Can you use HSA to pay for speech therapy?

Asked by: Darian Bailey  |  Last update: September 10, 2025
Score: 5/5 (13 votes)

Speech therapy is eligible for reimbursement with flexible spending accounts (FSA), health savings accounts (HSA), and health reimbursement accounts (HRA). They are not eligible for reimbursement with dependent care flexible spending accounts and limited-purpose flexible spending accounts (LPFSA).

Can I use my HSA card for speech therapy?

​Can I use my Health Spending Account (HSA) to pay for speech therapy? AYes, you can use your HSA to pay for speech therapy, provided it is conducted by a credentialed Speech Therapist or Speech Pathologist. The therapist's credentials must be included on the receipt to qualify for reimbursement.

Can I use HSA for talk therapy?

Yes. You can use an HSA to cover some mental health expenses, including therapy to treat a diagnosed mental condition. However, therapy that isn't specifically designed for medical or mental health needs — like marriage or family counseling — often won't qualify for HSA coverage.

Does health insurance cover speech and language therapy?

Many insurance plans, like Medicaid, Medicare, or employer plans, cover speech therapy if it's “medically necessary.” For example, speech therapy may be covered if it's needed for a speech disorder caused by a medical condition or injury. But coverage, session limits, and approval rules can vary a lot.

What can an HSA not be used for?

Generally, you can't use your HSA to pay for expenses that don't meaningfully promote the proper function of the body or prevent or treat illness or disease. Nutritional supplements and weight loss programs not prescribed by a physician are examples of expenses that would not be covered by your HSA.

Can I use FSA or HSA to pay for my chiropractic care?

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Can I use my HSA to pay for gym membership?

Generally, the IRS doesn't allow pretax dollars in HSAs or FSAs for gym memberships. This is because they see them as expenses for general well-being rather than medical necessity. However, with a Letter of Medical Necessity (LMN), your HSA or FSA could be used to fund those expenses.

Is it illegal to use HSA money for anything?

You generally can't use HSA funds to pay premiums. Once you turn 65, you can use the money in your HSA for anything you want. If you don't use it for qualified medical expenses, it counts as income when you file your taxes.

Why would insurance deny speech therapy?

Since speech therapy can last months or even years, many insurers sometimes try to avoid paying. Insurance companies generally do this by stating that speech therapy is not medically necessary.

Can I pay for speech therapy?

You can pay for speech therapy yourself, or your health insurance might cover some of the costs. Each has its own set of pros and cons. Young children may be able to receive free or low-cost therapy through your state's early intervention program, as well.

Is speech therapy considered medical or behavioral health?

Speech therapy is often considered a form of rehabilitative therapy and may be covered under medical insurance plans.

How do I pay my therapist with my HSA card?

Using your HSA to pay for therapy and counseling is simple. You can pay for services directly from your HSA account. All you need to do is present your HSA debit card to your provider. Your HSA plan administrator will track your expenditures.

Can I use my HSA for massage therapy?

When it's a medical necessity for a specific condition, massage may be eligible for reimbursement. The service can be covered by a health savings account (HSA), or a flexible spending account (FSA).

Is an HSA or FSA better?

Bottom line: Both HSAs and FSAs provide financial benefits for managing health care expenses. HSAs offer more flexibility and long-term growth potential, making them a valuable tool for future financial planning. Learn about HSA options from Aetna.

Is talk therapy covered by HSA?

Start seeing a therapist

The good news is mental health therapy, including virtual appointments, is an HSA eligible expense. You can use your HSA to directly pay for your sessions or you can pay out of pocket and reimburse yourself to get your tax savings later.

Is speech therapy a deductible medical expense?

Yes, as a medical expense on Sch A if you itemize. But your total medical expense has to be greater than 10% of your AGI to get any deduction.

How to know if something is HSA eligible?

Lip balm is typically HSA-eligible if it meets certain requirements, but here's what you should know.
  1. Common or routine medical expenses. Annual exams. ...
  2. COVID PPE supplies. ...
  3. Menstrual products and OTC medications. ...
  4. Family planning products. ...
  5. Emergency medical expenses. ...
  6. Mental health expenses. ...
  7. Dental care. ...
  8. Vision care.

Can speech therapy be free?

Speech therapy is offered free or at low cost for eligible families. As a rule, the RiteCare® Clinics accept preschool children who have difficulty speaking or understanding the spoken word or school-age children who have difficulty learning to read. Some centers also offer literacy training for adults.

What is fees in speech therapy?

What is fiberoptic evaluation of swallowing? A fiberoptic endoscopic evaluation of swallowing (FEES) test is a procedure used to assess how well you swallow. During the procedure, a speech-language pathologist (SLP) passes a thin, flexible instrument through your nose.

What happens if you don't get speech therapy?

Without treatment, children with speech impairments may have difficulty learning to read and write. Research suggests children with speech impairments may develop mental health issues like anxiety and depression.

How to get therapy when insurance doesn t cover it?

10 Affordable Therapy Options Without Insurance
  1. Medicaid. ...
  2. Sliding Scale Therapists. ...
  3. Online Therapy. ...
  4. Employee Assistance Programs (EAPs) ...
  5. College Healthcare Centers. ...
  6. Disability Benefits. ...
  7. Group Therapy. ...
  8. Support Groups.

Which of the following is excluded for speech therapy service?

Anything considered “educational,” such as a reading disorder or dyslexia, or services considered “maintenance” in nature is almost always an exclusion.

How does IRS know what you spend HSA on?

Verification of expenses is not required for HSAs. However, total withdrawals from your HSA are reported to the IRS on Form 1099-SA. You are responsible for reporting qualified and non-qualified withdrawals when completing your taxes.

What is the downside of an HSA?

Drawbacks of HSAs include tax penalties for nonmedical expenses before age 65, and contributions made to the HSA within six months of applying for Social Security benefits may be subject to penalties. HSAs have fewer limitations and more tax advantages than flexible spending accounts (FSAs).

What if I accidentally used my HSA card for groceries?

If you catch the transaction early enough, you might even be able to contact the retailer and ask them to reverse the charge and fill it on a new card. If you bought something in person, you can also return it to the store and then buy it again with a different card.