I want other options
Can I use my HSA or FSA for acupuncture, chiropractic or herbs?
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Yes for acupuncture and chiropractic care. The IRS lists both as medical care. Herbs and supplements are different: they count only when a medical practitioner recommends them to treat a specific condition a physician has diagnosed.
What to do
- Keep every receipt. It should show the provider, the date, the service and the amount.
- For herbs or supplements, ask your doctor for a short note naming your diagnosis and what they recommend.
- Check your HSA or FSA administrator's list, or call them, before you pay for something new.
What to say
My doctor recommends this to treat a diagnosed condition. Can you write that in a short letter I can send to my FSA, with my diagnosis and how long I should take it?
Say it to your doctor. Many administrators call this a letter of medical necessity.
What to watch out for
This is a sensitive stepSmall details here can change the outcome, and some mistakes are hard to undo. We highly recommend a free 15-minute call with us before you decide.
Swiping the card before checking. If an HSA pays for something that isn't a qualified medical expense, you pay income tax on it plus a 20% extra tax. An FSA can ask for the money back.
Also: throwing away receipts. Keep them as long as you keep your tax records.
Better done together
We’re here to help
HSA and FSA rules are written for tax forms, not for people. It is easy to be unsure what counts, what paperwork you need, and what to do when a claim comes back.
We can look at what you are paying for, help you ask your doctor for the right note, and set up a simple way to keep receipts. Book a free 15-minute call and we'll go through it together.
Every situation is different, and these are sensitive moments, so we look at yours with care. We often see what others miss, and we never take commissions from insurance companies: the only thing we are working for is what is right for you.
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The rule behind it
IRS Publication 502 lists acupuncture and fees paid to a chiropractor for medical care as medical expenses. It says nutritional supplements, vitamins, herbal supplements and "natural medicines" don't count unless a medical practitioner recommends them as treatment for a specific medical condition diagnosed by a physician. Things that only support general health don't count. An HSA can pay for medical care as defined in section 213(d) of the tax code (IRS Publication 969). Money from an HSA used for anything else is taxed as income, plus a 20% additional tax, unless you are 65 or older, or disabled. Health FSAs follow the same definition, but your employer's plan can set narrower rules.
Sources
- IRS Publication 502 · Medical and Dental Expenses (acupuncture, chiropractor, nutritional supplements)
- IRS Publication 969 · Health Savings Accounts and other tax-favored health plans
- IRS · Changes to health care spending under the CARES Act
- NIH NCCIH · Paying for complementary and integrative health approaches
Amanda Alcodia
Last reviewed: October 2026
Education, not medical, legal or insurance advice.
Useful next steps
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