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Can you pay for substance abuse therapy with an HSA?
Are you wondering if you can pay for substance abuse therapy with a health savings account (HSA), flexible spending account (FSA), or health reimbursement arrangement (HRA)? You may also be wondering if this item is eligible or ineligible for reimbursement with your HSA, FSA, or HRA.
Yes, you can pay for substance abuse therapy with an HSA, FSA, or HRA.
HSA fast facts
- Health savings accounts (HSAs) were created as part of the Medicare Prescription Drug, Improvement, and Modernization Act, or MMA, signed into law by President George W. Bush on December 8, 2003. The MMA was the largest overhaul to Medicare in the program's history.
- HSAs are only available as part of a high-deductible health insurance plan (HDHP).
- As part of the 2020 CARES Act, over-the-counter medications and menstrual care products became eligible for purchase with an HSA.
- Contributions to an HSA can be made by an employer and/or employee on a pre-tax basis. You can find current and historical HSA contribution limits on this site.
- Funds in a health savings account can be invested in a similar way as other retirement accounts and are a rare example of an account that's triple tax advantaged. That is, funds are contributed pre-tax, can be withdrawn for eligible medical expenses without taxation, and if you invest the funds within your HSA the earnings or interest are tax free.
- Funds can be withdrawn at any time for any reason, but funds withdrawn for non-approved medical expenses before the age of 65 are subject to income taxes and an additional penalty.
- You can no longer contribute to an HSA once you're enrolled in Medicare.
Explore HSA eligibility for other products and services
Common HSA providers
- Bank of America
- Blue Cross Blue Shield
- Fifth Third
- HealthSavings Administrators
- HSA Authority
- HSA Bank
- Optum Bank
What about FSA and HRA eligibility?
The same HSA eligibility status for substance abuse therapy applies to flexible spending accounts (FSAs) and health reimbursement arrangements (HRAs) as well.
This page is intended to be an educational reference only. Please check with your HSA administrator or health insurance provider to confirm if you can pay for substance abuse therapy with your HSA card before making any purchases.
A good rule of thumb is that if your doctor diagnosed you with a specific medical condition or ordered a treatment, product, or prescription specifically for you, your health savings account should cover it. Sometimes your HSA will even cover items that it normally wouldn't if you have a letter of medical necessity signed by your doctor. Again, you should check with your HSA administrator before any purchase if you have any questions about an item being eligible or ineligible.