Does HSA Cover Toothbrushes and Other Oral Care?

A Health Savings Account (HSA) provides a tax-advantaged way to save and pay for qualified medical expenses. These accounts offer a triple tax advantage: contributions are tax-deductible, earnings grow tax-free, and withdrawals for eligible expenses are also tax-free. Understanding what dental items and services qualify for HSA coverage, especially common items like toothbrushes, helps maximize these benefits.

Understanding HSA Eligible Expenses

HSA eligible expenses adhere to specific criteria defined by the IRS. According to IRS Publication 502, “medical care” generally includes amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body. Expenses must be primarily for medical care, not for general health improvement or cosmetic purposes. After the CARES Act, many over-the-counter (OTC) medicines became eligible without a prescription. However, other OTC items, supplies, or equipment often require a doctor’s prescription or a Letter of Medical Necessity to be eligible, unless specifically listed by the IRS.

Coverage for Toothbrushes and Oral Care Items

Standard toothbrushes, toothpaste, and dental floss are generally not considered HSA-eligible expenses. These items are viewed as general hygiene products for everyday use, rather than being primarily for the diagnosis, cure, mitigation, treatment, or prevention of a specific medical condition. The IRS typically excludes expenses that are merely beneficial to general health, such as vitamins, from eligibility.

However, a specialized toothbrush or other oral hygiene product prescribed by a dentist for a specific medical condition, such as gum disease or a dental appliance, can be eligible. Dental procedures are also typically HSA-eligible. This includes cleanings, fillings, crowns, medically necessary orthodontia (like braces), sealants for disease prevention, and dental implants, as they directly relate to treating or preventing dental diseases or affecting tooth structure and function.

Paying for Dental Care with Your HSA

When using your HSA for eligible dental expenses, you have a few payment methods available. Many HSA providers issue a debit card that can be used directly at the time of service, similar to a regular debit card. Alternatively, you can pay for the eligible dental expense out-of-pocket and then reimburse yourself from your HSA. It is important to maintain detailed records for all expenses paid with HSA funds, including receipts, Explanation of Benefits (EOB) forms from your dental insurance, and any required prescriptions or Letters of Medical Necessity, for tax purposes and in case of an IRS audit.