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Can You Use HSA for Dental Care? An In-Depth Guide

Smiles meet savings in this health how-to

January 31, 2024
Sam O'Keefe Co-Founder and CEO of Flex
Sam O'Keefe
Co-founder & CEO of Flex
Flex - Can You Use HSA for Dental Care? In-Depth Guide
Flex - Can You Use HSA for Dental Care? In-Depth Guide

Overview

Overview

Overview

Good dental hygiene is not just about dazzling strangers with your radiant smile. Maintaining oral health is connected to a range of health benefits — your mouth is the entrance to your digestive and respiratory tracts after all! 

Read on to learn about proper oral care and how you can leverage your Health Savings Account (HSA) or Flexible Spending Account (FSA) for healthy teeth, gums, and more.

What Are The Health Benefits of Dental Hygiene?

Besides a bad first impression, poor oral health can contribute to various systemic diseases, which is why regular dental care is a cornerstone of preventive medicine. Here are some examples:

  • To start, the bacteria responsible for gum inflammation (periodontitis) can infiltrate the bloodstream, potentially contributing to heart disease in the form of arterial plaque formation, and can lead to endocarditis too.

  • Oral health can also influence your respiratory system, as poor dental hygiene has been linked to an increased risk of respiratory infections, including pneumonia. 

  • Further, cognitive issues like Alzheimer's, diabetes, and preterm births form a list of oral-derived problems that is much longer than you’d expect.

For more info, turn to leading authorities like the American Dental Association (ADA) and the Mayo Clinic.

Tips for Maintaining Dental & Oral Hygiene

Establishing an effective oral hygiene routine is key to preventing dental issues. Here are 8 tips for a healthy smile — and healthy you. 

1. Brushing technique matters

Use a soft-bristled toothbrush and angle it at 45 degrees toward the gumline. Employ gentle, circular motions, ensuring you cover all surfaces of your teeth, for a minimum of two minutes.

2. Flossing is non-negotiable

Floss reaches where your toothbrush can't — between teeth and below the gumline. Make it a daily ritual by gently guiding the floss between each tooth, forming a C-shape around the tooth's side. This removes trapped food particles and prevents the buildup of plaque.

3. Have regular dental check-ups

Schedule check-ups at least twice a year. Your dentist can detect issues early, providing timely interventions to maintain your oral health.

4. Mind your diet

Limit sugary snacks and beverages that contribute to tooth decay. Instead, opt for a balanced diet rich in calcium, phosphorus, and vitamin D to fortify your teeth and bones.

5. Hydration is key

Water helps rinse away food particles, neutralizes acids, and maintains saliva production – your body's natural defense against cavities.

6. Kick bad habits

Smoking and excessive alcohol consumption can wreak havoc on your oral health. Quitting these habits not only benefits your overall health but also preserves your oral well-being.

7. Invest in a mouthwash

While not a substitute for brushing and flossing, an antimicrobial mouthwash can be a great addition to your routine. It helps kill bacteria, freshens breath, and reaches areas that your toothbrush might miss.

8. Replace your toothbrush regularly

Toothbrushes wear out over time, and frayed bristles are less effective. Aim to replace your toothbrush every three to four months, or sooner if bristles show signs of wear. 

Also, if you need a quick reminder to set your appointments, just remember National Tooth Fairy Day! It is celebrated on February 28th and August 22nd, to remind you of your recommended biannual dentist visits.

What Are The Signs of Poor Oral Hygiene?

With teeth, early intervention is essential. Here are the most common signals that your oral health might need a bit of extra attention:

  • Persistent bad breath (halitosis)

  • Bleeding gums

  • Increased tooth sensitivity

  • Cavities (tooth decay)

  • Gum recession

  • Swollen or inflamed gums

  • Changes in tooth color

  • Continuous pain or discomfort

If you notice any of these flags, it's time to make changes to your oral hygiene routine. Your mouth is a center for communication, and deciphering its messages ensures a healthier, happier you.

Can You Use HSA to Pay for Dental Expenses?

The average American adult spends $1,000 a year on tooth health, which is why many choose to explore options beyond traditional insurance. 

Thankfully, Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) offer a tax-advantaged way to save for medical expenses, including dental care. So much so that, according to HealthEquity, one of the largest HSA providers, about 25 percent of dollars spent from their HSAs and Health Reimbursement Arrangements (HRAs) go towards dental and vision expenses. 

Ready to join your fellow HSA/FSA savers by investing in your dental health?

What’s the difference between dental insurance and HSA/FSA?

Dental insurance operates on a traditional model, wherein you pay monthly premiums in exchange for coverage. This typically includes preventive services, basic procedures, and the occasional major treatment. 

While it offers the safety net of predictable costs and broad coverage, the premiums, out-of-pocket costs, and uncertainty of what exactly is covered (and what isn’t) are tough to overlook.

That’s where HSAs and FSAs come in, offering a more self-directed approach. They allow you to set aside pre-tax dollars to cover qualified medical expenses, including dental care. 

How does an HSA or FSA work?

In short: An HSA is a tax-advantaged savings account designed for people with high-deductible health plans. Contributions to the HSA are made with pre-tax dollars, reducing taxable income, then you can use the funds tax-free for qualified medical expenses, which gives you a unique combination of savings, tax benefits, and flexibility for healthcare expenses.

Remember that “[qualified] medical care expenses must be primarily to alleviate or prevent a physical or mental disability or illness,” according to the IRS

Sometimes, you can use your funds on medically necessary items that are not IRS-approved. This requires consulting with your doctor or healthcare provider and obtaining a Letter of Medical Necessity (LOMN), which outlines why the individual needs the product or service and how it addresses a specific medical issue or illness.

What are the tax benefits of using HSA or FSA?

Contributions to your HSA reduce your taxable income, which brings immediate tax benefits. Plus, the growth of your HSA funds is tax-free, and withdrawals for qualified medical expenses remain untaxed.

What Common Dental Expenses Are Covered by an FSA and HSA?

You can use your HSA and FSA for a wide range of dental expenses, ensuring your oral health doesn't break the bank. These are some examples of eligible expenses, along with common questions below:

  • Fluoride treatments

  • Veneers and dentures

  • Extractions

  • Sealants

  • Bonding

  • Restorations

  • Surgeries

  • Root canals

  • Dental crowns

  • Dental fillings

Can you use HSA for dental cleaning?

Yes, routine dental cleanings and check-ups are eligible expenses that can be paid using HSA funds. If you happen to have a co-pay for that visit, you can also use your HSA to cover that expense as well.

Can you use HSA for braces?

Straighten your smile with those HSA dollars! Orthodontic treatments, including braces, are generally HSA/FSA eligible.

Can you use HSA for Invisalign?

Yes, Invisalign is considered an eligible expense under HSA/FSA guidelines. 

From Invisalign’s website: “Before you begin your Invisalign treatment, talk to both your doctor’s office and your benefits manager. You may be able to pay your doctor and be reimbursed from your FSA or HSA. Your benefits provider may also be able to pay your doctor directly.”

Can HSA be used for dental implants?

Do you need a dental implant as part of a prosthesis surgery, such as a crown, bridge, or denture? This common and costly procedure is typically eligible for HSA/FSA reimbursement.

Does HSA cover dental restoration, surgeries, or other similar treatments?

Yes, HSAs can typically be used for various dental procedures, including restorative treatments, surgeries, and similar necessary dental interventions. Here's a breakdown of some common procedures:

1. Dental Crowns:

You can use your HSA funds to cover the cost of a dental crown. Crowns are considered a qualified dental expense when they are medically necessary for the health and function of your teeth.

2. Dental Fillings:

HSA funds can be used for dental fillings. Fillings are considered a preventive or corrective dental procedure, aligning with the criteria for qualified medical expenses.

3. Root Canals:

HSAs can typically be used for root canal procedures. Root canals are considered a dental treatment aimed at preserving the health of the affected tooth, making them eligible for HSA reimbursement.

What Dental Expenses Are Not HSA or FSA Eligible?

While many dental expenses are eligible for HSA and FSA reimbursement, not every accessory and procedure gets the green light. These typically include non-medical or cosmetic dental procedures, as well as over-the-counter dental products, which we cover next.

Can you use HSA for a toothbrush, floss, mouthwash, etc.? How about electric toothbrushes and water flossers/waterpiks?

Routine dental supplies like toothbrushes, floss, and mouthwash are not eligible for HSA/FSA reimbursement because they are considered general health services.

However, some exceptions exist. Electric toothbrushes and water flossers may be eligible if prescribed by a dentist for a specific dental condition.

Can you use HSA for cosmetic dentistry?

Cosmetic dentistry, including teeth whitening and veneers for purely aesthetic purposes, is generally not eligible for HSA/FSA reimbursement.

What are the consequences of using HSA funds for unqualified dental expenses?

This is where you want to be careful, using HSA or FSA funds for non-qualified expenses is likely to incur a tax penalty. 

As a heuristic, remember that qualified medical care expenses must address, alleviate or prevent a specific physical or mental disability or illness. 

If you withdraw HSA funds for non-qualified dental expenses before the age of 65, you'll face not only ordinary income tax on the withdrawal but also an additional 20% penalty. Make sure to verify the eligibility of an expense before reaching for the funds.

How To Use Your HSA/FSA To Pay for Dental Care

Using HSA/FSA to cover dental care costs isn’t complicated, but there is some strategy and finesse involved. Here's a quick roadmap to follow:

1. Understand HSA Reimbursement:

Keep meticulous records of your dental bills and receipts, and once you've incurred a qualified dental expense, initiate the reimbursement process. Submit a reimbursement request with all the necessary documentation to your HSA provider.

2. Identify FSA/HSA Eligible Expenses:

In the eyes of the IRS, not all dental expenses are created equal. Familiarize yourself with the extensive list of FSA/HSA eligible expenses, ensuring your dental procedures align with the criteria.

3. Follow the HSA Withdrawal Rules:

Ensure you're withdrawing funds for eligible dental expenses, maintain accurate records, and adhere to any specific rules or timelines set by your HSA provider.

Sounds like a lot of work, right?

Smile With Flex: Use Your HSA/FSA for Dental Care More Simply, Easily and Faster

Flex partners with merchants to make the process super simple for consumers. Here’s how it works:

For pre-approved medical expenses: Pay for the product or service with your HSA or FSA card. Flex substantiates the purchase automatically, meaning you don't need to submit for reimbursement.

If the item falls outside of standard IRS guidelines: Flex will check your eligibility for a Letter of Medical Necessity. When you go to checkout, a doctor’s appointment takes place:

  • Fill out a short eligibility form, sharing relevant information with Flex’s medical team. 

  • If you qualify, Flex sends the LOMN to you via email.

  • Then, simply enter your HSA or FSA card details and complete the purchase. Again, no more need for reimbursements!

Yes, You Can Use HSA For Dental Care!

Your smile isn't just a friendly expression, it's a reflection of your overall health — or health of your wallet. Luckily, by leveraging the tax benefits of an HSA or FSA, you can greatly reduce dental expenses and ensure that your journey to a healthy mouth is financially sound. 

As you explore this new, proactive approach to oral hygiene, may your smile shine bright, and your financial outlook stay as healthy as your teeth!

Good dental hygiene is not just about dazzling strangers with your radiant smile. Maintaining oral health is connected to a range of health benefits — your mouth is the entrance to your digestive and respiratory tracts after all! 

Read on to learn about proper oral care and how you can leverage your Health Savings Account (HSA) or Flexible Spending Account (FSA) for healthy teeth, gums, and more.

What Are The Health Benefits of Dental Hygiene?

Besides a bad first impression, poor oral health can contribute to various systemic diseases, which is why regular dental care is a cornerstone of preventive medicine. Here are some examples:

  • To start, the bacteria responsible for gum inflammation (periodontitis) can infiltrate the bloodstream, potentially contributing to heart disease in the form of arterial plaque formation, and can lead to endocarditis too.

  • Oral health can also influence your respiratory system, as poor dental hygiene has been linked to an increased risk of respiratory infections, including pneumonia. 

  • Further, cognitive issues like Alzheimer's, diabetes, and preterm births form a list of oral-derived problems that is much longer than you’d expect.

For more info, turn to leading authorities like the American Dental Association (ADA) and the Mayo Clinic.

Tips for Maintaining Dental & Oral Hygiene

Establishing an effective oral hygiene routine is key to preventing dental issues. Here are 8 tips for a healthy smile — and healthy you. 

1. Brushing technique matters

Use a soft-bristled toothbrush and angle it at 45 degrees toward the gumline. Employ gentle, circular motions, ensuring you cover all surfaces of your teeth, for a minimum of two minutes.

2. Flossing is non-negotiable

Floss reaches where your toothbrush can't — between teeth and below the gumline. Make it a daily ritual by gently guiding the floss between each tooth, forming a C-shape around the tooth's side. This removes trapped food particles and prevents the buildup of plaque.

3. Have regular dental check-ups

Schedule check-ups at least twice a year. Your dentist can detect issues early, providing timely interventions to maintain your oral health.

4. Mind your diet

Limit sugary snacks and beverages that contribute to tooth decay. Instead, opt for a balanced diet rich in calcium, phosphorus, and vitamin D to fortify your teeth and bones.

5. Hydration is key

Water helps rinse away food particles, neutralizes acids, and maintains saliva production – your body's natural defense against cavities.

6. Kick bad habits

Smoking and excessive alcohol consumption can wreak havoc on your oral health. Quitting these habits not only benefits your overall health but also preserves your oral well-being.

7. Invest in a mouthwash

While not a substitute for brushing and flossing, an antimicrobial mouthwash can be a great addition to your routine. It helps kill bacteria, freshens breath, and reaches areas that your toothbrush might miss.

8. Replace your toothbrush regularly

Toothbrushes wear out over time, and frayed bristles are less effective. Aim to replace your toothbrush every three to four months, or sooner if bristles show signs of wear. 

Also, if you need a quick reminder to set your appointments, just remember National Tooth Fairy Day! It is celebrated on February 28th and August 22nd, to remind you of your recommended biannual dentist visits.

What Are The Signs of Poor Oral Hygiene?

With teeth, early intervention is essential. Here are the most common signals that your oral health might need a bit of extra attention:

  • Persistent bad breath (halitosis)

  • Bleeding gums

  • Increased tooth sensitivity

  • Cavities (tooth decay)

  • Gum recession

  • Swollen or inflamed gums

  • Changes in tooth color

  • Continuous pain or discomfort

If you notice any of these flags, it's time to make changes to your oral hygiene routine. Your mouth is a center for communication, and deciphering its messages ensures a healthier, happier you.

Can You Use HSA to Pay for Dental Expenses?

The average American adult spends $1,000 a year on tooth health, which is why many choose to explore options beyond traditional insurance. 

Thankfully, Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) offer a tax-advantaged way to save for medical expenses, including dental care. So much so that, according to HealthEquity, one of the largest HSA providers, about 25 percent of dollars spent from their HSAs and Health Reimbursement Arrangements (HRAs) go towards dental and vision expenses. 

Ready to join your fellow HSA/FSA savers by investing in your dental health?

What’s the difference between dental insurance and HSA/FSA?

Dental insurance operates on a traditional model, wherein you pay monthly premiums in exchange for coverage. This typically includes preventive services, basic procedures, and the occasional major treatment. 

While it offers the safety net of predictable costs and broad coverage, the premiums, out-of-pocket costs, and uncertainty of what exactly is covered (and what isn’t) are tough to overlook.

That’s where HSAs and FSAs come in, offering a more self-directed approach. They allow you to set aside pre-tax dollars to cover qualified medical expenses, including dental care. 

How does an HSA or FSA work?

In short: An HSA is a tax-advantaged savings account designed for people with high-deductible health plans. Contributions to the HSA are made with pre-tax dollars, reducing taxable income, then you can use the funds tax-free for qualified medical expenses, which gives you a unique combination of savings, tax benefits, and flexibility for healthcare expenses.

Remember that “[qualified] medical care expenses must be primarily to alleviate or prevent a physical or mental disability or illness,” according to the IRS

Sometimes, you can use your funds on medically necessary items that are not IRS-approved. This requires consulting with your doctor or healthcare provider and obtaining a Letter of Medical Necessity (LOMN), which outlines why the individual needs the product or service and how it addresses a specific medical issue or illness.

What are the tax benefits of using HSA or FSA?

Contributions to your HSA reduce your taxable income, which brings immediate tax benefits. Plus, the growth of your HSA funds is tax-free, and withdrawals for qualified medical expenses remain untaxed.

What Common Dental Expenses Are Covered by an FSA and HSA?

You can use your HSA and FSA for a wide range of dental expenses, ensuring your oral health doesn't break the bank. These are some examples of eligible expenses, along with common questions below:

  • Fluoride treatments

  • Veneers and dentures

  • Extractions

  • Sealants

  • Bonding

  • Restorations

  • Surgeries

  • Root canals

  • Dental crowns

  • Dental fillings

Can you use HSA for dental cleaning?

Yes, routine dental cleanings and check-ups are eligible expenses that can be paid using HSA funds. If you happen to have a co-pay for that visit, you can also use your HSA to cover that expense as well.

Can you use HSA for braces?

Straighten your smile with those HSA dollars! Orthodontic treatments, including braces, are generally HSA/FSA eligible.

Can you use HSA for Invisalign?

Yes, Invisalign is considered an eligible expense under HSA/FSA guidelines. 

From Invisalign’s website: “Before you begin your Invisalign treatment, talk to both your doctor’s office and your benefits manager. You may be able to pay your doctor and be reimbursed from your FSA or HSA. Your benefits provider may also be able to pay your doctor directly.”

Can HSA be used for dental implants?

Do you need a dental implant as part of a prosthesis surgery, such as a crown, bridge, or denture? This common and costly procedure is typically eligible for HSA/FSA reimbursement.

Does HSA cover dental restoration, surgeries, or other similar treatments?

Yes, HSAs can typically be used for various dental procedures, including restorative treatments, surgeries, and similar necessary dental interventions. Here's a breakdown of some common procedures:

1. Dental Crowns:

You can use your HSA funds to cover the cost of a dental crown. Crowns are considered a qualified dental expense when they are medically necessary for the health and function of your teeth.

2. Dental Fillings:

HSA funds can be used for dental fillings. Fillings are considered a preventive or corrective dental procedure, aligning with the criteria for qualified medical expenses.

3. Root Canals:

HSAs can typically be used for root canal procedures. Root canals are considered a dental treatment aimed at preserving the health of the affected tooth, making them eligible for HSA reimbursement.

What Dental Expenses Are Not HSA or FSA Eligible?

While many dental expenses are eligible for HSA and FSA reimbursement, not every accessory and procedure gets the green light. These typically include non-medical or cosmetic dental procedures, as well as over-the-counter dental products, which we cover next.

Can you use HSA for a toothbrush, floss, mouthwash, etc.? How about electric toothbrushes and water flossers/waterpiks?

Routine dental supplies like toothbrushes, floss, and mouthwash are not eligible for HSA/FSA reimbursement because they are considered general health services.

However, some exceptions exist. Electric toothbrushes and water flossers may be eligible if prescribed by a dentist for a specific dental condition.

Can you use HSA for cosmetic dentistry?

Cosmetic dentistry, including teeth whitening and veneers for purely aesthetic purposes, is generally not eligible for HSA/FSA reimbursement.

What are the consequences of using HSA funds for unqualified dental expenses?

This is where you want to be careful, using HSA or FSA funds for non-qualified expenses is likely to incur a tax penalty. 

As a heuristic, remember that qualified medical care expenses must address, alleviate or prevent a specific physical or mental disability or illness. 

If you withdraw HSA funds for non-qualified dental expenses before the age of 65, you'll face not only ordinary income tax on the withdrawal but also an additional 20% penalty. Make sure to verify the eligibility of an expense before reaching for the funds.

How To Use Your HSA/FSA To Pay for Dental Care

Using HSA/FSA to cover dental care costs isn’t complicated, but there is some strategy and finesse involved. Here's a quick roadmap to follow:

1. Understand HSA Reimbursement:

Keep meticulous records of your dental bills and receipts, and once you've incurred a qualified dental expense, initiate the reimbursement process. Submit a reimbursement request with all the necessary documentation to your HSA provider.

2. Identify FSA/HSA Eligible Expenses:

In the eyes of the IRS, not all dental expenses are created equal. Familiarize yourself with the extensive list of FSA/HSA eligible expenses, ensuring your dental procedures align with the criteria.

3. Follow the HSA Withdrawal Rules:

Ensure you're withdrawing funds for eligible dental expenses, maintain accurate records, and adhere to any specific rules or timelines set by your HSA provider.

Sounds like a lot of work, right?

Smile With Flex: Use Your HSA/FSA for Dental Care More Simply, Easily and Faster

Flex partners with merchants to make the process super simple for consumers. Here’s how it works:

For pre-approved medical expenses: Pay for the product or service with your HSA or FSA card. Flex substantiates the purchase automatically, meaning you don't need to submit for reimbursement.

If the item falls outside of standard IRS guidelines: Flex will check your eligibility for a Letter of Medical Necessity. When you go to checkout, a doctor’s appointment takes place:

  • Fill out a short eligibility form, sharing relevant information with Flex’s medical team. 

  • If you qualify, Flex sends the LOMN to you via email.

  • Then, simply enter your HSA or FSA card details and complete the purchase. Again, no more need for reimbursements!

Yes, You Can Use HSA For Dental Care!

Your smile isn't just a friendly expression, it's a reflection of your overall health — or health of your wallet. Luckily, by leveraging the tax benefits of an HSA or FSA, you can greatly reduce dental expenses and ensure that your journey to a healthy mouth is financially sound. 

As you explore this new, proactive approach to oral hygiene, may your smile shine bright, and your financial outlook stay as healthy as your teeth!

Flex is a modern marketplace for consumers to discover and purchase HSA/FSA eligible products. From fitness and nutrition, to sleep and mental health, Flex takes a holistic view of healthcare and enables consumers to use their pre-tax money to do the same.