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Using Your Flexible Spending Account (FSA) for Dental Care

Here’s what you can and can’t use it for.

By
Eric Whiteside
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Eric Whiteside is the creator of the Capitalist Fool blog. He has 40+ years of experience in trading, investing, and finance.
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Updated August 28, 2020
Reviewed by Charles Potters

Flexible spending accounts (FSAs) are accounts that allow employees to obtain reimbursement for various medical expenses. Because FSAs are classified as tax-exempt savings accounts, no employment or federal income taxes are deducted from contributions. The Internal Revenue Service (IRS) states that an FSA has no reporting requirements for federal tax returns. Distributions are free provided they are used for qualified medical expenses.

So, can an FSA be used for dental expenses? Well, it depends. Eligible expenses include deductibles and co-payments. However, not all types of dental procedures are covered.

Key Takeaways

  • In 2021, the FSA contribution level maximum is $2,750, according to the IRS.
  • An FSA is a “use it or lose it” type of benefit. If you don’t spend down your money by a specified date during a calendar year, you lose those funds.
  • Some employers may allow for a carry-over amount or offer a short-term extension.
  • Anything related to cosmetic dentistry is automatically not covered by an FSA.
  • If you have a dependent care FSA (another kind of FSA offered by employers), dental care reimbursement is not eligible.

Dental Expenses That Can Be Paid With FSAs

When it comes to using an FSA for dental expenses, reimbursement rules generally follow the deduction rules as spelled out in IRS Publication 502. The basic guideline is that anything that treats or prevents a dental disease is eligible for FSA coverage:

  • Teeth cleaning
  • Fillings and sealants
  • Crowns
  • Bonding
  • Dentures
  • Tooth extraction
  • Inlays and onlays 
  • All diagnostic and preventative services
  • Treatments for gingivitis, temporomandibular joint syndrome and disorder, gum recession, and oral surgery

FSAs can differ depending on your employer, so if you are unclear about whether or not a procedure is covered, it may help to contact HR and carefully go over your policy.

Expenses That Are Excluded

Unfortunately, cosmetic procedures—such as teeth whitening, veneers, and cosmetic orthodontics—are not covered by FSAs. If you want to get your teeth bright and white, you’ll have to pay out of pocket, as cosmetic dentistry is simply not on the list. In fact, you can’t even buy toothpaste of any kind or dental floss using FSA funds, as they are not eligible expenses. Oral pain remedies, however, are typically covered by plans.

There is an obvious discrepancy with orthodontia. While the IRS says that some procedures treat disease and some are cosmetic, there is no specific set of rules that defines the specifics regarding which procedures qualify for coverage under an FSA. Your orthodontist should be able to help you determine what your plan may cover.

Know Your Plan: Flexible Spending Plans Vary

The IRS provides general rules for FSAs, but each FSA provider interprets those rules differently. Talk to your employer and your plan provider before you start any course of treatment. Your dental office should be willing to coordinate with your insurance provider to make sure the services you are receiving are covered under your FSA.

Article Sources
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  1. Internal Revenue Service. "Publication 502: Medical and Dental Expenses."

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Guide to Dental Insurance