Can I Use My HSA for Dental Expenses?

A Health Savings Account (HSA) provides a tax-advantaged way to save and pay for qualified medical expenses. To be eligible, an individual must be covered under a high-deductible health plan (HDHP) and not have other health coverage. For 2025, HDHPs have minimum deductibles ($1,650 self-only, $3,300 family) and out-of-pocket maximums ($8,300 self-only, $16,600 family). Contributions are tax-deductible, funds grow tax-free, and withdrawals for qualified medical expenses are also tax-free.

Understanding What Dental Expenses Qualify

HSA funds can be used for “qualified medical expenses” as defined by the Internal Revenue Service (IRS), and include a wide range of dental care. These expenses must primarily be for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any part or function of the body. Common dental services are eligible.

Routine preventative care such as dental cleanings, examinations, and fluoride treatments are eligible expenses. More involved procedures like fillings, extractions, root canals, and crowns also qualify. If you require dental implants or bridges to treat a dental disease or replace missing teeth, these are covered. Orthodontic treatments, including braces and clear aligners, are eligible because they correct dental issues that can lead to more serious problems.

Not all dental expenses are eligible. Purely cosmetic procedures, such as teeth whitening or veneers for aesthetic enhancement, are not covered. If a cosmetic procedure, like veneers, is performed to repair damage from an injury or disease and serves a medical necessity, it may qualify. General oral hygiene products, including toothpaste, toothbrushes, and dental floss, are ineligible unless specifically prescribed by a dentist for a medical condition.

How to Use Your HSA Funds for Dental Care

Accessing your HSA funds for dental care can be done through several convenient methods, depending on your HSA provider. One common approach is using an HSA debit card directly at the time of service. This allows for immediate payment, simplifying the transaction process.

Alternatively, you can pay for your dental expenses out-of-pocket using your personal funds and then reimburse yourself from your HSA. This method offers flexibility, as there is no time limit for requesting reimbursement, provided the HSA was established before the expense was incurred. To do this, you generally log into your HSA account online, enter expense details and date, and choose a reimbursement method, such as an electronic transfer or check. Some HSA administrators also allow direct payment to providers through their online portals or by issuing checks from the HSA.

Important Considerations for HSA Record Keeping

Maintaining thorough records for all HSA transactions is important for tax compliance and potential IRS audits. The IRS requires account holders to keep sufficient documentation to prove that distributions were used exclusively for qualified medical expenses. This documentation ensures that funds were not used for ineligible expenses or claimed as itemized deductions elsewhere.

Essential documents include itemized receipts from your dental provider, Explanation of Benefits (EOB) statements, and any invoices or payment confirmations. Keep these records for at least three years from the date you file your tax return for the year the expense was incurred, or as long as your HSA remains open, whichever is longer. Some financial professionals suggest retaining records for up to seven years for added security. Failing to provide proof for HSA distributions can result in the withdrawal being subject to income tax and a 20% penalty. Organizing these records, whether through digital copies or physical files, helps streamline the process if verification is ever required.