Is FSA teeth whitening misappropriated? Before proceeding with the treatment, emphasizing what is eligible downplays the struggle about what is not covered.
Given that FSA teeth whitening is a topic of discussion, especially regarding what is covered and what is not. It sets limits on improving one’s appearance. To move further, let’s understand FSA and how it works.
FSA understanding prevails before diving into teeth whitening. A flexible spending account, also known as a flexible spending arrangement (FSA), sets aside pre-tax money to cover out-of-pocket healthcare costs from your paycheck. This bank account builds a safety net.
According to the IRS, only qualified medical expenses are reimbursed, and teeth whitening is not a medically necessary expense. Teeth whitening often falls short in this category, as over 37 million Americans have used teeth whitening products since 2020. Teeth whitening enhances a person’s physical appearance and is elective, as it is backed by the American Academy of Cosmetic Dentistry.
The IRS is defining qualified medical expenses. Diagnosis, cure, mitigation, treatment, and prevention of disease, which is not focused on improving appearance. Teeth whitening is not a treatment for an injury or illness, and therefore, it is not covered by FSA reimbursement. It is applicable to professional visits and at-home whitening kits.
Mostly, employers make contributions to an FSA, and the employee submit the claim with proper documentation through the employer, stating that it is not covered by the insurance. The cost is reimbursed as per the guidelines. As it is an employer-sponsored program, if you don’t qualify, you will lose your FSA money.
A HSA store survey found that 66 percent of individuals incorrectly believed that teeth whitening is FSA-eligible and medically necessary.
The authorities declared teeth bleaching an elective treatment rather than a medical necessity. It cannot be covered through an FSA. There are exceptions that can change the course from cosmetic to medically necessary. Teeth whitening remains a necessary treatment after extensive dental work or severe stains due to a medical condition. They may help with reimbursement if there is a strong clinical justification.
The alternatives for patients to afford teeth whitening, other than FSA limitations.
There are practices that offer dental savings plans. It includes dental procedures at discounted rates, which might potentially save substantial amounts on the bill.
In-house financing options allow improved budgeting across several months. Dentist payment plans spread the cost and bring some relief, depending on the needs.
Some patients would like to save especially for procedures. Removing debt concerns gives control over the finances.
Dental financing through third-party financing has added interest expense.
Then there are budget-friendly options, such as toothpaste and whitening strips, which do not provide spectacular results.
This professional treatment would cost $650 per visit. It includes the use of peroxide gel, which is applied to the teeth under guidance. The application time is 15 to 20 minutes, and there are several sessions. The maximum time to use the gel and the number of sessions are dependent upon the stains.
The process does not require a dentist’s sight, and the kit costs from $100 to $400 per tray. According to the American Academy of Cosmetic Dentistry, it is emerging as a preferred choice and is adopted by 29 percent of the U.S. population. According to the statistical data on the Mintel survey (2021), 37 percent of the population comprises early to mid-adults.
The most economical option. It costs between $20 to $100. Whitening pens and strips are utilised at home in one's own comfort.
Given that teeth whitening is non-eligible for FSA, HSA, or other arrangements. Let’s discuss how FSA funds can be used in other dental health-related procedures.
A common dental replacement for missing teeth. Dentures can improve appearance and bring confidence. Fortunately, these are beneficial for everyday activities and do not alleviate problems.
Caps and crowns restore damaged teeth through root canals. Not to forget, crowns and caps enhance the appearance. They are undemanding, unlike teeth whitening. They require low maintenance and are FSA-approved.
It is an advanced treatment to protect the teeth from decay and cavities. There are dental procedures that are FSA eligible, such as sealants, fluorides, X-rays, fillings, extractions, and dentures. Fluoride is a medically necessary treatment rather than a cosmetic one.
Orthodontia includes braces, teeth retainers, and Invisalign, and is an FSA-eligible item. Orthodontia supported with teeth whitening treatments can be transformational for reimbursement.
Let’s discuss some questions as we move along.
FSA or HSA will not cover the expenses for teeth whitening. Certainly, these funds can be used selectively for other dental procedures. Medically necessary procedures such as fillings, X-rays, and teeth cleaning are eligible for reimbursement.
Teeth whitening strips, pens, and trays are all considered cosmetic treatments. Direct medical benefit procedures, tools, and items are eligible for reimbursement.
FSA funds are not eligible for over-the-counter items such as toothpaste, floss, and toothbrushes. If a dentist recommends a toothpaste, rinse, or prescribed tool or treatment that is working in diagnosing a condition, it should be eligible for reimbursement.
Need more information? Book a consultation at Capline Dental Services.
