Does an HSA Cover Dental Work?

A Health Savings Account (HSA) provides a tax-advantaged savings option for individuals enrolled in a high-deductible health plan (HDHP). This account allows funds to be set aside on a pre-tax basis to cover qualified medical expenses. HSAs cover a wide range of dental expenses, offering a way to save and pay for healthcare costs, including many dental procedures.

Qualified Dental Expenses

An HSA can be used for a variety of dental services and orthodontic procedures that are considered medically necessary. These eligible expenses generally encompass diagnostic, preventative, and restorative dental services aimed at preventing or alleviating a dental disease or condition. Routine cleanings and dental check-ups are covered as preventative care.

Many common dental treatments, such as fillings, crowns, bridges, and root canals, qualify for HSA use. Extractions, including wisdom tooth removal, are eligible expenses. Dentures, whether complete or partial, are covered when needed to restore oral function due to missing teeth.

Orthodontic treatments, including traditional braces and clear aligners like Invisalign, are HSA-eligible if recommended by a dentist or orthodontist to correct dental issues. Dental implants are covered when used for restorative purposes, such as treating a dental disease, rather than solely for cosmetic enhancement. The Internal Revenue Service (IRS) Publication 502 defines what constitutes a qualified medical expense.

Non-Qualified Dental Expenses

Not all dental procedures are eligible for HSA coverage. Cosmetic procedures that do not address a medical condition are typically excluded. Procedures performed solely to improve appearance, without a primary purpose of diagnosis, cure, mitigation, treatment, or prevention of disease, do not qualify. Teeth whitening, for instance, is considered a purely cosmetic procedure and is not eligible for HSA reimbursement.

Veneers are generally not covered if their purpose is purely aesthetic. However, if veneers are recommended to repair damage from an injury or a health-related dental issue, they may qualify with proper medical justification. Using HSA funds for non-qualified expenses can lead to penalties, including income tax on the withdrawal and an additional 20% penalty if the account holder is under age 65.

Using Your HSA for Dental Care

Accessing HSA funds for dental expenses involves several practical methods. Many HSA providers issue a debit card linked to the account, which can be used directly at the dental office at the time of service. This allows for immediate payment from your tax-advantaged funds. Alternatively, individuals can pay for qualified dental expenses out-of-pocket and then reimburse themselves from their HSA.

Reimbursement can be done by transferring money online from the HSA to a personal bank account or by requesting a check. It is important to maintain thorough records for all qualified dental expenses. This documentation, including receipts, invoices, and Explanation of Benefits (EOB) statements from your dental insurance, serves as proof for eligible medical expenses. These records are essential for an IRS audit.