Are Mouth Guards an HSA-Eligible Expense?
Unsure if your mouthguard is HSA-eligible? Discover the IRS criteria, medical necessity rules, and required documentation for qualified expenses.
A Health Savings Account (HSA) offers a tax-advantaged way to save and pay for qualified medical expenses. Many individuals with high-deductible health plans utilize HSAs to manage healthcare costs effectively. Mouth guards can be HSA-eligible, but their eligibility depends on specific criteria and the primary purpose for which they are used.
General HSA Eligibility
The Internal Revenue Service (IRS) defines qualified medical expenses as costs paid for the diagnosis, cure, mitigation, treatment, or prevention of disease. These expenses also include treatments affecting any structure or function of the body. To be eligible for HSA reimbursement, an expense must primarily relate to medical care.
Items purchased for general health improvement, cosmetic purposes, or simply for convenience typically do not qualify. The expense must be medically necessary, not merely beneficial or elective, to align with IRS guidelines.
Specific Eligibility for Mouth Guards
Mouth guards are eligible for HSA reimbursement when they serve a medical purpose, treating a diagnosed condition rather than for general protection or cosmetic enhancement. A common qualifying condition is bruxism, or teeth grinding. A custom or over-the-counter mouth guard prescribed or recommended by a dentist for bruxism can qualify. These appliances protect teeth from damage caused by grinding or clenching, often occurring during sleep.
Similarly, mouth guards used as part of a treatment plan for Temporomandibular Joint (TMJ) disorders are generally eligible. TMJ disorders involve issues with the jaw joint and surrounding muscles, and a mouth guard can help position the jaw correctly to alleviate symptoms. Oral appliances prescribed for sleep apnea, a condition where breathing repeatedly stops and starts during sleep, also qualify.
Conversely, mouth guards are generally not HSA-eligible if their primary use is for general athletic protection or cosmetic reasons. For example, a mouth guard worn solely for sports to prevent injury, without a diagnosed medical condition, is typically not covered. Similarly, if a mouth guard is used for cosmetic purposes, such as teeth whitening, it would not qualify. The key distinction lies in whether the mouth guard treats or prevents a specific medical condition.
Documentation and Reimbursement Process
To substantiate a mouth guard as an HSA-eligible expense, proper documentation is required. This typically includes a prescription from a dentist or doctor, explicitly stating the medical condition the mouth guard treats. For over-the-counter items or in cases where further justification is needed, a Letter of Medical Necessity (LMN) from a healthcare provider may be requested by the HSA administrator.
The LMN should detail the patient’s diagnosis, the recommended treatment, and how the mouth guard alleviates the medical condition. Maintaining detailed receipts showing the purchase of the mouth guard is also crucial. It is important to keep thorough records of all prescriptions, LMNs, and receipts for tax purposes and in case of an IRS audit.
HSA funds can be used in several ways to cover eligible expenses. Some individuals use an HSA debit card directly at the point of sale if the vendor accepts it. Another common method involves paying for the expense out-of-pocket and then submitting a claim for reimbursement to the HSA administrator, either online or via mail. Account holders can also pay out-of-pocket and reimburse themselves later, even years in the future, provided they maintain all necessary documentation. Specific procedures for reimbursement can vary slightly depending on the HSA administrator, so reviewing their guidelines is advisable.