If you have a Flexible Spending Account (FSA) or a Health Savings Account (HSA), now is the time of year — Reimbursement Season! You’ve begun tallying expenses, submitting receipts, and figuring out how much is left over (hopefully!) to spend before your funds expire.
Most FSA and HSA plans reimburse patients for any non-cosmetic medical treatment, as well as prescriptions and many over-the-counter medications. But what about dentistry? We’ve told you about the connection of oral wellness to overall health, but does it play out on paper? What dental expenses does your plan cover?
You should always review your plan details or check with your FSA/HSA administrator before incurring any health-related expenses, especially for dental care. Plans vary greatly on covered condition and the definitions around certain procedures. However, a basic rule of thumb is this: any routine procedure to treat or prevent dental disease should be covered. Any cosmetic or elective procedures (unless there is a serious underlying health issue) are not eligible for reimbursement. Here are some common dental services and their coverage:
YES!
- Preventative — This includes teeth cleaning, basic fluoride treatments, fillings, sealants, and all diagnostic and preventative services.
- Restorative — These can include crowns, bonding, dentures, tooth extraction, inlays, onlays, or overlays. Again, the standard of acceptance is based on medical necessity, rather than cosmetic or aesthetic preference.
- Mouth guards — As we’ve discussed, those who suffer from Bruxism can do serious damage to their teeth during the night, and these guards protect the mouth and prevent injury.
- Oral Disorders – Treatments for gingivitis, TMDs, gum recession and most oral surgeries are generally reimbursable.
NO.
- Teeth Whitening
- Veneers
- Cosmetic Orthodontia
MAYBE?
Corrective Orthodontia — Check with your individual plan administrator. Treatment may be eligible for FSA/HSA reimbursement if there is a health condition associated with the patient’s teeth misalignment. Some of the qualifying diagnoses include:
- Speech impediment
- Jaw or TMJ pain
- Difficulty eating or chewing
- Sleep apnea
- Bruxism
- Gum Disease
Our team at Meyer & Johns is ready to help you with any FSA/HSA-related questions you have — just give us a call or send a message.