Insurance won’t cover all of your Invisalign? How to use your HSA or FSA to pay the rest?

Even good dental insurance rarely pays for all of Invisalign. Orthodontic benefits usually cover a percentage up to a lifetime maximum, and the rest is yours. The good news is that a health savings account (HSA) or flexible spending account (FSA) can usually pay that balance with pre-tax money.

Quick answer: Orthodontic treatment, including Invisalign, is generally a qualifying dental expense for HSAs and FSAs. Insurance pays its share first; you can use HSA or FSA funds for your deductible, coinsurance and the balance above your orthodontic maximum.

Is Invisalign HSA and FSA eligible?

The IRS lists orthodontic treatment among the dental expenses you can pay with pre-tax health accounts (IRS Publication 502, Medical and Dental Expenses). Clear aligners used to straighten teeth fall under orthodontics. Treatments that are purely cosmetic do not qualify, so if you are unsure, check with your account administrator.

HSA or FSA: which differences matter?

• HSA: available with a qualifying high-deductible health plan. The money is yours and rolls over every year, so you can save toward orthodontics over time. Rules are in IRS Publication 969.
• FSA: offered by employers. You choose an amount each year, and it is generally use-it-or-lose-it, though some plans allow a short grace period or a limited carryover. Planning orthodontic treatment around the FSA year makes the most of it.

How do you use your account together with dental insurance?

1. Get a pre-treatment estimate so you know what insurance will pay.
2. Work out your share: the difference between the treatment fee and the insurance estimate.
3. Plan your contributions: set your FSA election for the year, or check your HSA balance.
4. Pay with your HSA or FSA card, or pay yourself and request reimbursement from the account.
5. Keep the paperwork: the itemized bill and the insurance EOB.

What does that look like in dollars? (illustrative numbers)

Say your treatment fee is $5,000 and your plan pays 50 percent of orthodontics up to a $1,500 lifetime maximum. Insurance pays $1,500, because 50 percent ($2,500) is more than the maximum. Your share is $3,500. Paying that with pre-tax HSA or FSA money instead of after-tax income saves you the income tax you would otherwise have paid on it. Your own fee, percentage and maximum will be different; a pre-treatment estimate gives you the real numbers.

When should you use your HSA or FSA?

• FSA elections are made once a year, usually during open enrollment, so plan expected orthodontic costs before you choose your amount.
• Orthodontic payments may come in installments. Ask your account administrator how they treat orthodontic payment plans; rules vary.
• HSA money can wait. Because it rolls over, you can build it up before treatment starts.

What other dental costs can your account cover?

Beyond orthodontics, HSAs and FSAs can generally pay for cleanings and exams, fillings, crowns, root canals, extractions and dentures, along with deductibles and coinsurance. Teeth whitening and other purely cosmetic treatments generally are not eligible.

How much does your insurance cover?

That depends on the plan. Our insurer-by-insurer guides explain how each one handles Invisalign:

• Does Cigna cover Invisalign? · Cigna PPO at Coit Dental
• Does Delta Dental cover Invisalign? · Delta Dental PPO at Coit Dental
• Does MetLife cover Invisalign? · MetLife PPO at Coit Dental
• Does UnitedHealthcare cover Invisalign? · UnitedHealthcare PPO at Coit Dental
• Does Aetna cover Invisalign? · Aetna PPO at Coit Dental

For a general idea of Invisalign fees, see Invisalign’s cost guide. For an exact figure for your case, book a consultation: we will check your insurance and explain what is left after your benefits.

Frequently asked questions

Is Invisalign HSA and FSA eligible?

Generally, yes. Orthodontic treatment to correct teeth alignment is a qualifying dental expense under IRS rules (see IRS Publication 502). Purely cosmetic procedures are not, so ask your plan administrator if you are unsure.

Can I use my HSA and dental insurance together?

Yes. Insurance pays its share first, and you can use HSA or FSA funds for your remaining balance, deductible or coinsurance.

What happens to unused FSA money?

FSA funds are generally use-it-or-lose-it, although some employers offer a short grace period or let you carry over a limited amount. HSA money rolls over from year to year.

Can I pay for my child’s Invisalign with my HSA or FSA?

Usually, yes, for a spouse or dependent who qualifies under your account’s rules.

Do I need receipts?

Yes. Keep the itemized bill and your insurance Explanation of Benefits in case your account administrator asks for proof.

General information only. Coverage and account rules vary by plan and employer; your plan documents and account administrator have the final word.