Making Functional Medicine More Affordable with a Health Savings Account (HSA) or Flexible Spending Account (FSA)

It’s no secret that paying for healthcare in 2025 is a concern. While most traditional healthcare practices and doctors accept health insurance, many do not. These include those who practice functional medicine, integrative healthcare, or the type of complementary medicine that combines functional and integrative with conventional.

Here at PROVOKE Health, we combine the best of functional medicine, conventional healthcare, and complementary therapies with an emphasis on motivating patients to achieve their health goals and objectives. In this case, we’re a bit of a hybrid. We accept insurance for select treatments and therapies — but not all.

Regardless of the healthcare practice in which you place your trust, paying for that care can be a stressful proposition. You may have heard about using a health savings account (HSA) or flexible spending account (FSA) to cover the cost of medical expenses with pre-tax dollars. With HSAs and FSAs, you deposit money into an account before taxes are taken out of it and then use that money tax-free to pay for certain medical expenses, such as copays for doctor visits and dental care, prescription and over-the-counter medications, and eligible medical procedures.

In these challenging times, understanding your options is important, and that’s what this post is about, with a focus on HSAs and FSAs.

How Pre-Tax Dollars Reduce the Cost of Functional Medicine

An HSA or FSA can help address a common challenge many patients face when they pursue functional, integrative, and complementary healthcare options, such as care provided by practices like ours. Insurance companies often deny claims for testing or treatment that’s outside the scope of the traditional medical and pharmaceutical industries.

However, insurance companies have no say over what doctor or medical treatments you choose to use your HSA or FSA funds. As long as you’re paying for an eligible medical expense, such as a doctor’s visit, lab test, or medical procedure, you’re free to spend the money however you wish.

This opens the door to a useful strategy for making functional medicine and integrative healthcare more affordable — using an FSA or HSA to pay for it. By paying with pre-tax dollars, your expenses for non-traditional medical care are essentially reduced by the amount of money you would have paid in taxes on those contributions.

How Much Can You Save? Let’s Do the Math

For example, suppose you contribute $4,300 to an HSA over the course of the 2025 tax year, and you use the entire amount to cover out-of-pocket costs for functional medicine consultations, tests, and prescribed treatments.

Also suppose — based on your income tax bracket — you’re required to pay 24 percent in federal income taxes. You’re saving $4,300 x 0.24 = $1,032. So, instead of paying $4,300 for functional and integrative healthcare, you’re actually paying $4,300 – $1,032 = $3,268.

Eligible Medical Expenses

You can use the funds in your health savings account (HSA) and/or flexible spending account (FSA) to pay any eligible medical expenses, which include the following:

• Co-pays and co-insurance: If your insurance requires that you pay a portion of the cost of your functional and integrative consultations out-of-pocket, you can pay from your HSA or FSA.
• Out-of-pocket deductible: If your insurance requires that you pay for medical expenses up to a certain amount before insurance starts to cover expenses, you can pay from your HSA or FSA.
• Testing, treatments, and preventive medical costs: At PROVOKE Health, you can use your HSA or FSA to pay for lab tests, intravenous (IV) nutrient supplements and peptide treatments, and any supplements we may prescribe.

The Differences Between FSAs and HSAs

Flexible spending accounts (FSAs) and health savings accounts (HSAs) allow you to pay medical and other eligible expenses (often including dental and vision) with tax-free dollars. In most cases, you receive a debit card tied to the account (and in some cases checks) to make payments. You may be able to pay in other ways and then reimburse yourself from the account, or file a claim (with a valid receipt) to receive reimbursement.

FSAs and HSAs are very similar, but they differ in the following ways:

• Self-managed versus employer-sponsored: HSA is self-managed, whereas FSA is employer sponsored. The big difference here is that an HSA follows you. If you leave your job or lose it, you keep your HSA. With an FSA, if you leave the job, you can still use any funds remaining in your account until those funds are used up or until the end of the year, but you can no longer make tax-free contributions to it.
• Insurance plan: HSA requires that you have a high-deductible health plan (HDHP). To qualify as an HDHP, the plan must have a minimum deductible of $1,650 (up from $1,600 in 2024) for an individual or $3,300 (up from $3,200 in 2024) for a family. The plan must also have maximum out-of-pocket expenses of $8,300 (up from $8,050 in 2024) for an individual or $16,600 (up from $16,100 in 2024) for a family. An FSA does not require that you have an HDHP. (An HDHP typically has lower premiums to make the health insurance more affordable, but it has a higher deductible, so if you need medical care, you’ll be paying more of the cost of it out of your own pocket before your insurance company will pay for any of it. An HSA is designed to help you cover those out-of-pocket costs.)
• Contribution limits: HSAs have higher contribution limits (the amount you can add to the account during the course of the year) than do FSAs. For 2025, HSA contribution limits are $4,300 (up from $4,150 in 2024) for individuals and $8,550 (up from $8,300 in 2024) for couples or families. The catch-up contribution limit for those over the age of 55 is $1,000 (unchanged from 2024). The FSA contribution limit for 2025 is $3,300 (up from $3,200 in 2024); if you’re married and your spouse’s employer offers an FSA, your spouse can contribute up to $3,300 also. (These limits change from year to year, so we recommend searching the web or asking your accountant to find out the limits for the current tax year.)
• Unused contributions: FSAs usually have a “use it or lose it” policy; that is, you must spend the money before the end of the year, or you lose it. Some plans allow participants to roll over a limited amount of the money to the following year. The maximum rollover allowed by law is $660 for 2025 (up from $640 in 2024). Many FSA participants rush to spend their money at the end of the year; they may order new glasses, stock up on over-the-counter medicines, or try to schedule a medical or dental procedure before the year ends. With an HSA, there are no restrictions on rollovers.
• Contributors: With FSAs, only the participant and the employer-sponsor of the plan are permitted to contribute pre-tax dollars to the account. In contrast, an HSA allows contributions from participants and their employers, family members, and anyone else. This can be helpful when caring for an elderly parent or helping an older child cover a medical expense.
• Investing: When your HSA balance reaches a certain threshold (usually about $1,000 or $2,000, depending on the provider), you can invest the funds in stocks, bonds, and other investment vehicles, which may earn a higher return than if the funds were held in an interest-bearing account. FSA funds, on the other hand, must remain in the account in which they’ve been deposited.
• Penalties: With an FSA, the only penalty is that you may forfeit any amount remaining in the account at the end of the year (use it or lose it). With an HSA, any unused funds are rolled over into the following tax year. However, if you withdraw funds before the age of 65 for ineligible expenses, you must pay income tax on that amount plus a 20 percent penalty. After the age of 65, you can withdraw money for any purpose without penalty, but you’re still required to pay income tax on any money you withdraw to pay for anything that’s not an eligible medical expense.
• Additional contribution decisions: With an HSA, you can decide how much to contribute (up to the specified maximum) over the course of the year. With an FSA, you need to decide how much to contribute during the open enrollment period. Changes can be made only in the event of a change in employment or family status. For example, if you decide to contribute $100 to your FSA from every paycheck, you can’t change that amount during the year.

Should I Use an HSA or FSA?

That depends. Consider the following:

• If you’re healthy, having a high-deductible healthcare plan with an HSA is usually a wise choice. You’ll pay lower premiums and can deposit the money you save on premiums into an HSA to cover any unforeseen medical expenses. However, having a high-deductible is risky; if you require expensive medical care, you could end up having to pay thousands and thousands of dollars before your insurance starts paying any portion of the bill.
• If you have a high-deductible health plan, a health savings account (HSA) is generally better than having an FSA because the contribution limit is higher — $4,300 for an HSA versus $3,300 for a flexible spending account (FSA). In addition, you can nearly double your HSA contribution (up to $8,550) for a couple or family, whereas the maximum contribution for an FSA is $3,300 per participant, regardless of whether you have individual or family coverage.
• If you don’t have a high-deductible health plan, you can’t use an HSA, but you can use an FSA if your employer offers it.
• If your employer offers an HSA-compatible FSA (also called a limited-purpose FSA) that is only for certain expenses, such as vision and dental, you can use both HSA and FSA over the tax year for additional tax savings. That assumes, of course, that you have a high-deductible health plan.

Check with your employer’s human resources administrator to find out more about insurance plans and FSA and HSA options. If you’re self-employed, consult a tax planning expert to explore your options.

Remember: Better Treatment Costs Less

Many people claim that they can’t afford to consult with a functional medicine and integrative healthcare practice like PROVOKE Health, because it’s not covered by their policy or because we’re “not in their network.” They ignore the hidden costs of the conventional treatment they’re getting. Those costs include the following:

• The cost of an incomplete diagnosis that stops at the symptoms and never gets to the root cause of the illness.
• Reduced productivity at work due to persistent symptoms.
• Lost time for additional doctor visits in pursuit of an accurate diagnosis and effective treatment.
• Manageable illnesses that become more serious chronic illnesses or that develop into other illnesses because they weren’t properly diagnosed and treated earlier.
• Lower quality of life.

Here at PROVOKE Health, the primary way we make healthcare more affordable is by providing care that restores health instead of merely providing partial and often only temporary symptomatic relief. Our focus is to optimize your health, so you can return to feeling your best and living a full and fantastic life. We accomplish this in two ways:

• By diagnosing and targeting the underlying causes of illness instead of chasing symptoms with medications that are often ineffective, provide only temporary relief, or do more harm than good.

For example, if you’re suffering from gastroesophageal reflux disease (GERD), we don’t simply prescribe an acid-blocker and send you on your way. Instead, we perform a thorough evaluation to identify potential root causes, which may include food sensitivities, bacterial or fungal overgrowth in the gut, emotional stress, low stomach acid, leaky gut (damage to the protective lining of the gut), environmental toxins (such as mold), and other factors. Depending on the root causes, treatments can be different from one patient to the next.

• By restoring optimal health. When the body is healthy, it is better equipped to heal itself and to defend itself against illness. In short, it is more resilient. We work closely with our patients to develop a personalized plan of care for each patient that often includes targeted diet and lifestyle changes, exercise, stress management, pharmaceutical medication, nutritional support, and supplements.

Stop thinking that you can’t afford functional and integrative healthcare. If conventional medicine isn’t making you feel any better, maybe you can no longer afford it. You may find that, with the help of an HSA or FSA, the cost of functional and integrative healthcare is not so far out of reach.