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Telehealth has grown rapidly in the US, making healthcare more convenient. But it is becoming more expensive. Understanding how to manage those costs is, therefore, essential. That’s where Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) come in.
These tax-advantaged tools, which include many telehealth services, can significantly reduce your spending on eligible healthcare expenses. This blog aims to explain telehealth and HSA or FSA accounts and how they work for virtual mental health care.
Quick Refresher: What Are HSA and FSA Accounts?
Health Savings Accounts (HSA)
An HSA is a tax-advantaged savings account that is available to people. With a high-deductible health plan (HDHP), you can use the funds to pay for qualified medical expenses, including telehealth services.
- Contributions are tax-free. Also, any interest or investment gains are tax-free.
- Unused funds roll over from year to year. There’s no expiration date.
- You own the account. This is even if you change jobs or health plans.
Flexible Spending Accounts (FSA)
An FSA is an employer-sponsored account. It lets you contribute pre-tax dollars to pay for eligible healthcare expenses.
- Typically comes with a “use it or lose it” rule; the funds must be used within the plan year.
- Some plans allow a small rollover. It is usually up to $640 or a short grace period.
- FSAs are not tied to a specific health plan. But it must be set up through your employer.
Are Telehealth Visits Covered by HSA or FSA?
Yes, telehealth visits are generally considered qualified medical expenses. These are also eligible for payment or reimbursement.
This includes a wide range of virtual services. These are:
- Primary care appointments
- Mental health therapy sessions
- Dermatology consultations
- Urgent care visits
Thanks to federal policy updates in 2020, telehealth was more clearly defined. It is as a covered expense under HSA and FSA guidelines. Many of these provisions have been extended. This allows more people to use their tax-advantaged funds for convenient, remote care.
Common Telehealth Services You Can Pay For With HSA or FSA
Virtual Urgent Care and Primary Care Visits
Many online platforms offer flat-fee or subscription-based access to doctors for general health concerns. These visits are typically shorter, more affordable and easier to schedule than in-person appointments.
Teletherapy and Mental Health Services
You can use HSA/FSA funds to cover individual therapy, couples counseling, and family therapy. These services are delivered through secure telehealth platforms. These include licensed professionals such as psychologists, social workers, and licensed professional counselors (LPCs).
Prescription Consultations and Refills
Need a refill or ongoing medication management? Virtual appointments with a doctor to discuss prescription medications. These are covered, including those related to mental health (e.g., SSRIs, ADHD medication) or chronic physical conditions.
Specialist Telehealth Visits
Specialist care through telehealth is typically HSA/FSA-eligible as long as the service is for a medically necessary condition. This can include dermatology, women’s health, and chronic condition management (e.g., diabetes, hypertension).
What’s Not Covered Under HSA/FSA for Telehealth
Cosmetic or Elective Services
Primary cosmetic or non-medically necessary services are typically not covered unless a doctor prescribes them for a specific medical condition. This includes hair loss treatments, skin rejuvenation, and weight loss programs.
Wellness Apps Without a Medical Recommendation
Subscription-based wellness apps are not eligible. They are not focused on meditation, fitness, or nutrition practices. This is unless they’re explicitly recommended. A healthcare provider prescribes it as part of a treatment plan.
Platform or Membership Fees (Without Medical Services)
General membership fees for telehealth platforms (e.g., annual access or tech support costs) that don’t include actual medical services. These typically can’t be reimbursed through HSA or FSA accounts.
How to Pay for Telehealth Using HSA or FSA
Direct Payment With HSA or FSA Cards
Most major telehealth platforms, such as BetterHelp, Teladoc, or Amwell, accept HSA or FSA debit cards at checkout. If your provider is set up for this, you can pay directly for eligible services without needing to file extra paperwork. You must be sure your service is HSA/FSA-eligible. This is before paying to avoid complications with your plan administrator.
Reimbursement Process
You can still pay out of pocket if your provider doesn’t accept HSA/FSA cards. You can submit a reimbursement request. This is done through your HSA/FSA account portal or administrator.
You’ll typically need to include:
- A completed claim form
- Proof of payment (receipt or statement)
- A clear description of the medical service provided
Documentation You’ll Need
To get reimbursed, be prepared to submit an itemized receipt or bill that includes:
- The date of service
- The name of the provider
- A description of the service (e.g., “virtual mental health therapy session”)
- The cost of the service
How Telehealth Saves You Money Beyond HSA/FSA
Telehealth can significantly reduce your overall healthcare costs. This is even without factoring in HSA or FSA savings. Here’s how:
Lower Visit Costs
Telehealth visits are often much cheaper than urgent or emergency room visits, especially for routine care or check-ins. An ER visit can cost hundreds (or even thousands) of dollars. Many virtual appointments range from $40 to $100.
No Travel or Time-Off Needed
With telehealth, there’s no need to drive or take public transportation. You might miss work or school for an appointment. That means zero transportation costs. It also provides less time off and no lost wages. It makes care more accessible and affordable.
Cost-Effective Subscription Models
Many telehealth platforms now offer monthly or annual memberships. It has bundle services at a reduced rate. For example, unlimited virtual visits or discounted mental health sessions can lead to significant long-term savings. It is especially for families or individuals needing regular care.
Tips to Maximize Savings With HSA/FSA for Telehealth
Want to get the most out of your HSA or FSA when paying for virtual care? Here are a few smart strategies to help you stretch your dollars further:
Schedule Regular Visits Before Year-End (FSA Users)
FSA funds are typically “use it or lose it.” Therefore, ensure you schedule your telehealth visits before the plan year ends. Check the deadlines if your plan allows a grace period or small rollover. Then, you can book appointments accordingly.
Use HSA as a Long-Term Tool for Telehealth
Unlike FSAs, HSA funds never expire and can even be invested for future healthcare needs. If you use telehealth regularly (e.g., monthly therapy check-ins), consider setting aside HSA funds. It is specifically for these recurring expenses over time.
Combine Employer Contributions With Subscriptions
You can combine those perks with a telehealth subscription plan. This is if your employer contributes to your HSA. It offers mental health benefits. This can reduce or even eliminate out-of-pocket costs. This is while giving you consistent access to care.
Quick Comparison Table
| Eligible for HSA/FSA | Not Eligible for HSA/FSA |
| Virtual therapy sessions (e.g., for anxiety, depression, couples counseling) | Wellness or meditation apps (e.g., Headspace, Calm — unless prescribed) |
| Online doctor visits for acute issues (e.g., colds, infections, rashes) | Telehealth for cosmetic concerns (e.g., wrinkle treatments, elective hair loss services) |
| Prescription management via telehealth (e.g., ADHD, birth control, SSRIs) | General telehealth platform fees (e.g., annual membership not tied to specific service) |
| Telehealth with specialists (e.g., dermatologists, endocrinologists, women’s health) | Weight loss programs (unless doctor-prescribed for a specific medical condition) |
| Virtual chronic care management (e.g., diabetes check-ins, blood pressure monitoring) | Life coaching or career counseling (non-medical services) |
Conclusion
Telehealth is not only convenient. But it’s also an HSA/FSA-eligible way to make healthcare more affordable. From therapy to urgent care and prescription refills, virtual visits offer a practical solution. It has a budget-friendly alternative to traditional care.
Strategically planning and using your HSA or FSA can save you money, reduce stress, and maximize your healthcare dollars. With Beem, the HSA becomes a quiet engine that lowers lifetime medical costs and stabilizes finances. Beem’s Everdraft™ also lets you withdraw up to $1,000 instantly without checks. Download the app here.
