HSA and FSA, in short

Health savings and flexible spending accounts let you pay for qualifying medical expenses with pre-tax money. The IRS rules (Publication 502) decide what qualifies.

  • Usually eligible: doctor and therapist visits, prescriptions, physical therapy, many medical tests.
  • Usually not: gym memberships and classes, unless a doctor prescribes them to treat a specific medical condition. Some plans then accept a letter of medical necessity.
  • Sometimes: massage and other treatments, with a letter of medical necessity.

Ask your plan administrator before you spend.

Physical therapy and insurance

Many plans cover physiotherapy, often with a limit on visits; some require a referral. Call and ask: number of visits, referral, and whether the clinic is in network.

Employer benefits

Many employers offer gym reimbursements, wellness stipends or discounted memberships. They're often unused. Ask HR, or look in your benefits portal.