Accepting FSA Payments

In these trying financial times, when stress levels are high and every dollar counts, massage is more necessary than ever. I am frequently asked if I can bill insurance for the services I provide. Some people don’t understand why it is not covered in most instances, considering other treatments like acupuncture and chiropractic care often are. My best answer is to suggest they look into flexible spending accounts, or FSA’s, as an alternative.

FSA’s are available through many health plans, most large employers, and any company that offers benefits under a “cafeteria plan.” Once the account is set up, the employee determines a set amount to be set aside pre-tax from their regular paycheck.

These accounts are typically used to cover qualified medical related costs not covered by insurance. The primary advantage of a FSA is that the money goes in before payroll taxes, which means roughly 30% more value on every dollar. Because expenses covered have to be “qualified,” it means your doctor has to prescribe massage for a specific health issue. The commonly accepted definition of what is qualified is as follows:

• Section 213(d) of the Federal tax code stipulates that a qualified expense must be “to alleviate or prevent a physical or mental defect or illness.”
  
• Since therapeutic massage is frequently used for stress related issues, like high blood pressure and anxiety, as well as chronic pain and musculoskeletal issues, a physician would most likely write a prescription for these types of conditions.
  
• A recent study, published July 5, 2011 (article) has shown that massage is clearly effective in reducing low back pain. This is a huge step forward in establishing the therapeutic value of massage in a resistant medical culture. Citing studies of this nature may be helpful in persuading a doctor who might be hesitant to prescribe.
  

The 2 common methods of using the FSA account are with a debit card and with reimbursement. Spa De Paris is now using the debit card option, as it cuts down on processing and paperwork.

Otherwise, the client pays for the session, gets a receipt from the therapist, and submits that receipt for reimbursement. Receipts need to include the medical reason for the visit in order for the FSA to process it. Spa De Paris is now able to accept debit cards.

One thing to be aware of with the Flexible Spending Account is that it is “use it or lose it.” These plans are annually renewed, typically at the beginning of the year, which means the full benefit is available January 1. However, anything left in the account after December 31 gets absorbed, leaving the employee with a loss.

While most people believe in the therapeutic benefit of massage, the financial concern is the most often the reason for visiting less frequently. With the Flexible Spending Account, you can think of your massage visit as being automatically discounted 30%.

A conversation with your HR person or health insurance provider is strongly recommended to find out the specifics about the plan you have access to.

I hope this information is helpful to those who are hesitant to visit their massage therapist at Spa De Paris because of the expense. I’d love to hear feedback from people who have used, or are currently using a FSA for massage.