"I know I need support, but coaching seems expensive."
If you've had this thought while looking at ADHD treatment options, you're not alone. Whether you're considering medication, therapy, coaching, or all three, the costs can feel like a barrier between you and the support you need. With ADHD medication averaging $750 to $1300 per month without insurance, plus therapy sessions at $100-200 each, many families struggle to afford comprehensive care.
The good news? For those who have Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs), and Flexible Spending Accounts (FSAs), ADHD coaching can be more affordable than you might expect. Yet, according to recent surveys, over 40% of eligible individuals aren't taking advantage of these benefits - often, simply because they don't understand how to use them effectively.
These tax-advantaged accounts can help make ADHD support more affordable while providing significant tax benefits - so we’re here to help you understand how to use HSA and FSA accounts to pay for ADHD coaching and other supports.
🏦 What is an FSA?
Flexible Spending Accounts (FSAs), also referred to as “Flexible Spending Arrangements” by the Internal Revenue Service (IRS), are special savings accounts offered by employers that let you set aside pre-tax money to pay for qualified healthcare expenses. Think of it as a dedicated healthcare piggy bank that helps you save on taxes while planning for medical costs. Note: These funds do expire each year, so it's important to use your FSA money before you lose it!
Key Facts
- For 2024, you can contribute up to $3,300 per year
- Your employer may also contribute to your FSA
- Money is taken from your paycheck before taxes, reducing your taxable income
- Must use funds within the plan year, though employers may offer:
- A grace period of up to 2½ months, OR
- The ability to carry over up to $660 to the next year
- You don't need to have health insurance to have an FSA
- If you're married, your spouse can have their own FSA through their employer
Using your FSA for ADHD support
Many ADHD-related medical expenses can be covered by your FSA. Here's how you can use it:
- ADHD Coaching: While general life coaching isn't covered, coaching that's prescribed by your healthcare provider as part of your ADHD treatment plan may be eligible
- Medical Appointments: Use FSA funds for copays and deductibles when seeing your psychiatrist, psychologist, or primary care physician
- Prescription Medications: Your ADHD medications are FSA-eligible
- Testing and Diagnosis: Initial ADHD assessments and follow-up testing are typically covered
💡 Pro Tip: Before starting ADHD coaching or treatment, get a Letter of Medical Necessity from your healthcare provider. This documentation helps ensure your expenses will be approved for FSA reimbursement.
Remember to check with your FSA administrator about specific coverage requirements, as policies can vary by employer. It's also wise to keep detailed records of all ADHD-related expenses and maintain copies of prescriptions, medical necessity letters, and receipts for reimbursement for seven years.
🏦 What is an HSA?
A Health Savings Account (HSA) is a tax-advantaged savings account that works alongside a high-deductible health insurance plan (HDHP). Think of it as a long-term health expense savings account that combines the immediate tax benefits of an FSA with the investment potential of a retirement account.
Key Facts
- 2024 contribution limits:
- Individual: $4,150
- Family: $8,300
- Must have a qualifying high-deductible health plan (HDHP) to contribute
- Triple tax advantage:
- Contributions are tax-deductible
- Money grows tax-free
- Withdrawals for medical expenses are tax-free
- No "use it or lose it" rule - funds roll over year after year
- Account stays with you even if you change jobs
- Can invest the money for potential growth
- After age 65, can use funds for non-medical expenses (will be taxed like regular income)
Using Your HSA for ADHD Support
An HSA can be a powerful tool for managing ADHD-related expenses, especially for long-term treatment:
- Medical appointments and copays
- Prescription medications
- Diagnostic testing
- Mental health provider visits
- ADHD coaching (with proper medical documentation)
- Build a dedicated fund for ongoing ADHD treatment
- Save for future medical needs while in good health
- Create a safety net for unexpected ADHD-related expenses
- Plan for potential treatment changes or intensive therapy periods
Ultimately, while HSAs require more active management than FSAs, they offer greater flexibility and long-term benefits for managing ADHD care costs. They can be particularly valuable if you anticipate ongoing ADHD-related expenses throughout your life.
⚖️ HSA vs FSA comparison
Here's a quick comparison of HSA vs. FSA benefits for ADHD coaching and treatment.
💰 How to use HSA & FSA to pay for ADHD coaching & treatment
Here are some practical ways you can use your HSA or FSA to make ADHD care more affordable:
- ADHD Coaching – Covered with a Letter of Medical Necessity from a healthcare provider
- Medication Costs – Pay for ADHD prescriptions, even if they aren’t covered by insurance
- Doctor & Therapy Visits – Use funds for psychiatrist, psychologist, or primary care copays and deductibles
- ADHD Testing & Diagnosis – Covers initial assessments and follow-up testing
- Mental Health Support – Covers therapy or counseling sessions related to ADHD treatment
- Behavioral Therapy – Includes cognitive-behavioral therapy (CBT) or other structured interventions
- Occupational Therapy – If recommended for ADHD-related executive function support
- Time Management & Productivity Tools – Some HSA/FSA plans may cover apps or tools prescribed by a provider
- Telehealth Services – Online therapy or coaching sessions may be eligible
Always check with your plan administrator to confirm which expenses qualify under your specific account!
Investing in your success with ADHD
With smart use of HSAs and FSAs, you can make this invaluable support more affordable and sustainable long-term. Don't let financial concerns hold you back from getting the ADHD support you deserve. Start planning your HSA or FSA strategy today, and take the first step toward a more supported, structured future.
Need a little help? Shimmer has several ADHD coaches with accounting experience! Book a free consultation with a Shimmer ADHD coach today and explore your HSA & FSA options!
🤔 Frequently Asked Questions
Can I use my HSA or FSA to pay for ADHD coaching?
Yes! ADHD coaching can be covered if it’s prescribed as part of your treatment plan. To qualify, you may need a Letter of Medical Necessity (LMN) from your doctor.
Does my FSA cover ADHD medication?
Yes. Most prescription medications for ADHD, including stimulants and non-stimulants, are FSA-eligible. You can use your FSA to cover copays and out-of-pocket costs.
What happens if I don’t use all my FSA money by the end of the year?
Most FSAs follow a use-it-or-lose-it rule, meaning unused funds expire at the end of the year. Some employers allow either:
- A grace period of up to 2.5 months, OR
- A carryover of up to $660 into the next year.Check with your FSA administrator to confirm your plan’s details.
Can I invest my HSA funds for long-term ADHD treatment?
Yes! Unlike FSAs, HSA funds roll over every year and can be invested tax-free. This means you can build a long-term ADHD treatment fund while growing your savings.
How do I get an HSA?
You must have a high-deductible health plan (HDHP) to open an HSA. If you’re self-employed or don’t have employer-sponsored insurance, you can open an HSA through a bank or financial institution.
Can I use HSA or FSA funds for ADHD-related therapy?
Yes! Therapy, including counseling and behavioral therapy for ADHD, is HSA- and FSA-eligible. This includes cognitive-behavioral therapy (CBT) and other mental health support.
Can I use my HSA/FSA for ADHD coaching apps or digital tools?
It depends. If a medical provider prescribes an ADHD-related productivity app or tool as part of your treatment, it may qualify. Check with your plan administrator to see what’s covered.
How do I get reimbursed for ADHD coaching with my HSA/FSA?
- Pay for your coaching session out of pocket.
- Submit a Letter of Medical Necessity (LMN) if required.
- File a claim with your HSA/FSA provider and include your receipt.
- Receive reimbursement from your HSA or FSA account.
Does my FSA or HSA cover ADHD testing and diagnosis?
Yes! ADHD assessments and follow-up testing are typically eligible expenses under both HSA and FSA plans.
