Use Pre-Tax Dollars to Cover Chiropractic Visits: Don’t Let Your FSA or HSA Go to Waste

As year-end approaches, many people scramble to find ways to spend leftover FSA funds before they vanish. But here’s a smart strategy: invest those dollars in your spinal health with a spinal wellness checkup or chiropractic visits. Let’s break down how you can use pre-tax dollars to get chiropractic care, and why now is a great time to act.

Why Chiropractic Visits Often Qualify as FSA/HSA Expenses 

• Chiropractic care (adjustments, exams, treatment) is typically considered a qualified medical expense by the IRS and FSA plans — as long as it’s for diagnosis or treatment of a medical issue, not purely for general wellness.
• The IRS list of eligible medical expenses explicitly includes “chiropractor outpatient care.”  
• FSA Store confirms that a chiropractic visit or exam can be reimbursed via FSA/HSA, though plan rules may vary.  
• However, some plans or employers may require documentation (a detailed receipt, diagnosis code, or letter of medical necessity) to substantiate that the care was for a medical condition.  
• Always double check your specific FSA/HSA plan (or ask your HR/benefits administrator) to confirm whether chiropractic services are covered under your plan.  

The “Use It or Lose It” Rule — Why Year-End Matters 

One of the biggest motivators for spending leftover FSA money is the “use-it-or-lose-it” rule. Here’s what you need to know: 

• Unlike HSAs, most FSAs do not roll over fully — funds left unused at the end of the plan year are forfeited (back to the plan/employer).  
• Some plans offer a grace period (e.g. until March 15) or a limited carryover amount ($570 or a plan-specific cap), but that depends on employer election.  
• Because of this, the final weeks of the year are prime time to schedule medical services — including chiropractic visits you’ve been delaying. 
• If you have leftover FSA balance, taking a spinal wellness check or adjustment now ensures you get full value before the deadline. 

How Patients Can Use Pre-tax Dollars for Chiropractic Visits 

Below is a step-by-step guide to making this work for you: 

What to Do	Tips / Notes
Check your FSA / HSA plan details	Review your benefits summary, or ask HR, to confirm chiropractic is eligible under your plan
Contact your chiropractor	Ask if they accept FSA/HSA or provide “FSA-eligible invoices” (with CPT/diagnosis codes)
Schedule before year-end or within grace period	Book now (or in the “grace months”) so the visit qualifies under this year’s FSA
Pay using your FSA/HSA funds	If you have an FSA debit card, pay directly. If not, pay out-of-pocket and submit for reimbursement
Submit documentation	Provide itemized invoice/bill, diagnosis code, provider information, etc. to your FSA administrator
Follow up	Ensure reimbursement is processed before plan deadlines; appeal if denied (with backup documentation)

Why it’s a Good idea – Beyond Tax Savings 

• You get immediate spinal care rather than letting funds go to waste. 
• A spinal wellness check can prevent worsening conditions (misalignments, nerve irritation) before they become more serious (and expensive). 
• It can support overall wellness, mobility, and quality of life — especially if you’ve been ignoring pain or tension. 
• Many people postpone routine chiropractic care — this is a financial incentive to invest in your body now. 

Caveats & Best Practices 

• Medical vs. wellness care: Purely elective adjustments (no medical diagnosis or symptoms) may face more scrutiny from FSA administrators.
• Plan limitations: Some FSAs (e.g. limited-purpose FSAs) may exclude chiropractic care; also, some plans restrict the number of visits or require preauthorization. 
• Documentation is key: Keep detailed receipts, provider information (license, tax ID), diagnosis codes, and any referral or prescription if requested. 
• Avoid double dipping: If you reimburse via FSA/HSA, you cannot also claim those same expenses as a tax deduction.  
• Timely submission: Submit reimbursement claims before your FSA deadline (often end-of-year or grace period) to avoid losing the benefit. 

Unused FSA funds don’t benefit you — they expire. But your spine will benefit from timely chiropractic care. With relatively low effort, scheduling a spinal wellness visit now can help you maximize your tax-advantaged dollars and support your health going into the new year. 

If you’re unsure whether your plan covers chiropractic care or how to submit claims, contact your HR or benefits administrator. And don’t wait — the time to act is now. 

Schedule your chiropractic visit, submit your claim, and let your FSA work for your body — not against it.

FAQ: Using FSA and HSA Funds for Chiropractic Care 

1. Can I use my FSA or HSA to pay for chiropractic care? 

Yes. In most cases, chiropractic services qualify as eligible medical expenses under both FSA (Flexible Spending Account) and HSA (Health Savings Account) plans. 

The IRS explicitly lists “chiropractor” under eligible medical expenses, as long as the treatment is for a diagnosed condition or medical issue—not purely for general wellness or maintenance. 

2. What types of chiropractic services are eligible? 

Eligible services typically include: 

• Initial exams and diagnostic evaluations 
• Spinal adjustments and therapeutic treatments for pain or dysfunction  
• Follow-up visits related to a diagnosed musculoskeletal condition  
• However, preventive or “maintenance-only” care (if no medical diagnosis is present) may not be reimbursable under some FSA plans. 

3. What documentation do I need to submit for reimbursement? 

Most FSA/HSA administrators require: 

• An itemized invoice or receipt from your chiropractor 
• The provider’s tax ID and license number 
• A diagnosis code or letter of medical necessity (if requested) 
• The date of service and total amount paid 
• Always save your receipts and documentation until reimbursement is processed. 

4. What’s the “use-it-or-lose-it” rule for FSAs? 

Most FSA funds expire at the end of the plan year, meaning unused balances are forfeited. 

Some employers offer limited exceptions: 

• A grace period (usually until March 15) 
• Or a small carryover allowance (up to $640 in 2024, depending on plan rules) 
• To avoid losing your funds, schedule your chiropractic appointment before year-end or during the grace period if available. 

5. How do I pay for chiropractic visits using FSA or HSA funds? 

You can: 

• Pay directly with your FSA/HSA debit card (if accepted) 
• Pay out-of-pocket, then submit a reimbursement claim with your supporting documentation  
• Check with your chiropractor to confirm if they accept FSA/HSA cards or provide detailed “FSA-eligible” invoices. 

6. What if my FSA claim for chiropractic care is denied? 

If your claim is denied, you can: 

Review the denial notice—most list the specific reason (e.g., missing documentation). 

• Submit an appeal with additional details such as a letter of medical necessity or updated diagnosis code from your provider. 
• Confirm your plan’s rules through your HR or benefits administrator to ensure compliance. 

7. Are there any limits to how much I can spend from my FSA or HSA on chiropractic care? 

There’s no specific cap on chiropractic expenses, but your reimbursement is limited to the balance available in your FSA or HSA. 

Keep in mind: 

• FSA contribution limit (2024): $3,200 
• HSA contribution limit (2024): $4,150 (individual) or $8,300 (family) 

8. Can I double dip by claiming FSA/HSA reimbursement and a tax deduction? 

• No. The IRS prohibits “double dipping.” 
• If you pay for chiropractic care with pre-tax FSA or HSA dollars, you cannot also claim those same expenses as a medical tax deduction. 

9. What if my plan doesn’t cover chiropractic visits?  

• A few specialized plans—like limited-purpose FSAs (for dental and vision only)—may not include chiropractic care. 
• If unsure, ask your HR department or plan administrator for confirmation. They can clarify whether your chiropractic visits qualify and what documentation is required. 

10. Why is now the best time to use FSA dollars for chiropractic care? 

Because unused FSA funds typically expire at year-end, now is the perfect time to: 

• Book a spinal wellness checkup 
• Address any lingering back or neck discomfort 
• Use pre-tax dollars to support your health before the funds disappear 
• It’s a simple way to prioritize your wellness while maximizing your benefits.