Money Left in Your FSA? Putting It Toward Chiropractic and Massage Before December 31
Yes, you can usually use flexible spending account (FSA) or health savings account (HSA) money for chiropractic care, since the IRS lists chiropractic treatment as a qualified medical expense. If your FSA runs on the calendar year, the weeks between now and December 31 are the time to use it, because money left over at the end of the plan year can be forfeited.
Every November we hear some version of the same thing at the front desk in Irondequoit: "I just checked my benefits and I still have a few hundred dollars in there." Usually that comes from someone whose neck or low back has been bugging them since summer, and who kept meaning to call. If that sounds like you, here is a plain walk-through of how these accounts work and how to use what's left before the year closes out.
How FSA and HSA deadlines actually work
The two accounts look alike on a pay stub, but they behave very differently at the end of the year.
A health FSA is the one with the deadline. You choose an amount during open enrollment, it comes out of your paychecks before taxes, and you're expected to spend it within the plan year. Many employers run that plan year January through December. Some give you a short grace period into the new year, and some let you carry a limited amount forward. Your employer picks one of those options or neither, so the rules on your plan are the ones that count.
An HSA is different. It goes with a high-deductible health plan, the money is yours, and it rolls over from year to year. There's no December rush with an HSA. It's still a good fit for chiropractic and massage visits when you need them, and plenty of people use it that way all year.
So the quick version: if you have an FSA, look up your balance and your plan's end date this week. If you have an HSA, there's no deadline, but the same eligibility rules below apply.
What usually counts at IronChiro
IRS Publication 502 is the list plan administrators lean on, and chiropractic care is on it. Beyond that, the details depend on your plan. Here is how the services at IronChiro tend to line up:
Chiropractic evaluations and treatment visits are generally eligible.
Massage therapy is often eligible when it's for a specific medical problem, like a strain or chronic pain, and many plans ask for a letter of medical necessity.
Shockwave therapy and spinal decompression are treatments for specific conditions, so ask your administrator how they handle them before you count on it.
Custom orthotics are medical devices, and many plans treat them as eligible.
Gift cards, wellness packages bought as presents, and general relaxation services usually don't qualify. If you're unsure about something, a two-minute call to the number on the back of your benefits card will settle it.
Whatever you book, ask for an itemized receipt. Most administrators want to see the date, the service, and what you paid. Keep it in the same folder or email thread as your other medical receipts so you're not digging for it in February when the reimbursement form shows up.
Picking care that's worth the money
A deadline is a good reason to call, but it isn't a reason to book random appointments just to spend down a balance. The better question is what's been nagging you.
For a lot of people around Irondequoit, that list looks pretty familiar by November. A low back that hasn't been right since the last weekend of raking. A stiff neck that gets worse once you're driving home from work in the dark. Shoulders that creep up toward your ears every time the temperature drops. A heel that hurts for the first few steps out of bed. Sore hips from a fall season of running or coaching or sitting on cold bleachers.
If you've never been to IronChiro, your first visit starts with an evaluation. We ask what's going on, look at how you move, and talk through what we find before any treatment starts. From there, the plan might be chiropractic care on its own, or it might include massage therapy, shockwave therapy for something stubborn like plantar fasciitis or tendon pain, or spinal decompression for certain low back and disc problems. It depends on you and what's causing the problem.
If you're already a patient and you've drifted away from your visits, this is a natural time to come back in. A fall check-in on something we've worked on before is often a quicker conversation than starting fresh.
Why booking in early November helps
Here's the practical part. Late December is when a lot of people discover their FSA balance at the same moment, and it lands right on top of holiday travel, school concerts, and office parties. Thanksgiving falls on November 26 this year, which eats into that week too.
Our office hours are Monday through Friday, 9 AM to 5 PM, so open appointments go faster as the month goes on. If you're thinking about a series of visits, starting in early or mid November gives you room to get several of them in before the plan year closes. Starting December 28 gives you one, maybe.
It also helps with the things you'd rather not fight through over the holidays. Long drives to see family, lifting suitcases, hauling the tree, sleeping on a guest bed, then the first real shoveling of the season. It's a lot easier to go into all of that feeling decent than to start care in January after a rough month.
A quick checklist before you call
Five minutes with this list will save you a phone call or two later:
Log into your benefits portal and write down your FSA balance and the plan year end date.
Check whether your plan has a grace period or a carryover, and how much.
If you want massage therapy covered, ask your administrator whether they need a letter of medical necessity.
Find your FSA or HSA debit card, or plan on paying and submitting for reimbursement.
Pick two or three days and times that work for you before you call, since that makes scheduling quicker.
If you also have health insurance that covers chiropractic, it's worth asking your plan whether you've met your deductible this year. Many deductibles reset in January, so care you get in the next few weeks may cost you less out of pocket than the same care after New Year's. Your insurance company is the only one who can tell you that for sure.
Frequently Asked Questions
Can I use my FSA or HSA card at a chiropractor?
In most cases, yes. Chiropractic care is listed as a qualified medical expense in IRS Publication 502, so FSA and HSA funds can generally be used for evaluations and treatment visits. Check your plan for any specific rules.
Is massage therapy FSA eligible?
Massage is often eligible when it treats a specific medical condition, like a muscle strain or chronic pain. Many plans ask for a letter of medical necessity, so check with your plan administrator before you book.
What happens to my FSA money if I don't use it by December 31?
If your plan runs on the calendar year and has no grace period or carryover, unused money is usually forfeited. Some employers allow a short grace period or a limited carryover, so look up your plan's rules.
Does HSA money expire at the end of the year?
No. HSA funds roll over from year to year and stay with you, so there's no year-end deadline. You can use them for eligible care whenever you need it.
What should I keep for reimbursement?
Ask for an itemized receipt that shows the date, the service, and the amount paid. Most plan administrators want that before they reimburse a claim.
Ready to use it before it's gone?
If you've got money sitting in an FSA and something that's been bothering you for months, this is a good month to deal with both. IronChiro is at 2164 Hudson Avenue in Irondequoit. Call 707-57-CHIRO (707-572-4476) or email info@ironchiro.com and we'll find a time that works before the year wraps up.
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