How can an HSA or FSA be used to pay for dental services?

Dental coverage can often bring a huge smile to employees. From orthodontia and sealants to cavities and root canals (ouch!), employees often rely on employer-sponsored dental coverage to pay for these often pricey services.

Let’s get practical and review what a Health Savings Account (HSA) or healthcare Flexible Spending Account (FSA) typically covers when it comes to the dentist. If you’ve ever been asked, “What dental expenses are HSA-eligible?” or “Does my FSA pay for dental crowns?” this information is for you—and your curious employees. Read on to understand more about HSA and FSA coverage for dental services, and how these spending accounts can help with out-of-pocket dental expenses.

HSA and FSA coverage for dental services

Because HSAs and FSAs are both tax-exempt accounts used to offset the cost of healthcare, every penny put into these accounts can pay for eligible dental expenses, tax-free.¹ And since some dental-related expenses are not covered by insurance, employees can save money by using an HSA or FSA to cover those costs. Looking at our data, from spend made via card transactions, for both HSAs and FSAs, around 15% of dollars are spent on dental services.²

What are the HSA and FSA rules for dental services and dental procedures?

You may already know that an HSA or FSA can be used for things like dental visits and crowns. But did you also know they can be used toward braces and other orthodontic work? It’s true.

FSAs and HSAs can help employees get reimbursed for a wide variety of dental treatments for themselves and their family.

Especially when it comes to more involved services like root canals and braces, it’s common knowledge that dental expenses can quickly add up to the thousands. Luckily, an FSA or HSA can help employees manage those expenses.

Here’s what the accounts typically cover:

• X-rays

• Sealants

• Dental implants

• Dental crowns

• Dentures

• Extractions

• Cavity fillings

• Gum cleaning

• Dental reconstruction

• Periodontal surgery

• Orthodontia (such as braces or Invisalign)

• Root canals

• Dental cleaning

• Wisdom-teeth removal

In some cases, employees can even use an FSA or HSA for travel expenses as long as it is for an eligible dental procedure at a dentist office. Cosmetics like veneers need a Letter of Medical Necessity (LMN).

What dental items or services are not HSA or FSA eligible?

While it seems like they would fit under the dental care umbrella, general self-care items like toothpaste, toothbrushes, mouthwash, and floss are not FSA or HSA eligible. Same goes for specialized or medicated toothpastes and teeth-whitening.

When employees have questions about certain items and dental treatments, look up eligible dental expenses here. Or encourage employees to reach out to their dentist office; they should know whether a service is eligible or not, as well as help patients plan how to pay for their dental care.

How can employees use an FSA or HSA on eligible dental expenses?

Paying for eligible services or items is easier than you think. In most places, people can use an HSA or FSA card like a credit card.³ If folks don’t have a card available they can submit a reimbursement form to their health insurance provider along with the receipt.

Important tip: If an employee or a covered dependent will be needing a dental treatment or dental procedure, such as braces or oral surgery, in a coming year, they can plan ahead. The employee can make sure their spending account contribution includes the expected amount for the dental services. It’s a way to get the most tax-free savings possible.

What if employees have an LPFSA?

Just like HSAs and FSAs, a Limited Purpose Flexible Spending Account (LPFSA) is a tax-advantaged account that can be used on eligible dental and vision expenses. But unlike HSAs which carryover, employees typically only have one year to spend LPFSA money before it goes away.

HSA and LPFSA for a winning combo

Employers can offer both an HSA and LPFSA in order to help employees maximize tax savings. A good practice in this case is for employees to use the LPFSA to pay for current eligible dental expenses and save their HSA funds for medical expenses, both now and in the future.

How a Health Payment Account can help employees manage unexpected dental expenses

Sometimes employees may experience a surprise dental expense, like an emergency root canal, that exceed the funds in their LPFSA or HSA. That’s where a Health Payment Account (HPA) can help. An HPA offers an interest-free line of credit for healthcare expenses, for expenses defined by the employer—which may include dental costs in addition to other medical, vision, and even veterinary expenses.⁴ Employees get immediate access to funds to pay for unexpected out-of-pocket eligible healthcare costs, including dental services.⁵

Overall, an HPA is one more tool employers can provide to reduce barriers to care for employees. Learn more about HPAs—from a no-fee option to cover out-of-pocket health costs to repayment through HSA, FSA, payroll deduction, or bank accounts.

Saving more, smiling more

Employees can feel free to lean on our HSA or FSA tools to help them plan for and cover eligible expenses.