSA to Pay for a Chiropractor

Here are some common circumstances where HSAs have tremendous advantages in helping you pay for chiropractic and other forms of health care. 

In each of these examples, individuals have successfully used their HSAs to pay for chiropractic care, taking advantage of the tax benefits and flexibility offered by these accounts.

When You Should Not Use an HSA for your Chiropractor

If you have an HSA, you always want to run all your out-of-pocket medical expenses through it.

This will enable you to spend pre-tax money, rather than post-tax money. So your money will go a lot further. Especially if you are in a higher tax bracket. 

But if you have the funds available to pay the expense without withdrawing money from your HSA, here’s one idea you may also want to consider: leave the money in the HSA for now, and reimburse yourself later.

If you leave your money in your HSA, it will continue to grow tax-deferred. If you open a self-directed HSA, you can put the money in stocks, mutual funds, or almost anything else you want. If it grows in value or pays out dividends, you normally  pay no taxes on this growth as long as the money stays in your HSA.

Later – even years later – you can withdraw the money to reimburse yourself for that expense. That way you can benefit from the tax-deferred growth that the HSA offers. Just make sure you save your receipts!

What happens if you use HSA for non-medical expenses?

If you use your HSA funds for non-medical expenses, such as entertainment or travel expenses, you will be subject to penalties and taxes. The IRS imposes a 20% penalty on non-qualified distributions from an HSA, in addition to any income tax owed on the distribution.

To avoid penalties and taxes, it’s important to only use your HSA funds for eligible medical expenses as defined by the IRS guidelines.

How To Maximize Your HSA Funds

Here are some excellent strategies for maximizing the benefit of your HSA account:

1. Contribute the maximum amount allowed.
   By contributing the maximum allowed amount to your HSA, you maximize your tax savings and potential for growth through investments. In 2023, the maximum contributions are $3,850 for individuals and $7,750 for families.Those 55 years old and above (and not enrolled in Medicare) can contribute an additional $1000 as a catch-up contribution. If you’re confident you won’t need to access your HSA money for anything other than qualified medical expenses until at least age 65, it may make sense to prioritize HSA contributions over traditional IRA contributions and some  unmatched retirement account contributions.
2. Use HSA funds only for qualified medical expenses.
   To avoid being charged income tax and the 20% penalty, it’s important to restrict the use of your HSA funds to eligible medical expenses only.
3. Invest your HSA funds.
   By investing your unused HSA funds via a self-directed retirement account, you can potentially get a higher return on your savings than you could by leaving them in an off-the-shelf HSA product. In addition to HSA savings accounts, most HSA providers will give you the ability to invest your funds in stocks, bonds, mutual funds, and other investments. There is risk involved in these investments. But any gains in your self-directed HSA will still receive the favorable tax treatment, as long as the money is left in your HSA. 
4. Save receipts and track expenses.
   Keep track of your medical expenses and save receipts. If you are ever audited, you will have a paper record to justify your tax-free HSA withdrawals.  
5. Shop around for a high-interest HSA account.
   Some HSA providers offer interest rates that are higher than the national average. Shopping around for a high-interest HSA account can help you earn more on your HSA funds.
6. Consider an HSA rollover.
   If you have an HSA with a provider that charges high fees or offers limited investment options, you may consider rolling over your HSA to another provider that better suits your needs. However, be sure to check for any potential fees with the new provider.

Paying for Medical Treatment with an HSA

With an HSA, you can allocate pre-tax funds towards eligible medical expenses. By doing so, you can lower your out-of-pocket costs and also decrease your income tax.

Any expense that is incurred for the purpose of treating or preventing a particular medical condition would be considered a qualified medical expense.

 Some examples of HSA-eligible medical expenses include:

You can consult IRS Publication 502 to get some more examples of expenses the IRS considers to be medical expenses, but note that it is not all-inclusive. 

Remember, you can use your HSA to pay for virtually any expense if it is for the treatment or prevention of a medical condition.

What are the Most Common Mistakes People Make with? 

Here are some of the most common mistakes people make with health savings accounts, and how to avoid them.

1. Not contributing enough.
   One of the biggest mistakes people make with HSAs is not contributing enough money to the account. HSAs are a tax-advantaged way to save money on healthcare expenses, so it’s important to contribute as much as possible to take full advantage of the tax benefits.
2. Not understanding the rules.
   Another common mistake is not fully understanding the rules surrounding HSAs. For example, there are limits on how much you can contribute each year, and there are restrictions on how the money can be used. It’s important to read the fine print and understand the rules before opening an HSA.
   
3. Using the funds for non-qualified expenses.
   HSAs are meant to be used for qualified medical expenses, such as deductibles, copayments, and prescriptions. However, some people make the mistake of using the funds for non-qualified expenses, such as elective cosmetic procedures or gym memberships, or for chiropractic care for general wellness purposes, rather than for the purposes of treating a specific diagnosed medical condition. If you use the funds for non-qualified expenses, you will have to pay taxes and a 20% penalty on the amount.
4. Not keeping receipts.
   It’s important to keep receipts for all qualified medical expenses paid out of an HSA. This is because you may need to provide proof of the expense in the future if the IRS audits your HSA. Not keeping receipts can make it difficult to prove that the expense was qualified.
   
5. Forgetting to reimburse yourself.
   Another mistake people make is forgetting to reimburse themselves for qualified medical expenses. Even if you don’t need the money right away, it’s important to reimburse yourself for any qualified expenses you’ve paid for out of pocket. This will ensure that the funds are used appropriately and that you don’t miss out on any tax benefits.

Can I Deduct Personal Medical Expenses if I Pay For Them Using an HSA?

Generally, no. If you use funds from your Health Savings Account (HSA) to pay for qualified medical expenses, you generally cannot also claim those expenses as a deduction on your taxes. This is because HSA contributions are made on a pre-tax basis, meaning that they have already received a tax benefit.

However, if you use your HSA funds for non-qualified medical expenses, you may be subject to taxes and penalties on the withdrawal. In this case, you may still be able to deduct the expense on your taxes if it exceeds a certain percentage of your adjusted gross income (AGI). As of tax year 2022, you can deduct qualified medical expenses that exceed 7.5% of your AGI.

It’s important to note that you cannot deduct the same expense twice – once as a deduction and again as an HSA distribution. If you have questions about the tax implications of using your HSA funds, you may want to consult with a tax professional or financial advisor.

Questions? Need Help?

If you have questions about enrolling in and using a High Deductible Health Plan, an HSA, or paying for chiropractic or other forms of alternative care, click here and make an appointment to speak with a Personal Benefits Manager.

Consultations are free, and you’re under no obligation. 

Conclusion

In conclusion, Health Savings Accounts (HSAs) can effectively cover various medical expenses, including conventional and alternative treatments such as chiropractic care. 

In this article, I discussed the benefits of using Health Savings Accounts (HSAs) to pay for chiropractic care and alternative medicine.

We also explored some common HSA management mistakes and debunked common misconceptions about HSAs and chiropractic treatments. Furthermore, we provided strategies for maximizing your HSA funds and managing medical expenses. 

Unlock the power of your HSA by using it for chiropractic care and other alternative medicine options. Invest in your health and enjoy the tax savings that come with a well-managed HSA. 

Here are some additional blogs: Can I Use an HSA to Pay For Counseling or Therapy? | Using Your HSA for Transportation Expenses: A Comprehensive Guide

Here are some additional pages related to this article: HSA Insurance Plans | HSAs for Employees

HSA for Chiropractor & Alternative Health Care FAQs

Can I use my health savings account for chiropractic care?

Yes, chiropractic care is considered an eligible medical expense for HSA purposes, provided it’s used to treat or manage a diagnosed medical condition. You can’t use your HSA to pay for chiropractic care for general wellness purposes.

You can use your HSA funds to pay for chiropractic treatments, including spinal manipulation and other therapies aimed at improving musculoskeletal health.

Can you pay for alternative medicine with an HSA?

Yes, alternative medicine such as acupuncture, chiropractic care, and naturopathy may be eligible for HSA reimbursement if it is prescribed by a licensed medical practitioner to treat a specific medical condition.

Are herbal remedies HSA eligible?

Herbal remedies are generally not eligible for HSA reimbursement unless they are prescribed by a licensed medical practitioner to treat a specific medical condition.

Is alternative medicine HSA eligible?

Alternative medicine is eligible for reimbursement under an HSA if it is for the treatment or prevention of a specific medical condition. However, it’s not an eligible medical expense if you are receiving the treatment for general wellness purposes.

Some popular forms of alternative medicine you may be able to pay for using an HSA include: acupuncture, chiropractic care, and massage therapy. 

What are the income requirements and limitations for HSAs?

There are no income requirements or limitations to use an HSA to pay for qualified medical expenses. Everyone with an HSA is eligible, no matter what your income.

There are also no income requirements to make pre-tax contributions to an HSA. You just have to be covered under a high-deductible health plan (HDHP) during the tax year for which you want to contribute.

Are HSAs subject to required minimum distributions (RMDs)?

No, health savings accounts are not subject to the required minimum distributions like other tax-deferred retirement accounts.

If you don’t need the money for healthcare, you can let your HSA assets compound indefinitely. You just pay income taxes on any amounts you withdraw after you turn 65. 

Is turmeric HSA-eligible?

Turmeric or other herbs are only eligible for HSA reimbursement if prescribed or recommended by your medical practitioner to treat a specific medical condition. 

See our article. “How to Use Your HSA to Pay for Nutritional Supplements” for more details.

Can I use my health savings account for chiropractic?

Yes, you can use your Health Savings Account (HSA) to pay for chiropractic care if it is a qualified medical expense according to IRS guidelines.

Chiropractic care is generally considered a qualified medical expense if it is used to treat a specific medical condition, such as back pain, and is performed by a licensed chiropractor. 

Can I use my HSA to pay for massage therapy?

Yes, but only under certain conditions. 

Massage therapy is generally not considered a qualified medical expense under the IRS guidelines, unless it is used to treat a specific medical condition such as chronic pain or muscle spasms.

It is best to get a Letter of Medical Necessity (LMN) from your healthcare provider to support the expense and demonstrate compliance with IRS guidelines. Otherwise, if you’re ever audited, the IRS could challenge the transaction. If you don’t have an LMN, you may have to pay income taxes and penalties on the entire amount.

Can you use money from your HSA for orthopedic shoes?

Yes, you can use your HSA to pay for orthopedic shoes if they are prescribed by a healthcare provider to treat a specific medical condition, such as a foot deformity or injury.

However, if the shoes are simply for general use or comfort, they would not be considered a qualified medical expense according to IRS guidelines. 

Can I use my HSA to pay for an electric toothbrush?

Typically, an electric toothbrush isn’t a qualified HSA expense.

However, if it’s prescribed by a healthcare provider to treat a condition like gum disease or sensitive teeth, it might be eligible for reimbursement. A letter of medical necessity (LMN) may be needed for IRS compliance. Your doctor can provide one for you, if medically appropriate. 

Can I use HSA for vitamins?

You can use your HSA to pay for nutritional supplements if they are recommended by your healthcare provider to treat or prevent a specific medical condition. 

Read more about how you can use your HSA to pay for nutritional supplements. 

Can I buy a foot bath with my HSA?

In most cases, you cannot use your HSA to buy a foot bath or other personal care item, as it is not considered to be a qualified medical expense.

However, if the foot bath is prescribed by a healthcare provider to treat a specific medical condition, such as foot pain or poor circulation, it may be considered eligible for reimbursement. Ask your healthcare provider to provide a Letter of Medical Necessity, and keep in your files in case you are ever audited. 

Can I use money in my HSA to pay for plantar fasciitis treatment?

You can typically use your HSA to pay for Plantar fasciitis treatments that are qualified medical expenses under IRS rules.

This includes visits to a healthcare provider, prescription meds, physical therapy, and medical equipment.

What food is HSA eligible?

Normally, food is not a qualified medical expense under IRS guidelines, so you can’t use your HSA funds to pay for groceries or meals.

Yet, if a healthcare provider prescribes certain food items to treat conditions like celiac disease or diabetes, they may be eligible for reimbursement. In such cases, a Letter of Medical Necessity (LMN) from your provider might be required to prove IRS compliance.

Can I buy a Fitbit with my HSA?

Usually, you can’t use HSA funds to purchase a Fitbit or other fitness wearable since they’re not qualified medical expenses as per IRS guidelines.

But if a healthcare provider prescribes a Fitbit to monitor a medical condition like heart disease or diabetes, it might qualify for reimbursement. Proving IRS compliance may require an LMN for your provider.

Can I use my HSA for acupuncture?

Yes, you can use your HSA to pay for acupuncture if it is considered a qualified medical expense under the IRS guidelines.

Acupuncture is generally considered eligible if it is used to treat a specific medical condition and is performed by a licensed healthcare provider. However, you may need an LMN (letter of medical necessity to show IRS compliance.)

Can I use my HSA for a DEXA scan?

Yes, you can use your HSA to pay for a DEXA scan.

Can you have too much money in your HSA account?

No, there is no limit to the amount of money that you can have in your HSA account.

However, there are limits to how much you can contribute to your HSA each year, as defined by the IRS.

Can you use HSA money for anything you need?

Yes, you can. The money in your HSA is your money. Even if it’s there because your employer, not you, made the contribution, it vests to you immediately.  So you can spend it however you wish, as soon as it’s in your account.

However, using your HSA funds for non-medical expenses will trigger an income tax liability and a 20% penalty on the entire amount.

Can I buy Tylenol with money from my HSA?

Yes, you can use your HSA to buy over-the-counter medications, such as Tylenol.
Previously, OTC-medications were not HSA-eligible expenses without a prescription. But the CARES Act removed that requirement for Tylenol, as well as a number of other common OTC medications  and products. 

What OTC Medications can I buy with an HSA?

In addition to common OTC pain relievers and anti-inflammatories  like Tylenol, acetaminophen, ibuprofen, aspirin, etc., the CARES Act made a broad range of additional OTC items HSA-eligible qualified medical expenses, including:

Can you buy toothpaste using my HSA?

In most cases, you cannot use your HSA to buy toothpaste or other personal care items, as they are not considered qualified medical expenses under the IRS guidelines.

Can I use my HSA card for gas?

Yes, you can use your HSA to pay for gas if it is directly related to a medical expense.

There are two methods to calculate this deduction: using the standard mileage rate of $0.16 per mile for a personal vehicle, or by allocating actual expenses related to the use of the vehicle for medical transportation such as parking fees, tolls, gas, and oil.

What happens to my HSA if I lose my job or retire?

If you lose your job or retire, your Health Savings Account (HSA) remains yours to keep.

You can continue to use the funds in your HSA to pay for qualified medical expenses tax-free – including chiropractic care – even if you are no longer covered by your workplace high-deductible health plan (HDHP) or any other HDHP plan.

However, there are some things to keep in mind:

• You can no longer contribute to your HSA if you are not covered by an HDHP: To contribute to an HSA, you must be covered by an HDHP. If you lose your HDHP coverage, you can no longer make contributions to your HSA.
• Your HSA funds can be used to pay for COBRA premiums: If you lose your job and have the option to continue your health insurance coverage through COBRA, you can use your HSA funds to pay for your COBRA premiums. This can help you continue to receive tax-free healthcare benefits even if you are not currently employed.
• There may be fees associated with your HSA: Some HSAs charge monthly maintenance fees or other account fees. If you lose your job or retire, you may want to review the fees associated with your HSA and consider whether it still makes sense for you to keep the account open.
• You may be subject to taxes and penalties if you use HSA funds for non-qualified expenses: If you use your HSA funds for non-qualified expenses after losing your job or retiring, you may be subject to taxes and penalties on the withdrawal. It’s important to continue to use your HSA funds only for qualified medical expenses to avoid these penalties.