Are Mouth Guards an FSA-Eligible Medical Expense?

A Flexible Spending Account (FSA) allows individuals to set aside pre-tax money from their paycheck to pay for certain out-of-pocket healthcare costs. A common question arises regarding specific medical devices, such as whether mouthguards qualify as an FSA-eligible medical expense.

Understanding FSA-Eligible Expenses

The Internal Revenue Service (IRS) defines what qualifies as an FSA-eligible medical expense. These are costs incurred for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any part or function of the body. Common examples include doctor visits, prescription medications, vision care, and dental care. Expenses must be primarily for a medical purpose and not merely beneficial to general health or for cosmetic reasons.

Mouthguards and FSA Eligibility

Mouthguards can be FSA-eligible, but their eligibility depends on their intended medical purpose. A mouthguard prescribed by a dentist or physician to treat a specific medical condition, such as bruxism (teeth grinding), temporomandibular joint (TMJ) disorders, or sleep apnea, is eligible for reimbursement. Both custom-made and over-the-counter night guards used for these medical conditions qualify. Conversely, mouthguards purchased for general athletic protection without a diagnosed medical condition, or for purely cosmetic reasons, are not eligible. An athletic mouthguard may be eligible if its primary purpose is injury prevention rather than performance enhancement.

Submitting Your FSA Claim for Mouthguards

To claim reimbursement for an FSA-eligible mouthguard, submit documentation to your FSA administrator. A detailed receipt from the purchase is required. For items like mouthguards, your administrator may request a Letter of Medical Necessity (LMN) from a licensed healthcare provider. This letter should include:

• The diagnosed medical condition
• The recommended treatment (the mouthguard)
• The duration of its necessity
• Clinical justification for its use

Some FSA plans offer a debit card for direct payment, which can simplify the process, but retaining all receipts for verification is advisable.

Key Considerations for Your FSA

Understanding your FSA’s specific rules is important to maximize its benefits. FSAs are subject to a “use-it-or-lose-it” rule, meaning any unused funds at the end of the plan year are forfeited. However, employers may offer options to mitigate this, such as a grace period of up to 2.5 months to incur new expenses after the plan year ends, or a rollover option allowing a portion of unused funds to carry over to the next year. Employers choose to offer either a grace period or a rollover, but not both.

For 2025, the maximum carryover amount is $660, and annual contribution limits are $3,300 per person. Confirm the specific rules and options with your FSA administrator.