Mental health care is health care, and the tax code treats it that way. For many families, a flexible spending account (FSA) or health savings account (HSA) can make ongoing treatment for anxiety, depression, substance use, and other conditions more affordable. If open enrollment is coming up at work, now is a good time to learn how these accounts work. It's also a chance to plan for the care you or your family may need next year. Mesa Springs in Fort Worth, Texas is here to help you take that next step.

Why Does Mental Health Care Count as a Medical Expense?

The IRS defines medical care as the diagnosis, treatment, or prevention of disease, and that includes mental illness. The key test is purpose. An expense needs to be mainly for treating or preventing a physical or mental health condition, not just for supporting general wellness. That's why therapy for depression qualifies, while a meditation app usually doesn't. Treatment for alcohol and drug use is also recognized, including inpatient care at a treatment center.

FSA vs. HSA: What's the Difference?

Both accounts use pre-tax dollars, which can lower your taxable income and stretch your health care budget. But they work differently.

A flexible spending account (FSA):

• Is offered through your employer and chosen during open enrollment
• Typically makes your full yearly amount available on the first day of the plan year, which can help if care starts early
• Is generally "use it or lose it," though some plans allow a grace period or a limited carryover
• Usually can't be changed mid-year unless you have a qualifying life event

A health savings account (HSA):

• Requires an HSA-eligible high-deductible health plan to make contributions
• Rolls over every year and stays with you if you change jobs
• Can grow over time to help cover future care
• Can only be spent up to the amount you've deposited so far

One note: a dependent care FSA is a separate account for child or adult day care costs. It can't be used for medical or mental health care.

Planning for the Longer Arc of Care

Mental health and substance use treatment may involve different levels of care over time, so costs can extend beyond a single visit. Inpatient hospitalization, partial hospitalization, intensive outpatient care, and routine outpatient services are not a required sequence. The appropriate level of care depends on each person's clinical needs, safety considerations, and professional assessment, and people may enter or transition between services differently. Thinking about a potential course of care can help you plan a realistic budget.

When choosing how much to contribute:

• Review last year's costs, including copays, prescriptions, and therapy sessions
• Ask your provider how often visits may be needed and for how long
• Check your insurance plan's mental health benefits and deductible
• Remember you can often use your account for a spouse or eligible dependents, which can help parents planning for a teen's care
• If you have an FSA, estimate carefully, since unused money may be lost at the end of the plan year

Can You Use an FSA or HSA for Out-of-Network Care?

In many cases, qualified medical expenses may be eligible even when care is provided outside your insurance network, subject to applicable IRS requirements and your account's rules. Keep detailed receipts and remember that the same expense cannot be reimbursed twice, such as once by insurance and again through an FSA or HSA.

Why Getting Care Sooner Matters

Mental health and substance use conditions are treatable, and getting support early can make recovery easier to manage. Planning ahead financially means cost is less likely to become a reason to wait. If you or someone you love is in crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline, or call 911.

Learn more about behavioral health services at Mesa Springs and how to take the first step toward care.