A tax-advantaged savings tool that can help cover mental health care costs, without putting public benefits at risk.‍

Table of Contents:

• What is an ABLE account?
• Can a mental health condition qualify?
• Why benefits eligibility is such a high stakes issue
• What mental health expenses can an ABLE account cover?
• How much can be contributed?
• True Link-supported ABLE Accounts
• A few more practical considerations

For families supporting someone with a diagnosed mental health condition, managing the costs of ongoing care can prove challenging. ABLE (Achieving a Better Life Experience) accounts are one tool that can help — with flexible spending on qualifying expenses, and protections that can help keep public benefits intact. 

Yet the Social Security Administration (SSA) estimates that fewer than 3% of eligible individuals have taken advantage of this tool and opened an ABLE account. In this post we cover what mental health conditions qualify, what the funds can be used for, and what families need to know about ABLE accounts.

What is an ABLE account?

An ABLE account is a tax-advantaged savings account for people with qualifying disabilities. It's designed to let individuals save and spend money on disability-related needs without putting their public benefits at risk. For a more detailed overview of how these accounts work, see our ABLE Accounts Explained guide.

Here are a few things you should know: 

• An ABLE account is owned by a person with a disability
• Money invested through an ABLE account grows tax-free and withdrawals for qualifying expenses are also tax-free. Some states also offer a state tax deduction for contributions
• Up to $100,000 in the account is exempt from Supplemental Security Income’s (SSI) $2,000 asset limit 
• Anyone can contribute: family members, friends, or the account holder themselves
• Annual contribution limits vary by year and may differ slightly by state of residence (the standard annual limit is uniform, but the ABLE-to-Work supplement varies by the resident’s state)

Can a mental health condition qualify?

Yes, but there are two important things to understand about how eligibility works.

First, the disability has to meet SSA's standard. To qualify for an ABLE account, your loved one either needs to be receiving SSI or Social Security Disability Insurance (SSDI) based on their disability, or have a written certification from a physician confirming that they have a physical or mental impairment that results in marked and severe functional limitations. Mental health conditions — including depression, bipolar disorder, schizophrenia, PTSD, anxiety disorders, and personality disorders — can meet this standard, but not every diagnosis qualifies. Check out this resource to learn more about ABLE eligibility. 

Second, the disability needs to have begun before a certain age. As of January 1, 2026, that threshold is age 46, which is a meaningful expansion from the prior limit of 26 years old. This change is significant especially for  mental health, because many conditions — including bipolar disorder, schizophrenia, and major depression — often emerge or become more challenging to manage in early-to-mid adulthood. People who were previously ineligible may now qualify. For a full breakdown of this and other recent legislative changes, click here.

If you're not sure whether your loved one qualifies, a benefits counselor or special needs attorney can help clarify the path.

Why benefits eligibility is such a high-stakes issue

For many families, the concern isn't only about covering expenses; it's about how to do this without putting their loved one’s benefits at risk.

SSI recipients can't have more than $2,000 in countable assets without risking their benefits. For SSI beneficiaries, this asset limit can create a real constraint: money saved in the beneficiary's name counts against the limit, and transferring funds to cover care costs can affect benefits depending on how and when it's done. So how can families plan ahead without putting those benefits at risk?

ABLE accounts offer a government-approved workaround. Up to $100,000 in the account is exempt from SSI's asset limit. If the account exceeds $100,000, SSI payments will be paused, but Medicaid coverage can continue during that period, and the account itself isn't closed. That's a meaningful distinction for someone whose medical care depends on Medicaid.

This means that saving for future expenses is possible, but it has to be structured correctly.

What mental health expenses can an ABLE account cover?

The list of qualifying expenses is broader than many people expect. Distributions used for qualified disability expenses (QDEs) come out tax-free, and the standard for what qualifies is whether the expense helps maintain or improve the person's health, independence, or quality of life. For an accountholder with a mental health condition, that can include but is not limited to:

• Therapy and counseling - including co-pays and out-of-pocket sessions not covered by insurance
• Psychiatric medications - prescriptions, co-pays, and deductibles
• Health insurance premiums - including coverage that makes mental health care accessible
• Housing - rent, utilities, mortgage payments (with a timing note: housing distributions should be spent in the same month they're withdrawn to avoid affecting SSI)
• Transportation - to appointments, work, or daily activities
• Technology - a phone or device that supports daily functioning and connection
• Basic living expenses - food, personal care, and day-to-day necessities

ABLE accounts may also be subject to adjustments each year, so be sure to keep up with upcoming changes here.

How Much Can Be Contributed?

The 2026 annual contribution limit is $20,000 and anyone can contribute. For account holders who are employed and not contributing to an employer retirement plan, the ABLE-to-Work provision allows additional contributions from their own earned income beyond the standard limit. Some states also offer a state income tax deduction for contributions, which varies by plan. 

True Link-supported ABLE Accounts

As of January 2026, participants in these ABLE programs can sign up for a True Link Visa® Prepaid Card directly through their ABLE Account: 

• ABLE United (Florida)
• Alabama ABLE Savings Plan
• CalABLE (California)
• Hawai'i ABLE
• Maryland ABLE
• Oregon ABLE
• ABLE for All (Oregon)
• STABLE (Arizona, Georgia, Idaho, Kentucky, Missouri, New Mexico, Ohio, Oklahoma, South Carolina, Utah, Vermont, West Virginia, and Wyoming)
• Washington State ABLE

Additionally, if you have an ABLE Account through another provider or state, you may still opt to use a True Link Visa Card to access and spend these funds by ordering a True Link Visa Card through our website and adding it as a linked bank account to disburse funds from your ABLE Account. 

True Link Visa Cards for ABLE Account holders are just one of the ways True Link supports people with disabilities; we are dedicated to providing life-changing financial solutions to this community. In fact, the Social Security Administration now provides guidelines in the Program Operations Manual System (POMS) for using True Link Visa Cards to make disbursements from special needs/supplemental needs trusts for beneficiaries who receive SSI.

A few more practical considerations

• One account per beneficiary. Your loved one can only hold one ABLE account at a time, though they can transfer to a different state's plan.
• Check for minimum balance requirements. Some programs have minimums or annual fees, although it’s ok to start small with modest contributions. 
• State plans vary. Investment options, fees, and features differ. True Link partners with many ABLE programs to let account holders move funds onto the card for everyday purchases. Additionally, some states offer state tax incentives to residents for contributions to their ABLE programs.
• Keeping records of how funds are used. True Link's card platform makes it easy to log receipts and document purchases as Qualified Disability Expenses (QDEs). Learn more about how to use an ABLE account for everyday purchases.

For families navigating the financial side of serious mental health conditions, ABLE accounts can fill a critical gap. If your loved one qualifies, opening an account can be a concrete step toward longer-term financial stability.

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How True Link Can Help You

True Link helps families and professionals manage and help protect the spending of people with complex needs — such as those living with disabilities, aging, or in recovery  — while empowering them with more independence. Our True Link Visa® Prepaid Card and online platform helps make it easier to send money digitally, set spending limits, track purchases, organize receipts, and get real-time alerts.

Learn more at https://www.truelinkfinancial.com/prepaid-card

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This post is informational and not legal or financial advice. Rules and contribution limits may vary by state. For guidance on how an ABLE account fits into your loved one's specific situation, consult a benefits counselor, special needs planning attorney, or other qualified professional.

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