Lifestyle spending account and massage therapy

A lifestyle or wellness spending account can be used for massage therapy only if your employer's list of eligible expenses includes it. These accounts sit outside the tax rules for private health services plans, so what they pay you is a taxable benefit, unlike an insured health benefit or a qualifying health spending account. Claim massage from your extended health benefit first, then a health spending account if your administrator accepts it, and use the lifestyle account for what is left or for wellness services the others exclude.

A lifestyle spending account (LSA), sometimes called a wellness, personal or flexible spending account, can pay for massage therapy when your employer has put massage on its list of eligible expenses. That list is the whole answer, because these accounts are not bound by the medical rules that govern health benefits. The trade-off is tax: what an LSA pays you counts as income. Here is how to make the most of one without surprises.

Your employer’s list decides, not the clinic

An LSA is an employer-designed perk. The employer chooses the categories, the yearly amount and the rules, and an administrator applies them. Alberta Blue Cross describes the wellness account it administers in exactly those terms: it may go by another name, such as a flexible account, it generally reimburses products and services that maintain and enhance wellness rather than medical needs, and each employer’s account has a customised list of eligible expenses that members should check before claiming.

Because the list is custom, two people at different companies can get opposite answers for the same 60-minute massage. Look for categories such as:

• health support, wellness or alternative therapies;
• fitness, sports and recreation;
• personal care or self-care services.

If massage therapy, or “registered massage therapy”, is named, you are set. If it is not named but a broad wellness category is, ask the administrator before you book.

Why lifestyle accounts are taxable

The Canada Revenue Agency does not publish a page on lifestyle spending accounts by name. The tax treatment follows from its general rules.

The CRA’s starting point is that when an employer pays or reimburses an employee’s medical expenses directly, the payment is a taxable benefit. The main exception is a private health services plan (PHSP). To count as a PHSP, a plan must be in the nature of insurance, cover only the employee and their family or household, and have all or substantially all of its premiums, which the CRA defines as 90 per cent or more, go to expenses eligible for the medical expense tax credit.

A lifestyle account fails that test by design, because it pays for gym fees, equipment, courses and other non-medical items. So its reimbursements are a taxable benefit, reported on your T4. Real Alberta plans state this openly. ASEBP, the Alberta School Employee Benefit Plan, says that unlike its health spending account, reimbursed wellness spending account expenses are taxable. AHS’s own employee benefits summary describes its health spending account as non-taxable and its personal spending account as taxable.

Where massage fits among your accounts

Use each pot for what it does best, in this order:

1. Your extended health benefit. Claim massage here first. It is insured, not taxed, and has its own yearly maximum.
2. Your health spending account, if you have one. In Alberta this is less certain than people expect. Massage therapists are not on the CRA’s list of authorized medical practitioners for Alberta, while acupuncturists and physiotherapists are, so some administrators restrict massage in an HSA. Our page on using a health spending account for massage therapy explains why.
3. Your lifestyle account. Use it for what the other two will not take: the remainder of a fee, sessions after your maximum runs out, or wellness services outside a health plan.

Two cautions apply. Do not claim the same dollars twice; our page on claiming massage therapy on two benefit plans covers coordination. And some wellness accounts exclude anything a health plan would cover. ASEBP’s wellness account, for example, lists health-related expenses that would be covered under its health spending account as ineligible, and its eligible categories mention alternative therapies such as reflexology and reiki without naming massage.

Questions to put to your administrator

A short message to your benefits administrator settles most of this before you spend anything. Ask:

• Is massage therapy, or registered massage therapy, an eligible expense on my lifestyle account, and under which category?
• Does the account accept services that my health plan or health spending account also covers, or only what they exclude?
• Are wellness services such as infrared sauna sessions, memberships or facials on the list?
• What is the claim deadline for this plan year, and what receipt details do you need?

Write the answers down; they rarely change mid-year, and they save guessing every time you book.

Deadlines and receipts

LSAs usually run on a plan year with a firm cut-off for claims. ASEBP gives a clear example: for its 2025 to 2026 plan year, members have until October 30, 2026 at 11:59 p.m. Mountain time to submit health and wellness spending account claims. Check your own plan’s run-off date, and submit receipts as you go rather than in a rush at the end of the year.

Keep the full receipt, not a card slip. ASEBP notes that receipts may be required for wellness account claims, and a receipt that names the service, the date and the provider answers most administrators’ questions.

Using a lifestyle account at Renu

Several of our services may fit a wellness list, depending on how your employer has written it:

Service	Published price
Massage, 60 min	$120
Massage, 90 min	$157
Infrared cocoon session on its own, 20 min	$25
Monthly pod membership	$129 + GST
Silk Express Facial, 30 min	$80

Esthetic services such as lymphatic facials and Brazilian lymphatic drainage are usually outside health plans, so a wellness account may be the only benefit that could help with them; our page on whether Brazilian lymphatic drainage is covered by insurance explains why. The infrared sauna and massage therapy pages describe those services in full. Book through Jane, keep your receipt, and claim it under the category your employer’s list names.

Questions people ask

Is a lifestyle spending account the same as a health spending account?

No. A health spending account is set up to meet the CRA's private health services plan rules, so its reimbursements are not taxable. A lifestyle or wellness account covers a broader, employer-chosen list and is taxable, which is why many administrators keep them as two separate pots.

Can I put an infrared sauna or pod session on my lifestyle account?

Only if your employer's list allows it, often under a heading such as fitness, wellness or health support. Wellness lists vary a great deal, so read yours or ask the administrator before you buy a membership.

Will I pay tax on a massage reimbursed from my lifestyle account?

Yes, the reimbursement is treated as employment income. Your employer reports it on your T4 and withholds the usual deductions, so the after-tax value is lower than the dollar amount.

Can I claim the same massage on my extended health plan and my lifestyle account?

Not for the same dollars. Claim the insured benefit first and use the lifestyle account only for the part left unpaid, if the account allows it. Many wellness accounts specifically exclude expenses that your health plan or health spending account would cover.

Sources

1. Canada Revenue Agency: Medical expenses, including payments from a private health services plan
2. Canada Revenue Agency: Premiums and contributions to insurance plans
3. Canada Revenue Agency: Authorized medical practitioners for the purposes of the medical expense tax credit
4. ASEBP: Wellness spending account
5. ASEBP: Spending accounts
6. Alberta Blue Cross: Submitting your claims (group plan members)
7. Alberta Health Services: General Support Services benefits at a glance

Page reviewed October 5, 2026. This page is education, not a diagnosis. For your own situation, talk to your doctor, surgeon or care team, or ask us.