When it comes to paying for mental health services, many people don’t realize they can use tax-advantaged accounts like HSAs (Health Savings Accounts) and FSAs (Flexible Spending Accounts). These accounts can make therapy more affordable—even if you’re paying out-of-pocket.
At Indy Mental Health and Wellness, I accept both HSA and FSA cards. Here’s what you need to know about how they work, how they’re different, and how to get one—especially if you’re self-employed.
What Is an HSA?
An HSA (Health Savings Account) is a special savings account that lets you put aside pre-tax money for qualified healthcare expenses—including therapy.
Key features:
· Must be paired with a High Deductible Health Plan (HDHP)
· Contributions are tax-deductible
· Funds roll over year to year
· You can invest your HSA funds (like a retirement account)
· You keep the account even if you change jobs or health plans
Great for: Long-term health savings, especially if you’re healthy and don’t need to spend the money right away.
What Is an FSA?
An FSA (Flexible Spending Account) is an employer-sponsored account that also lets you use pre-tax dollars for healthcare expenses.
Key features:
· Funded through your employer (not available if you’re self-employed)
· Use-it-or-lose-it: Most funds must be used by the end of the plan year
· Cannot be invested or carried over between jobs
· No need for a high-deductible health plan
Great for: Employees with predictable healthcare expenses and employer-provided benefits.
What Can You Use HSA/FSA Funds For?
Both HSAs and FSAs can be used to cover qualified medical expenses, including:
· Individual therapy
· Couples counseling (if medically necessary and prescribed)
· Psychiatric care
· Medication management
· Some wellness and preventative services
At Indy Mental Health and Wellness, I accept both HSA and FSA cards, just like a debit or credit card.
How to Use Your HSA/FSA Card for Therapy
1. Confirm your therapist accepts HSA/FSA cards (I do!)
2. Swipe your card at the time of service, or
3. Pay out of pocket and submit for reimbursement if needed
4. Save your receipts in case you need to verify the expense later
Be sure to check with your HSA/FSA provider for any documentation requirements—some might ask for a receipt with CPT codes or a letter of medical necessity.
What If You’re Self-Employed?
If you’re self-employed, you can’t open an FSA (it’s only available through employers), but you can absolutely open an HSA if you meet the requirements.
To qualify for an HSA:
· You must be enrolled in a High Deductible Health Plan (HDHP)
· You cannot be enrolled in Medicare
· You cannot be claimed as a dependent on someone else’s tax return
How to open one:
1. Shop for a qualifying HDHP through the Marketplace or a private insurer
2. Choose an HSA provider (many banks, credit unions, and investment platforms offer them)
3. Open the account and start contributing (up to the IRS limit each year)
For 2025, the HSA contribution limits are:
· $4,150 for individuals
· $8,300 for families (+ $1,000 catch-up if you’re 55+)
Using an HSA or FSA to pay for therapy is a smart, tax-savvy way to prioritize your mental health. Whether you’re employed or self-employed, these accounts can help make therapy more accessible and affordable. Have questions about how to use your HSA or FSA for sessions at Indy Mental Health and Wellness? We’re happy to walk you through it.
Click HERE to schedule an appointment!