When Is a Water Flosser HSA Eligible?

A Health Savings Account (HSA) is a tax-advantaged savings account for qualified healthcare expenses. Individuals with a high-deductible health plan (HDHP) can contribute to an HSA, often on a pre-tax basis. Funds grow and are withdrawn tax-free for eligible medical costs. Unspent funds roll over annually, allowing for long-term savings. Understanding what constitutes an eligible expense, such as a water flosser, is important for maximizing HSA benefits.

Understanding HSA-Eligible Expenses

The Internal Revenue Service (IRS) outlines specific criteria for what qualifies as an HSA-eligible expense. According to IRS Publication 502 and Section 213(d), eligible expenses are those incurred primarily for medical care. This encompasses costs related to the diagnosis, cure, mitigation, treatment, or prevention of disease, and payments for treatments affecting any structure or function of the body.

Expenses must directly address a medical condition rather than serving general health or cosmetic purposes. While certain medical devices and services are eligible, personal expenses that merely benefit general health, such as routine vitamins or exercise equipment, do not qualify. The expense must be an integral part of medical treatment or prevention for a specific health issue.

Qualifying Oral Hygiene Expenses

Many standard dental procedures are recognized as HSA-eligible. These include routine dental cleanings, fillings, tooth extractions, and orthodontic treatments like braces. Procedures such as crowns, dental implants, and dentures are also covered, provided they are not solely for cosmetic enhancement.

Common everyday oral hygiene products, such as toothpaste, standard dental floss, and mouthwash, are typically not considered HSA-eligible. These are viewed as general health products for personal care, not primarily for medical treatment or disease prevention. For an oral hygiene product to qualify, it must generally be for the diagnosis, cure, mitigation, treatment, or prevention of a specific dental disease or condition.

Water Flosser Eligibility Requirements

A water flosser is classified as a personal care item and is not automatically eligible for HSA reimbursement. Its eligibility changes when it is deemed medically necessary to treat or prevent a specific dental condition. This requires a recommendation from a licensed medical professional, such as a dentist, orthodontist, or physician.

For a water flosser to qualify, it must be prescribed for the diagnosis, cure, mitigation, treatment, or prevention of a specific dental or medical condition. Examples include severe gum disease, periodontitis, gingivitis, or orthodontic conditions where traditional flossing is difficult or ineffective. It may also be eligible for individuals with conditions like diabetes, where diligent oral hygiene is crucial to prevent complications, or for post-surgical dental care. A Letter of Medical Necessity (LMN) from the healthcare provider, detailing the specific diagnosis and how the water flosser addresses it, is typically required to substantiate the expense.

Essential Record Keeping for Reimbursement

Maintaining thorough records is crucial for substantiating HSA-eligible expenses, particularly for items like a water flosser that require medical necessity. Individuals are responsible for proving that distributions from their HSA were used for qualified medical expenses. The IRS mandates sufficient records to demonstrate eligibility in case of an audit.

Key documents to retain include the original receipt or proof of purchase for the water flosser. Also keep the prescription or Letter of Medical Necessity (LMN) from the healthcare provider, clearly stating the medical condition and why the water flosser is necessary for treatment or prevention. Any Explanation of Benefits (EOB) from an insurance provider, showing amounts not covered by insurance, should also be kept. These records should be maintained for at least three to seven years, aligning with typical tax audit periods.