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Posted May 27, 2021

HSA mental health


The last year has had a tremendous impact on the mental health of our nation’s workers. Since the start of the pandemic, mental and behavioral health requests increased 100 percent. For the youngest employees, that increase was even higher. Increasingly, employers are seeing the need to boost their mental health support of employees due to pandemic fatigue, among other reasons. 

Your employees who participate in a health savings account (HSA) can save money on a variety of mental health-related expenses. As part of Mental Health Awareness Month, we’ll walk through the HSA eligibility of these expenses. 


Mental counseling may qualify as an HSA-eligible expense if the counseling is as a result of a diagnosed medical condition. That means you may need to first seek a diagnosis from a doctor and get diagnosed in order to use your HSA funds on any counseling that follows. Marriage counseling, career counseling, life coaching, and parenting counseling do not qualify as HSA expenses. 


Psychoanalysis is defined by Simply Psychology as “a set of psychological theories and therapeutic methods which have their origin in the work and theories of Sigmund Freud.” It’s commonly used to treat anxiety, phobias, panic attacks, and a variety of other mental health needs. Psychoanalysis will qualify for HSA funds if it’s being provided for medical treatment and not just benefit an individual’s general health. 

Therapy or psychological care

Your employees could be increasingly reaching out for therapy or psychological care for any number of reasons. Like with psychoanalysis, therapy or psychological care qualifies for HSA dollars only if provided for medical care and not for the general improvement of mental health, stress relief, or personal enjoyment. 

Service animal

Animals play a critical role in mental health. Common examples include psychiatric service dogs and emotional support animals. If an individual can show that he or she is using a service animal primarily for medical care to alleviate a mental disease or illness, then expenses for buying, training, and maintaining a service animal may be eligible for HSA funds if the expenses would not have been paid for if not for the defect or illness.

Prescription/OTC meds

Employees with mental illness may depend on antidepressants, anti-anxiety drugs, and mood stabilizers. A variety of over-the-counter drugs and prescription medications are available for purchase with HSA funds. 


In some countries and culture, acupuncture is counted on as a form of treatment for a variety of mental health issues. Fortunately, acupuncture is also an HSA eligible expense when used for medical care. 

Sleep deprivation treatment

Stress can lead to a lack of sleep, which will have a profound impact on your employees’ mental wellness. One study found that chronic sleep problems affected 50 to 80 percent of patients in a typical psychiatric practice. Sleep deprivation treatment may help alleviate mental health symptoms and is HSA eligible.

Telemedicine visits

At the start of the pandemic, the use of telemedicine skyrocketed by more than 1000% in March 2020 and 4000% in April 2020, according to one study. Like many changes during the pandemic, it’s popularity could last even after the pandemic is behind us. HSAs do cover medical practitioners’ fees for telemedicine.

Would you like to learn more about emerging trends surrounding mental health in the workplace? Check out our latest episode of Benefits Buzz

The information in this blog post is for educational purposes only. It is not legal or tax advice. For legal or tax advice, you should consult your own counsel. 


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