Can a Health Savings Account Be Used for Dental?

A Health Savings Account (HSA) functions as a tax-advantaged savings vehicle designed to cover qualified medical expenses. These accounts are typically available to individuals enrolled in a high-deductible health plan. A common inquiry among account holders centers on whether these funds can be applied to dental care costs.

Dental Services Covered by HSAs

Many dental services are eligible for HSA reimbursement, provided they address a medical need. The Internal Revenue Service (IRS) defines qualified medical expenses as those incurred for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any structure or function of the body.

Routine preventive care, such as dental exams, cleanings, and X-rays, qualifies for HSA use. Restorative treatments like fillings, crowns, and root canals are also eligible. More involved procedures, including tooth extractions, dentures, and dental implants, can be paid for with HSA funds when medically necessary to replace missing teeth or restore function.

Orthodontic treatments, such as braces and clear aligners, are eligible if they correct a medical issue like a misaligned bite, rather than being purely cosmetic. Periodontal treatments for gum disease also qualify, as do prescription medications for dental pain or infection. Out-of-pocket costs like co-pays, deductibles, and coinsurance for dental insurance can also be covered by an HSA if the underlying dental service is HSA-eligible.

Dental Services Not Covered by HSAs

While many dental services qualify, HSAs do not cover expenses primarily for general health or cosmetic enhancement. The distinction is whether the service is medically necessary to treat or prevent a disease or to affect a body function. If a procedure is solely for improving appearance without a medical indication, it is not eligible.

Examples of non-eligible dental expenses include teeth whitening, a purely cosmetic procedure. Cosmetic veneers are not covered unless medically required to correct damage from injury or disease. General hygiene products like toothbrushes, toothpaste, mouthwash, and dental floss are excluded, as they are for general health maintenance rather than specific medical treatment.

How to Use Your HSA for Dental Costs

Accessing funds from your HSA for dental expenses offers flexibility, with several common methods available. Many HSA providers issue a debit card, which functions like a regular debit card at the time of service. You can use this card directly at your dentist’s office to pay for eligible treatments.

Another common approach involves paying for the dental service out-of-pocket, then reimbursing yourself from your HSA. This process entails submitting a reimbursement request to your HSA administrator, often through an online portal or by mail. Many HSA plans offer online bill pay services, allowing direct payment to your dental provider. You can reimburse yourself for qualified medical expenses incurred after your HSA was established, even years later, if you maintain proper documentation.

Maintaining Records for Dental Expenses

Maintaining accurate records for HSA-related dental expenses is important. This documentation serves as proof of eligible spending, which is important for tax purposes and in the event of an IRS review. The IRS requires account holders to substantiate that distributions were used exclusively for qualified medical expenses and were not reimbursed from other sources.

Key documents to retain include receipts from your dental provider detailing the service and amount paid. If you have dental insurance, the Explanation of Benefits (EOB) from your insurer should also be kept, as it outlines how your insurance covered the service. Proof of payment from your HSA, such as a debit card statement or reimbursement confirmation, is also necessary. It is recommended to keep these records for at least three years, aligning with the period a tax return remains subject to audit.