Dental Procedures: FSA Eligibility

Dental procedures are eligible expenses with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA) and a limited care flexible spending account (LCFSA). Dental procedures reimbursement is not eligible with a dependent care flexible spending account (DCFSA).

What are the most common eligible dental procedures?

In the world of consumer-directed healthcare accounts, dental care causes a great deal of confusion as to what is covered and what is regarded as simply necessary for "general health" purposes and therefore not eligible for reimbursement. For instance, common dental care items like toothbrushes, toothpaste and dental floss are considered "general health" products and not eligible for reimbursement, even though they contribute to the prevention of oral disease and other dental issues. However, eligible expenses include regular cleanings and checkups, as well as a huge slate of potential dental procedures.

While some dental procedures will be reimbursed differently, many require co-insurance or a co-payment, the following procedures are considered eligible and can alleviate a wide variety of potential dental ailments. These include:

  • Bonding: Bonding of the teeth is considered a minor cosmetic procedure, but it can also help to correct dental imperfections that arise as a result of dental diseases, injuries and other ailments. The procedure consists of the application of a tooth-colored resin that is "bonded" to the teeth with adhesives and then affixed to the area with a high intensity curing light.
  • Bridgework: Bridges and implants are used to replace damaged or missing teeth, which utilize crowns to anchor a false tooth in place that is surrounded by two natural teeth. This is an advanced procedure that is used to correct dental imperfections or side effects from injuries/ailments.
  • Crowns/Caps: This is a form of dental restoration that is meant to replace cracked or broken teeth by placing an artificial crown (also known as a cap) to restore the shape of the tooth below the gum line.
  • Dentures: Both full and partial dentures used to replace false teeth are eligible expenses, as well as the cleaning supplies, sealants and other accessories needed to wear them comfortably.
  • Extractions: In the event that a tooth becomes diseased, extremely painful or severely damaged, a tooth extraction will remove the existing tooth, which is typically followed with implants or bridgework to replace the old tooth.
  • Fillings: If a tooth has a cavity or has experienced some type of trauma, fillings are used to strengthen the tooth with restorative materials to repair it.
  • Gum Surgery: If gingivitis is allowed to advance to its more advanced state, periodontal disease, gum surgery is done to reverse the effects of this condition. This surgery typically involves removing the infected tissue, as well as eliminating plaque and bacteria above and below the gum line.
  • Root Canals: A root canal is required when trauma or a cavity damages the tooth's root, which becomes infected or inflamed. During this procedure, the infected root is removed and the spaces are filled with permanent materials to keep this area free from future contamination.
  • Sealants: These sealants act as a barrier against cavities that are placed in the grooves of chewing surfaces to prevent tooth decay. They are constructed with plastic and are most often used on the back molars that are more prone to deterioration over time.

Eligibility Table

Flexible Spending Account (FSA) Limited Care FSA Dependent Care FSA Health Savings Account (HSA) Health Reimbursement Account (HRA)

Eligible

Eligible with Rx

Eligible with LMN

Not Eligible

Legal Information / Regulations

Eligible expenses for Limited FSAs can vary. To find out exactly what your Limited FSA covers, contact your FSA administrator.

 


AZ-PROD-WEB01 11/19/2017 12:25:51 PM