If you work for a medium- to large-size employer, chances are you have the option to set up a health savings account (HSA), also known as a flexible spending account (FSA) or a cafeteria plan.

Setting up such an account allows you to pay for qualified medical expenses with your pre-tax dollars. During open enrollment, you estimate how much money to set aside for the plan year based on your anticipated spending. The cap now is $2,500 per job per individual.

Once the plan year begins, the entire amount is available for your use. Dividing that amount by the number of paychecks you receive over the year, a set amount is deducted from each paycheck.

You submit your qualified receipts and get reimbursed. In some cases, you may be given a flex card to use for these expenses.

Often you lose any funds not spent by the end of the year, but in some cases there’s a grace period for spending it down, or $500 may be allowed to roll over into the next plan year. The IRS changes the rules from time to time. I found some information in this article in Forbes.

You can usually use your HSA or FSA to pay for massage, but check with your particular plan.

Some plans require a doctor to send a Letter of Medical Necessity before they will reimburse you for massage, because massage can be medical or non-medical (although it’s always therapeutic, in my opinion).

Your plan may not require such a letter. ADP’s plan for 2013 does not.

If your plan requires one, the Letter of Medical Necessity needs to include a medical reason for massage. Conditions that qualify, according to the IRS, include stress, back pain, hypertension, anxiety, depression, pain management, arthritis, carpal tunnel syndrome, diabetes, fibromyalgia, and chronic fatigue. Contact your HSA/FSA plan administrator if you have any questions about whether your condition is eligible.

The letter also needs to specify the number of sessions per month (such as twice a month) and the duration of treatment (such as 12 months).

If you are in the top tax bracket and set aside (and spend) the maximum, $2,500, you can save 40 percent, which is $1,000. Your savings on regular massage can be significant, especially when combined with negotiating discounted packages for regularly scheduled massages.

I myself used my FSA for 3 years of monthly craniosacral sessions years ago when I worked for the State of Texas. These sessions meant so much to me that I planned ahead. My doctor was happy to send me a Letter of Medical Necessity for stress that I submitted with my first receipt of the plan year. He updated the letter each year.

If you’d like to save money on massage at The Well, I recommend using an FSA/HSA if you have access to one. Whether you have one or not, we can negotiate a discounted package where you prepay for regularly scheduled massages.

Just let me know if you need a receipt and have paid with cash or check, and I’ll email you one within 24 hours (no printer at studio). Credit card receipts can be emailed immediately.