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

• People most often obtain Flexible Savings Accounts (FSAs) through their employer. In some cases, the employer will also contribute funds.
• They pull pre-tax funds from your wages and set them aside for medical expenses.
• The IRS determines how much you can contribute to an FSA ($3,050 per employer) and which treatments it can cover.
• FSA funds don’t roll over, so you must use them before the end of the calendar year. The only exception is if your employer allows for a small rollover ($615 or less).
• As of 2021, there were over 2.4 million FSAs in the US with over $3.28 billion in contributions.

FSAs and Braces: Are They Covered?

Braces typically qualify as an FSA-eligible expense, and that’s because dentists and orthodontists typically deem them medically necessary. In fact, braces is one of the specific treatments the IRS lists as an eligible dental treatment.

Cosmetic dentistry doesn’t fall under the same umbrella, which is why you usually can’t use an FSA to pay for veneers or teeth whitening treatments. Orthodontics can be considered cosmetic too, but it’s very rare. Braces and clear aligners are often correct problems that cause pain, tooth decay, gum disease, and more, which is why you can typically pay for them with an FSA.

Do FSAs Cover Dental Work?

The IRS determines which expenses FSA funds can cover. 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 vs. HSAs: How Are They Different?

FSAs are pretty similar to Health Savings Accounts (HSAs): 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.

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.

Final Thoughts

Aligning your smile can improve your overall health and boost your confidence. But that doesn’t make the price tag any more approachable. If you have an FSA, you can decrease the cost of your treatment. If you combine these benefits with orthodontic insurance, payment plans, or financing, you can potentially make braces work for you. To learn about all your options, speak with your FSA manager and orthodontist.