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Victor R. Siegel, DDS

Paying for Dental Care with Your FSA

By Victor Siegel on July 14, 2014

A couple with full, attractive smilesAs important as professional dental care is, the cost of some procedures can be a deterrent for patients. This can be troubling when it comes to regular cleanings and exams, but it can be especially problematic when a patient requires restorative work as soon as possible. Even patients with dental insurance may have difficulty meeting their co-pays or deductibles if they have not budgeted accordingly. But with a little foresight, you can plan for your future dental care and even save a good sum of money in the process.

We encourage our Rockville patients to explore all of their financial options so that they can comfortably afford our services. One such payment option is a flex spending account (FSA), which can partially or fully cover the expenses of most restorative and general dentistry procedures. Refer to the following information to learn more about FSAs and how they can help you afford the care you need. 

How Does an FSA Work?

A flex spending account is a small, private account that is created in cooperation with your employer. If you agree to open an FSA at the beginning of the fiscal year, you and your employer can agree to put a portion of your paycheck into this account. The money set aside in an FSA is not subject to taxation, effectively allowing you to keep a larger percentage of your gross income. The stipulation, however, is that this money must be used by the end of the year, and it can only be used on certain goods or services.

Although each FSA is slightly different, most accounts at least allot for health services, through which employees can pay for various medical and dental procedures. As of 2013, the maximum amount allowed in any FSA per year is $2,500; this may be used on a single procedure or spread out across multiple visits.

What Does an FSA Cover?

Depending on which FSA you have, the terms of coverage may vary. In most instances, though, patients can generally expect coverage for procedures that are deemed beneficial to one’s health or well-being. This includes preventative dental procedures such as exams and cleanings, as well as restorative procedures, but excludes anything that is purely cosmetic. More specifically, you would likely be able to use your FSA for:

  • Routine visits: X-rays, professional cleanings, fluoride treatments, and other preventative treatments should be covered by your FSA.
  • Restorations: Any manner of restorative dentistry that is deemed necessary for your dental health should be covered by your FSA. Examples include dental fillings, crowns, extractions, implants, dentures, and bridges. Although these procedures may also be covered by insurance, an FSA can help pay the rest of a co-payment, co-insurance, or deductible.
  • Orthodontics: Because straight teeth benefit your dental health as well as your smile, there is a good chance that orthodontic treatment can be paid for by an FSA. If you are considering Invisalign®, speak with your dentist regarding whether your FSA plan would deem it medically relevant.
  • Mouthguards: If you want a professionally crafted mouthguard to protect your teeth, your FSA may provide the expenses for it. The same is true for other occlusal splints, such as a night guard to protect your teeth from bruxism.  

Are Any Cosmetic Procedures Covered?

Although an FSA tends to encompass a wider range of services than an insurance plan might, there are still strict limitations on how it can be used. In the same way that insurance plans don’t cover elective procedures, an FSA will almost assuredly not cover cosmetic dentistry. Teeth whitening, for instance, would still require payment out-of-pocket or via financing.

There is a possibility, though, that your FSA can be used for a cosmetic restoration if it is cited as a way to improve your dental health. For example, if your dentist determines that your teeth are suffering from erosion and need to be protected by a restoration, dental bonding or porcelain veneers may be covered by your FSA for that reason alone. Similarly, teeth that have been weakened by a large chip or crack may also require the use of bonding or veneers. Still, the distinction can be subtle, and it is best to not anticipate coverage for any procedure until both your dentist and FSA plan have agreed that it should.  

Get the Care You Need

Regardless of FSA or insurance plan, we will work to deliver the highest quality of care in a way that is most affordable to you. Contact us for more information on our services and financial options, and to schedule your next appointment at our office.

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Victor R. Siegel, DDS

16815 Crabbs Branch Way
Rockville, MD 20855

Open Today 8:00am - 5:00pm

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