If you have a Flexible Spending Account (FSA), your tax-free health funds won’t last forever, which means you’ll need to spend them every year or lose them. What can you spend them on? Quite a bit, actually. FSAs are established through your employer and you can use the money you deposit for a variety of dental or orthodontic treatments.
At-home aligner services like SmileDirectClub occupy a unique space in the orthodontic industry, so you might be unsure if they’re eligible for FSA payment. But many times, they are. If you’re getting SmileDirectClub treatment, you may be able to manage your costs by paying with an FSA. Don’t know how to get started? How FSAs work? What an FSA is? Below you’ll find all that and more.
Table of Contents
What Is a Flexible Spending Account (FSA)?
An FSA is a savings account that allows you to deposit pre-tax income for the sole purpose of paying future health care expenses. You can choose to deposit a certain percentage of your paycheck, and your employer might contribute as well, although it’s not required. You can link an FSA to a debit card and use it just like you would any other card. Or, you can file for reimbursement on eligible expenses. The current limit on FSA deposits is $2,650 per year, so you shouldn’t plan on having more than that available for treatments.
People who have routine health expenses—like prescription drugs and office visits for chronic conditions—often find FSAs helpful, since they have a set number of tax-free dollars to cover their month-to-month health expenses. But even if you have intermittent expenses, you can simply choose to deposit less money in your FSA and it can help cover whatever comes up.
It’s important to remember that FSA money does not roll over from year to year. It’s a “use it or lose it” system. So if you’re approaching the year’s end and still have funds left, you’ll want to find something to spend them on.
How to get an FSA
You can only set up an FSA if your employer offers it as an option. When the benefits coordinator goes over your options, they will likely let you know whether or not you have the option of getting an FSA. If you’re interested, your employer will provide the forms you need to get started.
Do FSA Funds Cover Dental/Orthodontics?
You can use FSA dollars for a wide variety of dental treatments and procedures. The specific qualifying treatments can vary based on your plan, but FSAs can typically cover preventative care and basic dental procedures, such as fillings and bridgework.
FSAs don’t ordinarily cover cosmetic procedures, though, so teeth whitening, veneers, etc. are probably out of the question. Sometimes orthodontic treatment is considered cosmetic and other times it’s not. It depends on your specific FSA.
What Types of Orthodontic Treatment Can an FSA Cover?
You can use FSA funds for just about any orthodontic treatment that isn’t considered cosmetic. How are cosmetic treatments determined? It’s different for various FSAs, so you’ll need to check with your specific plan and employer.
Generally, orthodontic treatments that you receive in-person, like braces and Invisalign are eligible for FSA payments. Our understanding is that most FSAs can also be used to cover at-home aligner treatment with services like SmileDirectClub or SmileDirectClub. However, this does not always seem to be the case. Since at-home aligner treatment is not suitable for correcting more severe misalignments, some FSAs do seem to classify this form of treatment as cosmetic and may refuse coverage.
Can I Use My FSA for SmileDirectClub Clear Aligners?
Many times, yes. But it depends on how your specific FSA classifies at-home aligner treatment. Cosmetic treatments like teeth whitening don’t normally fall under the qualifying treatments, and some FSAs will lump SmileDirectClub in with these nonessential procedures. In most cases, though, they include it with other orthodontic treatments instead.
According to a blog post on SmileDirectClub’s website, “many HSAs and FSAs cover invisible aligners,” so you can probably use yours. But just to be sure, you’ll want to check your list of qualifying treatments or speak with your FSA administrator to see if at-home aligners are included.
Will SmileDirectClub Help Me Use My FSA?
When you use an FSA to pay for orthodontic treatment, you’ll often need to provide a receipt or other proof of purchase. SmileDirectClub will provide an itemized receipt to share with your FSA when you order their aligners. However, any other paperwork is up to you—they won’t help you fill it out or communicate directly with your FSA administrator or insurance provider.
If you would prefer an online aligner service who handles every part of your FSA and dental insurance processes, take a look at byte. They’re the only home aligner company that will facilitate your payment, reimbursement, and/or paperwork for you.
How To Use FSA Funds for SmileDirectClub Treatment
You might have a card connected to your FSA, which makes payment pretty simple. You can simply input the card’s information at checkout like you would for any other credit or debit card. As long as your FSA considers at-home aligners an eligible expense, your payment should be automatically approved, although you might still need to submit a receipt or other confirmation.
Otherwise, you’ll need to pay for your treatment, then get a reimbursement from your FSA. This requires an itemized receipt, which SmileDirectClub will provide, and potentially an additional claim form. Contact your FSA administrator or your employer’s H.R. office to get the documents you need. However, the itemized receipt is as far as SmileDirectClub will go. The rest is up to you.
What If I Have Dental Insurance, Too?
Dental insurance benefits can vary significantly depending on your plan. But if it includes orthodontic benefits, your dental insurance might cover SmileDirectClub treatment. Dental insurance plans can sometimes cover up to 50% of at-home aligners, although they might also have an age limit, lifetime spending limit, or waiting period, so familiarize yourself with the details.
SmileDirectClub has partnerships to be in-network with UnitedHealthCare, Aetna, Anthem, Blue Cross Blue Shield, and Empire, so if you have one of these providers, you may receive coverage. SmileDirectClub will check for you to see if your plan covers their treatment, but you’ll have to file your official claim on your own.
Regardless of your plan, you’ll have some out of pocket costs. You can cover those leftover expenses, though, by using your FSA. If you use insurance and an FSA, you might be able to cover your entire treatment cost. If it’s early in the year and you’re anticipating other medical or dental expenses throughout the year, you might want to conserve your FSA funds. At the end of the year, though, you should make sure to use them before they expire.
Flexible Spending Accounts vs. Health Savings Accounts
They’re similar in name, but not always similar in function. Here are some of the differences you should know.
|Who qualifies||Anyone whose employer offers them as a benefit||Only people with a qualifying high deductible health plan (HDHP)|
|2020 contribution limit||$2,650 for an individual||$3,550 for an individual, $7,100 for a family|
|Contribution adjustments||Only during open or special enrollment periods||Anytime|
|Expiration||Dec. 31 every year||None, unused funds will roll over|
|Account ownership||Owned by the employer. You lose it if you change jobs.||Owned by the individual and follows you during employment changes.|
|Using funds||Might not have access to funds for non-medical expenses||Can withdraw funds for non-medical expenses, but must pay a 20% penalty|
Just like FSAs, you can usually use HSA funds to pay for SmileDirectClub treatment. Again, it depends on your specific plan, so you’ll want to check the details before signing up for either one.
Your FSA could help you lessen the financial weight of orthodontic treatment, especially if it’s used alongside dental insurance coverage. Check with your employer and/or FSA administrator to see if SmileDirectClub at-home aligners are included in their qualifying treatments. If so, you could be looking at a much lower bill for your treatment.