A med spa owner called us in the second week of December a couple of seasons back, half panicked. Her January through November had been fine, but the holidays always went dead and she had a stack of open slots. We asked one question: had she told her patient list that their flexible spending money was about to disappear? Long pause. She had not. We sent one plain email to her list that afternoon. Within three days she had rebooked most of December with people spending money they were about to lose anyway. Nothing fancy. She just reminded them.
This is one of the most overlooked plays in healthcare marketing, and it repeats every single year like clockwork. Your patients set aside pretax money for care, forget about it, and then lose it when the calendar flips. You provide the exact care that money is for. The only missing piece is someone connecting the two. That someone should be you.
First, the difference that changes your whole message
FSA and HSA get lumped together, but for your marketing they behave in opposite ways, and knowing the difference makes your reminders far sharper.
FSA is the one with the deadline. A flexible spending account follows a use it or lose it rule. Whatever a patient has not spent by December 31 is usually gone for good. Some plans offer a short grace period into March or let a small amount carry over into the next year, but most of the balance simply vanishes back to the employer. The 2026 contribution limit is 3,400 dollars per person, per the IRS, and plenty of families set aside far more than they end up using. That gap is the money you are helping them rescue. For the official plain language on this, the government's own use it or lose it explainer is worth pointing patients to.
HSA never expires, but the deductible resets. A health savings account rolls over year after year, so there is no December cliff on the balance. The urgency is different and just as real. Most patients meet their deductible sometime during the year, and on January 1 it resets to zero. So a patient who has already hit their deductible pays much less for a procedure done in December than for the same procedure in February. If they have been putting off that treatment, the cheapest time to do it is right now, before the reset. That is a genuinely useful thing to tell someone.
Two accounts, two reasons to act, one deadline that lands at year end. Your job is to make both crystal clear.
Why this money keeps getting left on the table
It is not that patients do not care about their own money. It is that the system practically hides it from them. FSA contributions come out of a paycheck at the start of the year and then go silent. There is no monthly bill, no reminder, nothing that nudges anyone until the deadline is already gone. In one recent year, more than half of FSA holders forfeited part of their balance, with an average loss north of 400 dollars per person, as covered in Money's reporting on the numbers. That is not carelessness. That is a design that makes forgetting easy.
Which is exactly why a reminder from a trusted practice lands so well. You are not selling anyone anything they do not want. You are telling a person that money they already set aside for healthcare is about to disappear, and that the care they may have been postponing is covered. Framed honestly, it is one of the most welcome messages you can send all year.
Which of your services likely qualify
More than most patients assume. Dental work and orthodontics, vision exams, glasses and LASIK, physical therapy, chiropractic care, dermatology, allergy treatment, mental health visits, and many medically related procedures are commonly FSA and HSA eligible. Some aesthetic and elective treatments qualify when there is a documented medical reason. Rules shift by plan and by year, so always tell patients to confirm the specifics with their own plan administrator. But the headline is real: a large share of the care you already provide can be paid for with pretax dollars.
The year end playbook, step by step
Here is the part you can actually run. None of it is complicated. The advantage goes to whoever is organized, not whoever is loudest.
1. Build the list before you need it
Your best audience is not strangers. It is the people who already know you and have unfinished business: patients who accepted a treatment plan but never scheduled, anyone due for work they have been putting off, and past patients you have not seen in a while. Pull those names now, in the slow months, so the list is ready when the season hits. This is also why building an email list pays off long before December, and why reactivating past patients and leads is often the cheapest growth a practice has.
2. Send a clear, early heads up
Email and text both work, and the two together work best. Keep the message short and human. Tell them their FSA money likely expires December 31, that their deductible resets January 1, that a lot of the care you offer qualifies, and that spots fill up fast at year end. One honest paragraph beats a glossy flyer. For the nuts and bolts of which channel to lead with, we broke it down in text versus email reminders. Start warming people up in September and October, not in the last week.
3. Make booking effortless
Urgency dies the second a patient has to call during business hours, wait on hold, or dig through your site to find the right service. Give them a direct path: a simple message, a clear button, an online booking link that lands on the exact treatment, not a generic homepage. The easier you make it to say yes in the moment they are motivated, the more of that expiring money turns into a booked visit.
4. Catch the after hours surge
Year end is when people finally deal with their to do list, and a lot of that happens at night and on weekends when your front desk is closed. A patient who remembers their FSA at 9pm and hits voicemail usually does not call back. This is where a lot of the season's money slips away. A practice that can answer and book around the clock captures the calls everyone else misses, which is exactly what our AI receptionist is built to do: pick up every call, answer the FSA question, and put the patient on the schedule day or night.
5. Say it out loud on your website and social
Not everyone is on your list yet. A simple banner on your site, a few posts, and a line in your Google presence that says you accept FSA and HSA can catch the person searching in November for a place to spend theirs. If you are promoting a specific treatment for the season, our guide to promoting a new service walks through how to do it without sounding like a used car ad.
Our honest take: this is service, not a gimmick
We will plant a flag here, because some owners feel a little squeamish about anything that looks like pushing treatment. Good. That instinct is correct, and it is exactly why this play works when you do it right. The line is simple. You are reminding people about their own money and telling them what is covered. You are never talking anyone into care they do not need. When a patient has been putting off a crown, or a round of physical therapy, or the LASIK they keep saying they will get to someday, the fact that it is covered and that the coverage expires is precisely the information that helps them finally take care of themselves. That is your job.
Practices that treat year end as a service moment, not a fire sale, tend to see the same thing: patients thank them for the reminder. Nobody says thank you to a discount blast. Plenty of people say thank you when you keep them from losing 500 dollars they forgot they had. That goodwill is worth more than the December revenue, and the December revenue is not small either. It also tends to link up with the rest of your calendar. We wrote about the seasonal swings most practices ride in whether summer is really your slow season, and year end is the mirror image: a predictable window you can plan for instead of dread.
One more practical note. If you have wondered whether to even take these cards at the front desk, that is a separate and worthwhile question we covered in whether your practice should accept HSA and FSA. The short version: making it easy to pay with pretax dollars removes one of the last reasons a motivated patient hesitates.
How EtherealMinds runs this for practices
When we build a patient acquisition system, seasonal moments like this are not an afterthought, they are scheduled into the year. For year end that means we segment your patient list into the people most likely to have unspent benefits, write the reminder emails and texts in plain human language, set up booking pages that make saying yes a two tap job, run the social posts and ads that catch new searchers, and make sure every after hours call gets answered and booked instead of lost. Then we track exactly how many appointments the campaign produced, so you know what it was worth and can run it again, better, next year.
So how do you get patients to use their FSA and HSA before it expires? You build the list early, you send an honest reminder that respects their intelligence, you make booking effortless, and you catch the calls that come in after hours. Do that, and a stretch of the calendar that most practices write off becomes one of the easiest wins of your year, funded by money your patients were about to throw away.
Turn expiring benefits into a booked Q4
Book a free strategy call. We will map out your year end FSA and HSA campaign, from the patient list to the reminders to the booking flow, so you fill your slowest months with care your patients already paid for. No vanity metrics, no pressure, just a plan you can run.
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