Using A Health Saving Account (HSA) For Cosmetic Dental

Sometimes, you can use Health Savings Account (HSA) funds to pay for cosmetic dentistry, as many procedures fall into a gray area.

IRS Publication 502 Medical and Dental Expenses excludes any cosmetic procedure that enhances the patient’s appearance while allowing those necessary to improve a deformity arising from a congenital abnormality, personal injury, or disease.  

Using HSA funds to pay for these treatments can lower your after-tax costs considerably. Therefore, you might want to discover how to overcome exclusion by supporting inclusion.

Learn from examples of two popular cosmetic dental procedures: veneers and tooth whitening.

HSA For Dental Veneers

Patients can sometimes use a Health Savings Account (HSA) for dental veneers, even though their principal application is cosmetic: improves appearance rather than restoring function.

An HSA is more likely to cover dental implants because IRS Publication 502 explicitly allows deductions for artificial teeth. Therefore, keep this in mind as you evaluate treatment options. 

Eligible Veneers

Your Health Savings Account may cover dental veneers when you establish they are necessary rather than cosmetic. You must make the case to your HSA plan administrator that the treatment is needed to correct a disfiguring disease, injury, or congenital abnormality.

The cost of veneers with insurance may be lower if your plan picks up a portion of the charges. Therefore, you have extra motivation to establish the medical necessity. Some of these conditions might fit the IRS criteria.

  • Personal injuries leading to broken or chipped teeth
  • Disfiguring diseases causing eroded tooth enamel
    • Acid reflux
    • Celiac disease
    • Enamel Hypoplasia

Cosmetic Veneers

Your Health Savings Account will not cover dental veneers when your motivation is disconnected from a disfiguring disease, injury, or congenital abnormality. In these more common cases, the HSA administrator will reject your claim as cosmetic.

Monthly payment plans for dental veneers might be a viable alternative when you cannot use your HSA funds. Private lenders do not consider the reason you want to upgrade your smile. They care about your ability to handle the periodic installments on time.

Your HSA administrator will probably reject claims for dental veneers under the cosmetic exclusion for procedures associated with appearance-related motivators.

  • Fill in gaps between teeth
  • Cover coffee or red wine stains
  • Change the shape or length of teeth
  • Adjust minor misalignments

HSA For Tooth Whitening

Using a Health Savings Account (HSA) for tooth whitening is possible, but the odds are stacked against you as this procedure usually falls into the cosmetic category.

However, every rule has exceptions.

Eligible Tooth Whitening

Your Health Savings Account might cover tooth whitening if you present an iron-clad case that the dental treatment stems from a medical problem. However, expect your HSA administrator to focus on an explicit rule while ignoring its ambiguous counterpart.

IRS Publication 502 contains two counterbalancing statements: clear-cut and vague (open to interpretation).

  1. You can’t include in medical expenses amounts paid to whiten teeth (see cosmetic surgery).
  2. You can include cosmetic surgery necessary to improve a deformity arising from a congenital abnormality, personal injury, or disease.

Therefore, you must overcome the explicit exclusion by presenting evidence supporting the ambiguous inclusion. Collaborate with your doctor and dentist to document the medical cause of your tooth discoloration and submit a letter of necessity.

For example, removing stains caused by prescription medications used to treat disease might do the trick. Some of these examples could qualify, especially if you recently used your HSA to pay for these earlier treatments.

  • Bacterial Infections: Antibiotics
  • High Blood Pressure: Anti-hypertension
  • Severe Allergies: Antihistamines

Ineligible Tooth Whitening

Your HSA will not cover most tooth whitening treatments to address discoloration caused by coffee, red wine, sodas, smoking, or chewing tobacco. IRS Publication 502 explicitly excludes this service, so you have no chance if there is no disease-related condition.

Free (Pro Bono) cosmetic dentistry is unlikely to help lower tooth whitening costs because charitable organizations and government programs also focus on dire needs. However, you could save money on other necessary oral care services such as fillings, extractions, root canals, etc.