What Dental Work Is Covered by an FSA?

At some point in every person’s life, whether it’s for a basic cleaning or an emergency tooth procedure, a visit to the dentist is necessary. Some patients choose to obtain traditional dental insurance through private means or group policies via employment. In other cases, patients may choose to cover their dental needs using what is called a Flexible Spending Account (FSA). Whatever your coverage plan, our team at Beacon Dental Health in New England can walk you through the financial process so that you get the high-quality dental care that you need.

What is an FSA?

A flexible spending account (FSA) are accounts obtained through work that allow employees to get reimbursement for a wide variety of medical expenses. FSAs are considered tax-exempt savings accounts and distributions from these accounts are free, granted that the money is strictly used for medical expenses.

How is an FSA different from traditional health insurance plans?

If a traditional insurance plan or policy is obtained through employment, a portion of an employee’s paycheck each month is taken out to pay monthly insurance premiums to guarantee certain medical coverage that varies per policy. For an FSA, a portion of your monthly earnings is contributed to the account by the employee (and sometimes the employer) to be used for medical and dental expenses. The FSA funds are used to cover the account owner, their spouse, and their dependents.

Can I use an FSA like a typical savings account?

Unlike a typical savings account, the FSA account is not used to save an indefinite amount of money for years to come. FSA is a “use it or lose it” account model, in that if the owner doesn’t spend down the money by a specific date in the calendar year, then those funds are lost. According to the IRS, in 2021, the maximum contribution level to a FSA account is $2,750.

What dental work is covered by FSA?

FSA funds can be used to cover dental work that is considered preventive or treatable against dental disease. Examples include:

• Fillings
• Sealants
• Teeth cleanings
• Dental bonding
• Inlays and onlays
• Tooth extraction
• Gingivitis treatment
• Temporomandibular joint syndrome (TMJ)
• Gum recession
• Oral surgery
• Crowns
• Oral pain remedies
• Diagnostic and preventive services

What dental work is not covered?

Cosmetic procedures and cosmetic orthodontics are not covered by FSA funding. Examples include:

• Teeth whitening procedures
• Veneers
• Braces
• Toothpaste and floss
• Any procedure used to realign teeth for aesthetic purposes

What makes a dental procedure cosmetic?

A dental or orthodontic procedure is considered cosmetic if the goal is to realign, repair, or color teeth for the purpose of beautifying one’s smile. For simplicity’s sake, oftentimes the IRS will describe dental care as medically necessary while orthodontics are purely cosmetic. There are many overlaps and unwritten rules where some orthodontic practices are used for treating and preventing dental diseases.

How can I be sure that my dental procedures are covered?

If a patient is struggling to determine whether their FSA plan will cover their dental procedures or not, come consult with our team at Beacon Dental Health. Our dentists can assist you with any questions or concerns so that you can walk away at ease knowing what specific procedures your plan will cover.

How often should I be visiting the dentist if I’m using an FSA?

No matter the coverage plan, patients should be scheduling regular visits for dental checkups and cleanings at least once every 6 months to prevent unnecessary tooth decay and discomfort. Take a closer look at your FSA plan and come up with a yearly budget to cover any expected or unexpected dental procedures.

How to get started on regular appointments with a dentist

If you have a flexible spending account (FSA) and would like to start up regular dental care visits or have any questions about coverage, call our team at Beacon Dental Health to schedule your appointment today.