Will My FSA Cover Braces?

Deciding to get braces is a big step for your oral health and self-confidence. But before you get your appliance put on, you need to know how you will pay for treatment.

Braces aren’t cheap. On the low end, they cost $3,000, and on the high end, upwards of $10,000. Then there are the additional costs to factor in, such as diagnostic images, additional appliances, and aftercare retainers.

For most people, this is more than they can pay for out of pocket. Flexible Spending Accounts (FSAs) are meant to help people reduce the burden of out-of-pocket medical expenses with or without insurance. They hold funds you and your employer contribute and you apply them to eligible treatments and products. Here is what you need to know about using your FSA to pay for braces.

FSAs at a Glance

FSAs are medical savings accounts you obtain through your employer. You contribute funds, and in most cases, your employer does as well. This money is not taxed, allowing you to reduce what you owe the IRS each year without losing money.

Whenever you need to pay for medical treatment or purchase qualifying medications and products, you can use your FSA funds to cover the cost. The biggest downside of having an FSA is that you have to use the funds before the end of the calendar year or lose access to them. The only exception is if your employer allows for a small rollover ($550 or less).

FSAs vs. HSAs: How Are They Different?

Overall, FSAs and HSAs are pretty similar: you accumulate tax-free money that you can apply to out-of-pocket medical expenses. However, they differ in ways that impact how you use them. Here’s a quick rundown of what you should know.

Do FSAs Cover Dental Work?

The IRS determines which expenses are covered by FSA funds. Their guidelines state that FSA funds can be used to cover dental procedures if they either treat or prevent dental disease or related health concerns. However, they generally cannot be used to cover cosmetic treatments.

Covered Dental Procedures

• Braces and aligners (in most cases)
• Dentures
• Sealants and bonding
• Fluoride treatments
• Dental cleanings
• X-rays and scans
• Fillings
• Root canals
• Extractions
• Crowns

FSAs and Braces: Is It Covered?

When looking at FSA coverage, braces and other orthodontic treatments are in a gray area. You can get braces because it is medically necessary. You can also get them for purely cosmetic reasons. For most patients, it’s a mix of both.

Let’s contextualize this. An overbite is an orthodontic condition that can cause pain, uneven wear on the teeth, and even jaw pain. Most people are also unhappy with their appearance when they have an overbite. Correcting it is both medical, since it corrects issues related to health, and cosmetic, since it improves appearance.

Then there is improper spacing. When there are small gaps or mild crowding, the individual typically doesn’t experience health consequences. However, they still might want to correct this to achieve a more conventionally attractive smile. This means braces would be purely for cosmetic treatment.

The line between essential and cosmetic orthodontic treatment is thin. To determine what your case is, speak with your orthodontist or dentist.

How to Use Your FSA Funds

The specifics of how you pay for medical expenses with your FSA will depend on your administrator. Each has its own platforms and methods. Most will offer the following options:

• Debit Card: Most FSA administrators issue debit cards tied to the account. These cards only work when used at terminals registered to approved medical merchants.
• Online Bill Pay: As with a traditional bank account, you will likely have an online banking platform tied to your FSA. You can use this to transfer money to your medical provider’s account.
• Reimbursement: With this method, you pay out of pocket at first, then submit evidence of payment and request reimbursement.

Chances are your dentist or orthodontist will be happy for you to use any FSA payment method for your braces. Just verify with them which ones work best.

What If I Have Dental Insurance, Too?

Having dental coverage is not a barrier to using your FSA to pay for your braces. You just need to make sure you don’t double-bill.

For example, if your braces cost $3,500 and your insurance company covers all $3,500, you cannot then take out FSA funds. However, if your insurance covers $3,000, you can use $500 of your FSA money to cover the rest.

Another thing to remember is that dental insurance doesn’t always cover braces. Some providers exclude orthodontics from their dental coverage, while others only cover braces when used on children and teens. Verify coverage limits with your provider before you sign on for treatment.