Is Orthodontics Covered by FSA?

Orthodontic procedures are necessary for overall oral health. Learn what procedures might be covered under your FSA plan.

April 6, 2022
Is Orthodontics Covered by FSA?

Dental care is often separate from most health insurance plans, and for that reason, a number of Americans are left without the ability to pay for dental procedures that they need. However, flexible spending accounts, or FSAs, can alleviate the financial burden and make it easier to afford certain procedures.

But FSAs are complicated, and there are certain restrictions in place that only allow you to use the money for specific purposes. Is orthodontic care one of them? And what else does an FSA cover? Here’s everything you need to know.

What Is Orthodontics?

Orthodontics is a specialty of dentistry that addresses the diagnosis and treatment of malpositioned teeth or jaws. Essentially, it is concerned with the overall shape of your mouth, gums, and tooth alignment.

Orthodontics is considered a specialty, which often means it requires a higher co-pay from dental insurance plans, or it’s just not covered under some dental plans entirely. 

What Is FSA?

An FSA is also known as a flexible spending account, and it’s a special account that you can put money into in order to pay for certain out-of -pocket healthcare costs. You don’t pay taxes on these funds, meaning you’ll save an equal amount on the taxes you would have had to pay on the money you set aside.

FSAs are limited to $2,850 per year per employer. Generally, you need to use the money within the plan year, but your employer may offer a grace period of up to 2.5 extra months to use the money in your FSA. 

They can also allow you to carry over up to $570 per year to use in the following year. Your employer may add funds to your FSA, but they are not required to.

These are different from a health savings account (HSA). While an HSA also allows you to set tax-free money aside for health expenses, it is generally more flexible since you control it. Your employer controls an FSA.

Do FSAs Cover Orthodontics?

In most cases, yes, your FSA or HSA plan can be used to fund eligible orthodontic treatments. Eligible treatments differ based on your employer's coverage plans, but the basic guideline is that anything that can prevent or treat dental disease is eligible for FSA coverage:

  • Cleanings
  • Fillings and sealants
  • Inlays and Onlays
  • Bonding
  • Crowns
  • Root canals
  • Tooth extraction
  • Gingivitis treatments
  • Oral surgery

This will likely include typical orthodontic treatments like braces or bridges, as long as your dental specialist can demonstrate a need for this treatment to prevent or treat a disease.

Expenses Not Covered By FSA

While FSA can cover most orthodontic treatments that affect your health and wellbeing, cosmetic orthodontics are not covered. These include whitening procedures. You can’t even buy a special toothpaste or floss with the money in an FSA, as these are also not considered eligible expenses.

In fact, most dental insurance plans, in general, do not cover cosmetic dentistry. But that doesn’t need to deter you from getting the dental care you want or need. 

Flossy is a membership-based program that gives you access to top dentists in your area for up to 50% off the national out-of-pocket pricing.

This includes cosmetic procedures like whitening and surgical procedures such as root canals. You can even save on cleanings, fillings, crowns, bridges, and more.

No annual fees, no annual premiums, and you only pay for the services you receive. Find a dentist near you to get the care you need.

Types of Orthodontic Treatments

  • Braces
  • Clear aligners
  • Elastics

Now that you know you can use your FSA account to fund orthodontic expenses, you’re probably chomping at the bit to get started with one. Here are a few of the more common types of orthodontic treatments that you might want to consider getting.

Braces

If you had braces as a child, you might have been the subject of some minor bullying. But there’s nothing to be embarrassed by when it comes to straightening your teeth because once those braces come off, you can kill those bullies with kindness by just showing off your perfect smile.

Braces are used to correct misaligned or crowded teeth, but they can also be used to help with a misaligned jaw. They are made of metal or ceramic, wires, and bonding material that attaches them to your teeth.

Braces move your teeth gradually by exerting constant pressure on them for extended periods of time. The shape of your jaw naturally adapts to conform to the pressure. Since your teeth aren’t connected to your jawbone (they’re connected to a membrane under the gums), they can be repositioned with relative ease.

While you might experience some soreness and tenderness as your teeth gradually shift, most people never feel too much discomfort while they have these on. You’ll need to visit an orthodontist every now and then to get your braces tightened.

Clear Aligners

The problem with braces is that you can’t remove them, and they can feel a bit embarrassing to wear - especially as an adult. Clear aligners, often referred to as Invisalign, are an alternative that is much more discreet.

Clear aligners are placed over the tops of your teeth, sort of like a retainer. Over time, you’ll wear new trays that are gently shifting your teeth into new positions. The best thing about clear aligners is that you can remove them when you eat or drink, and they’re virtually invisible to anyone who might be speaking to you.

Elastics

Dental elastics are used in addition to braces to correct jaw alignment. These are rubber bands that are attached to the braces to pull the jaw forward or backward. Typically, these need to be worn for 10-12 hours out of the day, and they should be removed when eating.

Conclusion

Orthodontic procedures can help realign your jaw and crooked teeth, helping to alleviate discomfort and correct over or underbites. However, it’s a specialty service that is not always covered by insurance plans. That said, flexible spending accounts, or FSAs, cover most orthodontic procedures.

This includes a number of procedures that work to prevent disease or infection, such as fillings, root canals, or crowns. However, an FSA cannot be used to pay for cosmetic orthodontics, such as teeth whitening.

So what do you do if you can’t use your FSA to pay for the oral care you want? You get Flossy! It’s a membership-based plan that only makes you pay for the services you get. From teeth whitening to bridges and veneers, you can save up to 50% on dental procedures – all without insurance.

No insurance? No problem. Flossy is made for people without an insurance plan. Give us a call to learn more about how you can get access to top dentists in your area.

Sources:

Orthodontia | MedlinePlus

Health Care Options, Using a Flexible Spending Account FSA | HealthCare.gov

What is a Root Canal? | American Association of Endodontists