Deciding to get orthodontic treatment is a major decision, one that has the potential to change your life for the better. However, before you can get the care you need, you have to determine how you’ll pay for it.
If you opt for Invisalign to straighten your teeth, you can expect the cost of treatment to fall somewhere between $3,000 and $7,000, depending on how complex your alignment issues are. Keep in mind that there also could be extra costs, such as those for attachments, tooth movement acceleration devices, and aftercare retainers.
If that is more than you can pay out of pocket, Flexible Spending Accounts (FSAs) can help. You use the funds you and your employer have been contributing over the course of the year to lower the financial burden of treatment. Here is what you should know about applying FSA funds to orthodontic care.
Table of Contents
FSAs at a Glance
FSAs are savings accounts owned by employers but used by employees. You contribute a portion of your salary or wage, and your employer can contribute as well. These funds can then be applied to approved medical expenses. Any money contributed to an FSA will not be subject to income or payroll tax, allowing you to pay less in taxes without earning less money.
The primary disadvantage of an FSA is that the funds generally do not roll over from year to year. The only exception is plans that allow a limited rollover ($550 or less). This means that with FSA funds, you either use it or lose it.
FSAs vs. HSAs: How Are They Different?
Thinking FSAs and HSAs sound pretty similar? Well, you’re right; they have a lot in common. But they also differ in key ways. Here’s what you need to know.
|How to Qualify||Hold a job that includes Flexible Spending Accounts (FSAs).||Enroll in a high-deductible health plan.|
|2021 Contribution Limit||$2,750||$3,600|
|Contribution Adjustments||Only during special or open enrollment periods.||Anytime|
|Expiration||Yearly on December 31st.||Funds roll over year after year.|
|Account Ownership||The employer||The insured individual|
|Using Funds||Typically restricted to medical expenses.||Can be used for medical expenses or withdrawn if you pay a 20% penalty.|
|Limits on Spending||You can use your FSA based on what you are expected to contribute by the end of the year.||You can only spend what had been contributed but can later file for reimbursement.|
Do FSAs Cover Dental Work?
The parameters for FSA coverage are set by the IRS. According to their guidelines, you can use your FSA funds to pay for any dental procedure that either treats or prevents dental disease. Essentially, if the treatment benefits your oral health, it is typically an eligible expense.
Procedures that are considered cosmetic are not eligible expenses. This means teeth whitening, veneers, and other similar services are not covered.
Covered Dental Procedures
- Braces and aligners (in most cases)
- Sealants and bonding
- Fluoride treatments
- Dental cleanings
- X-rays and scans
- Root canals
FSAs and Invisalign: Is It Covered?
So, what does this mean for FSA Invisalign coverage?
Orthodontics lies in something of a gray area. It can be a medical necessity. It can also be purely cosmetic. This means that applying FSA funds to Invisalign might be approved, or it might not.
For example, Invisalign might be used to correct an overbite, underbite, or severe crowding that can cause tooth decay. It could also be used to move the teeth so they better come together when eating, protecting the jaw joint. In these cases, Invisalign treatment is a medical necessity.
However, in-office aligners can also correct mild to moderate problems with spacing and crowding — conditions that aren’t aesthetically perfect but also aren’t threatening to the health of the patient. In these cases, Invisalign is a cosmetic treatment.
If you are uncertain where your personal case falls, discuss it with your dentist or orthodontist and get clarification from your FSA provider.
How to Use Your FSA Funds
The exact method for using your FSA funds will depend on the rules and setup that your administrator has. Most will offer the following options:
- Debit Card: If your provider issues debit cards, you can use your FSA account like a checking account. Just keep in mind that the card only works at medical merchants.
- Online Bill Pay: Just like a traditional bank account, most FSAs will have online banking. Using the administrator’s portal, you transfer money to your dentist’s or orthodontist’s account.
- Reimbursement: If you go this route, you pay for your treatment out of pocket but then submit a claim to be reimbursed for the cost.
Most medical providers are happy for you to exercise any of these FSA payment options, allowing you to choose whichever works best for you.
What If I Have Dental Insurance, Too?
Having dental coverage does not prevent you from using your FSA funds to cover Invisalign treatment. The only thing you need to remember is that you cannot double bill. In other words, if your insurance pays for Invisalign in full, you cannot also get reimbursed through your FSA funds; if your insurance covers all but 2,000 of Invisalign treatment, you can use your FSA to pay for that remaining amount.
However, keep in mind that just having dental insurance doesn’t mean it will help pay for Invisalign. Be sure to verify your coverage limits and ask about distinctions between essential and cosmetic treatments, as well as orthodontics for adults and teens.
Invisalign has the ability to transform the way you feel about your smile, as well as your overall dental health. If you can benefit from treatment, it is essential that you find ways to make the cost work for your budget. By utilizing your FSA funds, you can reduce your burden, then use insurance, payment plans, and financing to make treatment accessible to you.
Frequently Asked Questions
How do I know if my misalignment is medical or cosmetic?
Only a medical professional can offer you guidance on this. After you are evaluated by a dentist or orthodontist, contact your FSA administrator to find out what you need to do to prove that your condition should be covered by the account.
Will it be easy to use my FSA funds for Invisalign?
Yes, in most cases, the process is pretty straightforward. We think the hardest part is typically verifying if your use of Invisalign is covered.
Am I limited in how much of my FSA funds I can spend on Invisalign?
No, and in fact, you can technically spend more on Invisalign than is currently in your FSA. This is because FSA spending limits are per year and based on your expected contribution, so even early in the year, you can utilize your full yearly contribution.
How do I get reimbursed if I first pay out of pocket?
In most cases, you use the online banking platform to transfer money from your FSA to your primary bank account. Other options include submitting a claim form by mail or fax, depending on what options your administrator offers.
Can I continue to use my FSA after changing jobs?
If you switched to a new position within the same company, more than likely, you can keep using your FSA. However, if you switch companies, your FSA does not travel with you. Since they are owned by the employers, when you leave a company, you leave your FSA behind.
What happens if I use FSA funds to pay for an ineligible expense?
Unlike with HSAs, the IRS doesn’t fine you for using your FSA money for non-medical expenses, though it will likely levy taxes on the amount spent. However, your employer will most likely fine you for this.
How do I know if I have access to an FSA?
You just need to ask your employer. While this should have been explained as part of your benefits package, it is possible that you forgot about your FSA or your employer added them since you began working for them.
Can my FSA funds cover Invisalign for my spouse?
Yes, you are allowed to use FSA funds to cover treatment for spouses and dependents.