Can You Use HSA for Teeth Whitening?

A Health Savings Account (HSA) is a tax-advantaged savings account created for individuals with high-deductible health plans. You contribute pre-tax dollars, which can then be used to pay for a variety of healthcare costs. The funds grow tax-free and can be withdrawn tax-free, as long as they are used for specific, approved purposes. The money in an HSA also rolls over from year to year, unlike some other health spending accounts.

Defining Qualified Medical Expenses

The Internal Revenue Service (IRS) sets the standards for what constitutes a “qualified medical expense” eligible for HSA funds. According to IRS Publication 502, these expenses must be primarily to alleviate or prevent a physical or mental defect or illness. This includes costs associated with the diagnosis, cure, mitigation, treatment, or prevention of disease.

Expenses that are merely beneficial to general health, such as vitamins or a gym membership, are not covered. The IRS rules are specific in excluding any expense that is not for treating or preventing a particular health condition.

Teeth Whitening as a Cosmetic Procedure

Teeth whitening is almost always classified as a cosmetic procedure, making it ineligible for payment with HSA funds. The primary purpose of whitening is to improve appearance, not to treat, prevent, or mitigate a disease. The IRS explicitly states that procedures directed at improving a patient’s appearance without meaningfully promoting the proper function of the body or treating an illness are not deductible medical expenses.

There can be a rare exception if the tooth discoloration is a direct result of a specific disease, congenital deformity, or injury. In such a limited circumstance, a dentist would need to provide a Letter of Medical Necessity. This letter must detail the underlying medical condition that necessitates the whitening procedure. Without this specific medical diagnosis and documentation, using HSA funds for teeth whitening is not permitted.

HSA Eligible Dental Care

While teeth whitening is excluded, HSAs can be used for a wide array of legitimate dental treatments intended to maintain oral health. These qualified expenses directly address the prevention or treatment of dental diseases. Routine preventive care, such as cleanings and exams, falls squarely within the IRS guidelines.

More extensive procedures that treat existing problems are also eligible. This includes fillings to repair cavities, root canals to save an infected tooth, and extractions for teeth that cannot be saved. The costs for crowns, dentures, and bridges are also considered qualified medical expenses because they restore the function of the teeth. Even orthodontic treatments like braces can be paid for with an HSA, provided they are deemed medically necessary to correct issues such as malocclusion, which affects proper chewing and oral health.

Consequences of Improper HSA Use

Using your HSA for a non-qualified expense like cosmetic teeth whitening has direct financial repercussions. The amount you withdraw for the ineligible procedure is no longer tax-free. You must report this distribution as taxable income on your federal tax return for the year the withdrawal was made.

Beyond the income tax, the IRS imposes an additional 20% penalty tax on the amount of the non-qualified distribution. This penalty applies to most account holders who misuse their funds. The only exceptions are for individuals who are age 65 or older, or those who become disabled. For all other HSA owners, the combination of income tax and the penalty applies.