The National Board For Health And Wellness Coaching (NBHWC) on July 17, 2023 released an update about the ability for health-and-wellness coaching clients to use their HSA or FSA accounts for our services.
Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) provide the opportunity for you to pay for qualified medical expenses that insurance doesn’t cover with income that is not taxed.
The board has received so many inquiries about whether health-and-wellness coaching qualifies for this offset, that it sought input from a team of healthcare attorneys and the Internal Revenue Service.
“The IRS determines what can be reimbursed by an HSA/FSA. Because health and wellness coaching is an emerging profession it is not yet specified in the IRS code language, however the IRS has issued guidance to the NBHWC that out-of-pocket costs of health and wellness coaching services can be a ‘qualified medical expense’ if the services are provided for the treatment or prevention of a disease,” the NBHWC said in a bulletin to coaches.
“As such, we believe that if an individual is referred to health and wellness coaching by their physician as a treatment for a specific disease that the individual either already has, or has an imminent probability of developing, then the individual’s out-of-pocket costs for such services may qualify as a deductible medical expense.”
The board recommends that clients interested in receiving benefits under their HSA/FSA for health-and-wellness coaching should consult their physician to discuss their medical treatment and care plan. If the physician decides that they have a condition that warrants the support of a health and wellness coach and they recommend that as a course of treatment, they provide a Medical Letter of Necessity for record-keeping and claim submission. See a sample Medical Letter of Necessity.
By the way, the medical profession, the health insurance industry and the NBHWC are in the middle of a process now to ultimately secure the insurance coding for health coaching to eventually become a covered healthcare expense. It’ll be good for everyone if patients become healthier and insurers pay less for emergency care.


