Will My HSA Cover Braces?

With any medical treatment, cost is a major concern. This is especially true with braces. With treatment ranging from $3,000 to $10,000, depending on the complexity of the case and the type of braces worn, few people can afford to pay out of pocket. And unfortunately, insurance doesn’t always cover orthodontic treatment, especially for adults.

Health Savings Accounts (HSAs) offer an alternative solution. By using the funds you’ve already been saving away, you can reduce your financial burden or even pay for your braces in full. Although every HSA establishes its own rules, most allow their pre-tax funds to be used for covering braces. Here’s what you need to know about using your HSA to cover orthodontic care.

HSAs at a Glance

Insurance is expensive, and most people look for ways to save on it whenever they can. Younger and healthier adults often opt for high-deductible health insurance plans. With these, you pay a lower monthly or yearly premium but have to meet a pretty high deductible before your policy starts to cover treatment.

While this can be a good financial trade-off for many people, it does make it harder to get the healthcare they need when they actually need it. HSAs are meant to bridge the gap.

As a tax-advantaged account, HSAs allow you and your employer to contribute money to be saved for health expenses without needing to pay taxes on those funds. How much you can save per calendar year is set by the IRS and changes from one year to the next. It is important to note that the funds carry over, rather than expiring on December 31st, allowing you to build up your health expense savings. Also, even though your employer can contribute to the account, your HSA belongs to you. If you change jobs, you retain access to the money.

HSAs vs. FSAs: How Are They Different?

If you’ve researched FSAs, you might think that HSAs sound pretty similar. And they are! However, there are some key differences you need to know about.

Do HSAs Cover Dental Care?

Yes, you can use your HSA funds to cover expenses related to dental care and orthodontia — but there are limits you need to keep in mind. The main one that impacts dental care is that HSA-covered treatments must be medically necessary. If a dental concern impacts your health or is considered preventative care, you should be able to use your HSA funds to pay for it.

HSA funds are not meant to be used to cover cosmetic procedures — and many aspects of dental care fall under this umbrella. The problem is that the line between a medical necessity and a cosmetic treatment can be rather thin. With dental and orthodontic treatment, it is always a good idea to contact your HSA administrator to verify whether or not your funds can be used to pay for your care.

HSA-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

HSAs and Braces: Are They Covered?

If you are wondering if braces are covered by HSAs, the answer is yes — sometimes. Orthodontic treatment, in general, exists in a gray area of HSA coverage. For those with moderate to severe orthodontic abnormalities, braces are essential medical treatment. For those with minor concerns, they are cosmetic.

Overbites, underbites, severe crowding, and large gaps can all cause dental health and general health problems. For example, if your teeth do not come together properly when chewing, you can place more pressure on one jaw joint than another, causing pain, stiffness, and damage. When correcting the position of your teeth can help heal problems or stop them from developing, you should be able to use your HSA funds to pay for braces.

But braces can also be used to close small gaps or correct mild crowding that isn’t causing health problems and likely never will. Generally speaking, this use of braces is considered cosmetic. If you want to make aesthetic corrections rather than medical ones, you might find that you are unable to use your HSA funds to cover treatment.

How to Apply HSA Funds to Cover Treatment

The methods you can use to access your HSA funds can vary between providers, so it is important that you do your research and find out what you need to do before you get treatment. With that said, most offer four options:

• Debit/Benefits Card: Your HSA administrator should have sent you a card that is attached to the funds in your account. You use it just like you would a normal debit card. Keep in mind it only works if you use it with a medical merchant.
• Checks: While these are becoming less common, most HSA managers will send you checks for your account. In some cases, you may need to make a special request for them. Once you have them, you use them like checks for a regular bank account.
• Online Bill Pay: More and more HSA administrators are offering this feature. With this, you go into your online portal and send money directly to your dentist or orthodontist. It works similarly to sending a payment with standard online banking.
• Reimbursement: In some cases, especially when your HSA balance is low, it is best to pay out of pocket, keep a record of the payment, and file for reimbursement later. You can file for reimbursement later on — even years down the road — once your HSA has more funds.

Most medical providers are happy for you to use any HSA payment methods available to you. You just need to decide which is most convenient for you.

What If I Have Dental Insurance, Too?

Not all dental insurance covers orthodontic treatment. If yours does, it might still have limits on what is covered and what percentage your insurer will take on. Be sure to look at differences in coverage for children and teens vs. adults and essential vs. cosmetic treatment.

In most cases, dental insurance will at least cover part of the cost of braces treatment. Expect to pay for at least some of your treatment on your own.

You are allowed to use both your insurance benefits and your HSA funds to cover the cost of braces. Take time to talk to the billing department at your dentist’s or orthodontist’s office to find out ways you can maximize your benefits.

Final Thoughts

Correcting your tooth alignment can improve your confidence and overall health. But this doesn’t mean you can afford to pay for treatment all on your own. If you have an HSA, you can lower the financial burden of treatment. Combining this with insurance coverage, financing, and payment plans, you should be able to make braces work for you. To learn more, speak with your HSA manager and your medical provider.