Online therapy with HSA or FSA money
Therapy and psychiatry are medical expenses an HSA or a health FSA can pay for. Here is how each online service says it takes that money (the card at checkout, or a receipt you claim back), and the IRS rules on what counts and when FSA money runs out. Every statement links to the page that makes it.
Yes, you can usually pay for online therapy with HSA or FSA money: the IRS counts therapy received as medical treatment, and psychiatric care, as medical expenses. Of 47 online services whose own pages say how, 26 take the HSA or FSA card at checkout, 2 reimburse by receipt, and GoodRx Care says it does not take it. FSA money is generally use-it-or-lose-it at the end of the plan year, unless your plan gives a grace period of up to 2 1/2 months or lets up to $680 carry over; HSA money never expires.
When FSA money runs out, and when HSA money doesn't
Most health FSAs run on the calendar year, so unspent money is at risk on December 31. Your plan documents or benefits portal say which rule yours follows.
Health FSA
- A health FSA is generally use-it-or-lose-it: money left at the end of the plan year does not carry over, unless your plan offers a grace period of up to 2 1/2 months or a carryover.
- A plan's grace period can run up to 2 1/2 months after the plan year ends.
- For plans that allow a carryover, at most $680 of unused 2026 money can carry over; the 2026 contribution limit is $3,400.
How 47 online services take HSA and FSA money
Each row is the service's own statement, linked to the page that makes it. A card can still be declined by your plan for a charge it does not count, so keep every receipt.
The other 21 services in our catalog say nothing about HSA or FSA on the pages we read; ask them, or your plan, before you pay.
HSA, FSA and online therapy, answered
- Can I use my HSA or FSA for online therapy?
- Usually yes. The IRS counts therapy received as medical treatment, and payments to a psychologist or for psychiatric care, as medical expenses, which is what HSA and FSA money pays for. Of 47 online services whose own pages say how they handle it, 26 take the HSA or FSA card at checkout and 2 want you to pay first and claim the money back with a receipt. Your plan administrator has the final word on any one charge.
- Is BetterHelp HSA and FSA eligible?
- BetterHelp takes HSA and FSA cards, according to its own pages: BetterHelp says it accepts HSA and FSA cards in the US, and you enter the card on the Payment page.
- Is Talkspace HSA and FSA eligible?
- Talkspace takes HSA and FSA cards, or a receipt you claim back, according to its own pages: Talkspace says you can pay out of pocket with an HSA or FSA card (check with your plan that the expense is eligible first), or pay by card and submit a superbill or bill to your HSA/FSA provider for reimbursement.
- What happens to my FSA money on December 31?
- A health FSA is generally use-it-or-lose-it: money left at the end of the plan year does not carry over, unless your plan offers a grace period of up to 2 1/2 months or a carryover. A plan's grace period can run up to 2 1/2 months after the plan year ends. For plans that allow a carryover, at most $680 of unused 2026 money can carry over; the 2026 contribution limit is $3,400. Your plan documents say which, if either, yours has. HSA money has no year-end deadline: it stays in the account until you use it, even if you change jobs.
- Do I pay with the card or get reimbursed?
- It depends on the service. 26 say you can pay with the HSA or FSA debit card itself (Alma, BetterHelp, Brightline, Brightside Health, Calmerry, Cerebral and others). Headspace Care and Workit Health ask you to pay another way and submit a receipt to your plan. Keep the receipt either way: plans can ask for proof that the charge was medical care.