Does an FSA Cover Dental Crowns?

A Flexible Spending Account (FSA) is an employer-sponsored account allowing individuals to set aside pre-tax dollars for eligible medical, dental, and vision expenses. Using an FSA can lead to tax savings, making healthcare services more affordable. This article clarifies FSA eligibility for dental crowns.

Understanding FSA Eligibility for Medical Expenses

The Internal Revenue Service (IRS) establishes guidelines for eligible medical expenses. A medical expense is defined as costs for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any body structure or function. Dental expenses are explicitly included.

Eligible healthcare expenses include doctor visits, prescription medications, co-payments, deductibles, and vision care like eyeglasses and contact lenses. These expenses must be primarily for medical care, not for general health improvement or cosmetic purposes. Eligibility rests on medical necessity.

Dental Crowns and FSA Coverage Rules

Dental crowns are eligible for FSA coverage when they serve a medical or restorative purpose. A crown, also known as a cap, is a dental restoration used to replace cracked or broken teeth, restore shape, or protect a tooth after a root canal. This dental work is considered medically necessary to treat or prevent dental disease or to restore tooth function.

Crowns needed to repair a severely damaged tooth, strengthen a tooth with a large filling, or serve as an anchor for bridgework are covered. Eligibility depends on the procedure being non-cosmetic, meaning it addresses a dental health issue rather than being solely for aesthetic enhancement. Cosmetic procedures, such as teeth whitening or veneers performed purely for appearance, are not eligible for FSA reimbursement.

Many other common dental expenses are also eligible for FSA reimbursement, including routine cleanings, fillings, extractions, root canals, dentures, and sealants. Orthodontic treatments can also qualify if medically necessary to correct a dental condition. The determining factor is whether the procedure is for the diagnosis, treatment, or prevention of a dental health problem.

Navigating Your FSA for Dental Procedures

When planning to use FSA funds for dental procedures, including crowns, confirm the specifics of your plan. While IRS guidelines establish general eligibility, individual FSA administrators and employer plans can have varying rules or specific documentation requirements. Contact your FSA administrator directly for clarity on what your plan covers.

Proper documentation is essential for successful reimbursement. You will generally need to provide itemized bills or statements from your dentist that clearly show the procedure performed, the date of service, and the amount paid. In some situations, especially for procedures that might have a cosmetic component but are medically necessary, a letter of medical necessity from your dentist may be required. This letter explains why the procedure is needed to treat a specific dental condition.

FSA funds can often be accessed through a dedicated debit card provided by your plan, or you can pay out-of-pocket and submit a claim for reimbursement. Maintaining meticulous records of all dental expenses and corresponding reimbursements is important for personal financial tracking and for potential verification purposes.