FSA or HSA: The Smarter Way To Pay For Chiropractic Care

Reviewed by: Dr. Steven Knauf, D.C.

By: Janett King

Managing healthcare expenses can feel overwhelming, but having the right tools can make all the difference. Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) are designed to help you take control of your medical costs by using pre-tax dollars for eligible healthcare expenses. Whether planning for routine care, managing ongoing treatments, or preparing for future medical needs, these accounts provide a smarter, more efficient way to pay for healthcare.

Understanding how FSAs and HSAs work isn’t just about tax benefits—it’s about making the most of your financial resources while prioritizing your well-being. Chiropractic care is one essential area where these savings can be used, helping you stay mobile, comfortable, and functioning at your best.

What is a Flex Spending Account (FSA)?

An FSA is an employer-sponsored benefit that lets you set aside pre-tax money for qualified medical expenses. The key here is pre-tax, meaning the money goes into your account before the IRS takes its share. That lowers your taxable income, which could lower your tax bill and increase the amount of your earnings you can use for healthcare costs.

Employers typically offer FSAs as part of their benefits package, allowing employees to elect a certain amount of money to be deducted from their paychecks over the year. This money is then available for eligible medical expenses, including doctor visits, prescriptions, and certain therapies.

Most FSAs operate on a use-it-or-lose-it system, meaning that any money left unspent at the end of the year may be forfeited. Some plans offer a small grace period or allow a limited rollover amount, typically up to $610, but this varies depending on your employer’s plan. Because of this, it’s important to plan and use your FSA funds wisely to avoid losing the money you’ve already set aside for medical care.

Since FSA contributions are deducted from your paycheck before taxes, they help reduce your taxable income, potentially lowering the amount you owe in taxes each year. This can be a strategic way to manage healthcare costs more effectively, but it requires a proactive approach to budgeting and spending throughout the plan year.

What is a Health Savings Account (HSA)?

An HSA is a personal healthcare savings account that allows you to set aside pre-tax dollars for medical expenses. To be eligible for an HSA, you must be enrolled in a high-deductible health plan (HDHP). The IRS requires this because HSAs are designed for individuals and families who take on more upfront healthcare costs in exchange for lower monthly insurance premiums. The HDHP structure encourages consumers to make cost-conscious medical decisions while still having a financial safety net for larger expenses.

Your HSA is not tied to your employer. If you change jobs or retire, the money in your HSA remains yours. There’s no deadline to use the funds, and any unused balance rolls over year after year. This makes it a powerful tool for long-term healthcare savings, especially for those who want to plan for future medical costs.

One of the biggest advantages of an HSA is the way it’s taxed. The money you contribute is tax-free; it grows tax-free if invested, and you can withdraw it tax-free for qualified medical expenses. This is often called the “triple tax advantage,” making HSAs an attractive option for short-term and long-term healthcare planning. Some HSA holders even use their accounts as an additional retirement savings vehicle, allowing funds to accumulate over time and covering medical costs later in life.

Another unique benefit of an HSA is the ability to invest contributions. Unlike an FSA, which is strictly a spending account, an HSA allows you to allocate funds into mutual funds, stocks, or other investment options. Over time, this can significantly increase the value of your savings, giving you additional financial security for unexpected healthcare expenses.

Because HSAs provide this level of flexibility, they’re often seen as an excellent tool for people looking to balance immediate healthcare needs with long-term financial goals. Whether covering routine medical expenses or saving for future care, an HSA provides a smart and tax-efficient way to manage healthcare costs over time.

How are FSAs and HSAs different?

At first glance, FSAs and HSAs seem similar since they help you save on healthcare costs using pre-tax dollars. However, their differences are significant and can impact your budget for medical expenses.

Ownership and portability: An HSA belongs to you, not your employer. If you change jobs or retire, your HSA funds remain available indefinitely. An FSA, on the other hand, is owned by your employer. If you leave your job, any unused FSA funds typically stay behind.

Contribution limits and rollovers: HSAs allow for higher annual contribution limits than FSAs. In 2024, individuals can contribute $4,150, and families can contribute $8,300. If you’re 55 or older, you can contribute an additional $1,000. The best part? Any unused HSA funds roll over year after year, allowing you to accumulate savings. FSAs, however, have a lower contribution limit of $3,200. Unless your employer allows a small rollover or grace period, any unspent funds are forfeited at the plan year's end.

Eligibility and requirements: To open an HSA, you must be enrolled in a high-deductible health plan (HDHP), which means you have higher out-of-pocket costs before insurance kicks in. FSAs don’t have this requirement and can be used with any type of health insurance plan, making them accessible to more people. Investment potential: HSAs offer an opportunity to grow your healthcare savings by allowing you to invest the funds in mutual funds, stocks, and other options. This is a major advantage for those who want to build long-term healthcare savings. FSAs do not offer an investment component and are strictly a spending account for the current plan year.

Usage flexibility: An FSA is designed for immediate, short-term healthcare spending. It best suits people anticipating predictable medical expenses, like prescriptions, copays, or regular doctor visits. An HSA, on the other hand, can be used for both short-term and long-term medical expenses, including retirement healthcare costs, making it a more flexible financial tool.

Choosing between an FSA and an HSA depends on your healthcare needs, insurance plan, and financial goals. If you prefer the flexibility of keeping your funds long-term and want the option to invest, an HSA is a strong choice. If you need to set aside money for the current year’s medical expenses and don’t want the requirement of a high-deductible health plan, an FSA may be a better fit.

Tax season and maximizing your savings

Tax season has a way of making people rethink their finances. Suddenly, those paycheck deductions and pre-tax contributions matter a little more, and finding ways to save feels much more urgent. But there’s good news. You have a built-in advantage if you’ve set aside money in a Flexible Spending Account (FSA) or a Health Savings Account (HSA). And if you haven’t? It might be time to start paying attention.

Understanding how these accounts work isn’t just about maximizing tax benefits. It’s about making smarter choices with your healthcare dollars. And when it comes to chiropractic care, there’s a lot you can do with those pre-tax savings.

What are pre-tax dollars and why do they matter?

Pre-tax dollars are funds deducted from your paycheck before taxes are calculated. That means you use your full earnings for healthcare expenses instead of paying income tax first. The result is more money to cover medical needs and potentially a lower overall tax bill.

Using pre-tax dollars strategically allows you to maximize your healthcare spending while reducing your taxable income. Since these funds are earmarked specifically for medical costs, you get more value for your money compared to paying for healthcare expenses with after-tax earnings.

How much can you contribute to an FSA or HSA?

The IRS sets annual contribution limits for both accounts. In 2024, the maximum contribution for an FSA is $3,200, though employers may set a lower limit. HSAs allow individuals to contribute $4,150, while families can contribute $8,300. Anyone 55 or older can contribute an extra $1,000.

The key difference is how the money is managed over time. An HSA allows you to build long-term savings, while an FSA is designed for short-term healthcare spending. Since HSA funds roll over and can even be invested, they provide a more flexible approach to saving for medical costs over the years. FSAs, on the other hand, require a more immediate spending strategy to ensure funds are used before they expire.

What is a qualified medical expense?

A qualified medical expense is a healthcare cost the IRS deems eligible for payment using FSA or HSA funds. These expenses typically diagnose, treat, or prevent a medical condition. Examples include doctor visits, hospital stays, prescription medications, and diagnostic tests. Other eligible expenses may include dental and vision care, mental health services, and medical equipment such as wheelchairs or crutches.

IRS Publication 502 provides a full list of qualified medical expenses, which can vary slightly between FSAs and HSAs. While these accounts cover many essential healthcare services, non-medical expenses such as cosmetic procedures, over-the-counter drugs without a prescription, or gym memberships typically do not qualify.

Is chiropractic care an eligible FSA or HSA expense?

Yes, chiropractic care qualifies as an eligible medical expense under FSAs and HSAs. That means adjustments, evaluations, and ongoing care that support mobility and overall well-being can be paid for with pre-tax dollars. Chiropractic care falls under qualified medical expenses because it treats musculoskeletal conditions, pain relief, and improved spinal function. Most cases, visits to a chiropractor, diagnostic assessments, and supportive treatments such as therapeutic exercises or manual therapy techniques are covered. However, additional services like massage therapy or supplements may require a Letter of Medical Necessity (LMN) from a healthcare provider to be eligible.

If you have an FSA or HSA, using those funds for chiropractic care can help you maintain mobility, manage discomfort, and invest in your overall health while maximizing your pre-tax savings.

What type of FSA covers chiropractic?

Not all FSAs are created equal. A standard FSA covers a broad range of medical expenses, including chiropractic care, while a limited-purpose FSA only covers vision and dental expenses. If you want to use an FSA for chiropractic care, ensure it’s a standard FSA.

Using your FSA or HSA for affordable chiropractic care

If you’re looking for an easy way to reduce out-of-pocket healthcare expenses, your FSA or HSA can help make chiropractic care more affordable. These accounts allow you to cover eligible medical expenses using pre-tax dollars, reducing what you pay at the time of service while maximizing the value of your healthcare spending.

How to pay for care at The Joint Chiropractic with your FSA or HSA

Most FSAs and HSAs come with a debit card linked to your account. If your plan provides one, you can simply swipe it at the front desk when paying for your visit. This allows you to cover your chiropractic care immediately without any additional steps.

If your plan requires you to pay upfront and submit for reimbursement, keep your receipts and follow your plan’s submission process to ensure you receive the full benefit of your pre-tax savings. Many plans have an easy online portal or mobile app where you can upload your receipts and request reimbursement quickly.

If you’re unsure whether your plan covers chiropractic care, checking your benefits summary or speaking with your plan administrator is a good place to start. Understanding how to use your FSA or HSA effectively can help you take full advantage of these funds while prioritizing your health.

Prioritizing your health while maximizing your savings

Your FSA or HSA helps you prioritize your health while making care more accessible and affordable. Chiropractic care supports mobility, comfort, and overall wellness, making it an ideal way to use these pre-tax savings.

By incorporating chiropractic care into your wellness routine and strategically using your FSA or HSA, you can take proactive steps toward maintaining your health while making the most of your healthcare dollars. Whether you’re managing discomfort, seeking preventative care, or simply looking to move and feel better, using your pre-tax savings wisely helps you confidently achieve your health goals.

The information, including but not limited to text, graphics, images, and other material contained on this page, is for informational purposes only. The purpose of this post is to promote broad consumer understanding and knowledge of various health topics, including but not limited to the benefits of chiropractic care, exercise, and nutrition. It is not intended to provide or be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your chiropractor, physician, or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this page.