Flexible spending accounts (FSAs) cover massages for certain medical treatments. These treatments must be approved and prescribed by a physician.

Medical Conditions

The Internal Revenue Service (IRS) has ruled that massage therapy for the sole purpose of tension and stress relief does not qualify as an eligible expense. Examples of medical conditions that your doctor would prescribe massage therapy could include back pain, arthritis, fibromyalgia, anxiety, depression, and pain management. 

How to Use an FSA for Massages

The first step to using your FSA to cover massage therapy expenses is to pay a visit to your primary care doctor or local physician. Let the doctor know you have an FSA and are seeking massage therapy as the solution to a medically eligible condition. The physician will then write a prescription for your massage if she deems it to be medically necessary. The physician should provide three pieces of information on your prescription: why the massage is medically necessary; the number of sessions per month or frequency of your visits; and, the length of treatment. 

About an FSA

FSAs allow you to set aside pretax money to pay for qualifying medical and dental expenses, including co-pays and deductibles.  For 2020, employees can contribute $2,750 to their health FSAs, up from the 2019 limit of $2,700.  These plans are only available with employer-based health care plans, and employers can also make contributions. One shortcoming to FSAs is the "use it or lose it" policy. Some plans provide certain rollover or grace period options, but most plans erase any money left in the account at the end of the year. (For related reading, see: 20 Ways to Use Up Your Flexible Spending Account.)