FSA vs. HSA: What Every Woman Needs to Know About Using Benefits for Therapy

Every year, millions of women lose hundreds of dollars in unused health benefits — money that could have covered something truly life-changing, like therapy. If you’ve ever wondered whether your Flexible Spending Account (FSA) or Health Savings Account (HSA) can help pay for mental health support, the short answer is yes.

Both FSAs and HSAs can cover therapy, but they work in slightly different ways — and knowing the difference can help you make the most of every dollar before the year ends.

Let’s break it down in simple, real-world terms.

Can a healthcare FSA be used for therapy?

Yes — and it’s one of the smartest ways to use your FSA funds before they expire.

A Flexible Spending Account (FSA) lets you set aside pre-tax dollars (usually from your paycheck) for qualified healthcare expenses, including mental health services like:

• Therapy sessions with a licensed professional (in-person or online)
• Psychiatric care
• Prescription medications for mental health conditions

That means if you pay for therapy out-of-pocket, you can use your FSA card directly or submit a reimbursement claim to get your money back.

The catch? Most FSAs operate on a “use-it-or-lose-it” system — if you don’t spend your balance by the end of the plan year (usually December 31), that money disappears.

So, if you’ve been putting off getting therapy, this is your reminder: those funds were made for your health — body and mind.

Who is an FSA best suited for?

An FSA is a great fit for anyone with predictable yearly health expenses — things like therapy sessions, prescriptions, or regular doctor visits. It’s also ideal if you want the instant tax savings that come from using pre-tax dollars, and you don’t mind spending those funds within the same year.

Many people appreciate FSAs for their simplicity. You can have contributions automatically taken from your paycheck, use your FSA card directly at checkout, and avoid the hassle of reimbursement paperwork altogether.

The key is to keep an eye on your balance as the year wraps up. While some employers offer a short grace period of about two and a half months or allow a small rollover (up to $640 in 2025), most FSA funds expire once the deadline passes — so it pays to plan ahead.

What’s an HSA — and how is it different?

An HSA (Health Savings Account) also lets you use pre-tax money for qualified medical and mental health costs. The difference is who can get one and how long the money lasts.

You’re only eligible for an HSA if you’re enrolled in a high-deductible health plan (HDHP). Unlike FSAs, the money in your HSA rolls over every year, and it stays with you even if you change jobs.

You can use your HSA funds for:

• Therapy (in-person or virtual)
• Psychiatric care
• Medications
• Other mental and physical healthcare expenses

Think of an HSA as a long-term health savings tool — one that can grow over time and support your wellness goals well into the future.

What is the biggest advantage of an HSA?

The standout benefit of an HSA is its triple tax advantage. Every dollar you contribute goes in before taxes, lowering your taxable income. The money in your account can then grow tax-free through interest or investments, and when you use it for qualified medical or mental health expenses, those withdrawals are tax-free too.

Think of it as a 401(k) — but for your health. And unlike an FSA, there’s no deadline or expiration date. Whether you use it for therapy next month or years down the line, your HSA funds are yours to keep and continue growing.

Can I have both an FSA and HSA?

Usually, no — at least not both full accounts at once. The FSA vs HSA decision typically comes down to your health plan type and how the IRS classifies these accounts.

Because FSAs and HSAs have overlapping tax benefits, the IRS doesn’t allow both simultaneously unless your FSA is a “limited-purpose FSA.”

A limited-purpose FSA only covers dental and vision care, so your HSA can remain active for medical and mental health expenses.

If your employer offers both, ask your HR department which type you have — and plan your spending accordingly.

How FSAs and HSAs make therapy more accessible

Therapy can feel expensive — especially without insurance coverage — but FSAs and HSAs make it far more accessible.

Here’s how these accounts can lower your mental-health-care costs:

• Pre-tax savings mean lower out-of-pocket costs. Because contributions are taken before taxes, you save about 15–25% on every therapy session compared to paying with after-tax money.
• No insurance limits or approvals. You can use funds for therapy even if it’s not covered by your plan.
• Full privacy and flexibility. You choose your therapist — in person or online — without going through an insurance network.

Research consistently shows that therapy helps improve mental health outcomes, from reducing symptoms of depression and anxiety to improving relationships and quality of life. Using your benefits to make therapy possible isn’t indulgent — it’s smart, proactive health care.

When to use your benefits — and what happens if you don’t

Here’s the part most people don’t realize: over 40% of FSA users lose money each year because they forget to spend it before their deadline. Once that cutoff passes, any unspent balance goes back to your employer.

If you have an FSA, log in to your account now and check your balance. Every dollar could fund something meaningful — therapy, medication, or another step toward better health.

Is it better to do an HSA or FSA?

There’s no one-size-fits-all answer when it comes to the FSA vs. HSA decision — it really depends on your health plan, financial goals, and how you want to use your benefits.

An FSA (Flexible Spending Account) is available through most employer health plans and is typically meant for short-term use. It’s funded with pre-tax dollars and tied to your employer, meaning if you leave your job, you’ll likely lose any remaining balance. Most FSAs also have a yearly deadline — if you don’t spend the money by year-end (or within a short grace period), it expires. In 2025, you can contribute up to $3,300.

An HSA (Health Savings Account), on the other hand, is only available if you’re enrolled in a high-deductible health plan (HDHP). But the money you put in stays yours forever — even if you change jobs — and rolls over from year to year. You can contribute up to $4,300 if you’re on an individual plan, or $8,550 for a family in 2025. The real bonus? You can even invest your HSA funds and let them grow tax-free.

If you’re choosing between them, ask yourself:

• Do I have a high-deductible plan? → Go with an HSA for long-term flexibility and growth.
• Do I want to use my funds this year? → An FSA might be the better fit for immediate needs.
• Do I plan to start therapy soon? → Either works — both cover therapy sessions, and both save you money.

Ultimately, the “better” account is the one you actually use. Mental health care is health care — and your benefits were designed to support that.

How to use your FSA or HSA funds for therapy

If you’ve been putting off therapy because of cost or confusion around benefits, there’s good news: BetterHelp recognizes FSA or HSA cards as an eligible expense by most providers. accepts both FSA and HSA payments.

That means you can connect with a licensed therapist online — on your schedule, from home — and pay with your pre-tax funds.

With sessions available online anytime, anywhere, BetterHelp makes therapy more accessible and affordable, so your hard-earned dollars go directly toward your healing.

Use your FSA or HSA before year-end to invest in your mental health. Don’t let your benefits go unused — connect with a licensed therapist through BetterHelp and get the care you deserve.