FSA for Mental Health: Therapy, Apps & BetterHelp Rules
Mental health care is essential healthcare. Fortunately, the IRS generally agrees, making most therapy costs eligible for FSA and HSA reimbursement. However, new "Digital Health" options like apps and text-based therapy have created some confusion.
1. Traditional Therapy & Psychiatry
Status: Eligible (No LMN Needed)
Visits to a psychologist, psychiatrist, or licensed counselor for medical care are fully eligible. This includes:
- Co-pays and Deductibles.
- Session fees (if paying out of network).
- Prescription medications (Antidepressants, etc.).
Note: Marriage counseling is generally not eligible unless it is specifically treating a diagnosed medical condition for one of the spouses.
2. BetterHelp, Talkspace & Apps
Status: Eligible (But keep records)
Online therapy platforms like BetterHelp are eligible if they are providing medical care for a specific condition (anxiety, depression).
Meditation Apps (Calm/Headspace): These are considered "General Wellness" and are NOT eligible on their own. However, if a doctor prescribes them to treat a specific diagnosis (like chronic insomnia or anxiety), you can buy them with an Letter of Medical Necessity (LMN).
3. Physical Items (Blankets & Lamps)
Can you buy a Weighted Blanket with FSA? Maybe.
Items that have a "Dual Purpose" (meaning they can be used for general comfort OR medical treatment) always require an LMN.
- Weighted Blankets: Eligible with LMN (for autism, anxiety, insomnia).
- Light Therapy Lamps: Eligible with LMN (for SAD/depression).
- Massage Guns: Eligible with LMN (for stress/pain management).