Using Your Medical FSA for Orthodontic Expenses

Paying for orthodontia can be different than purchasing other FSA-eligible products or services. Some orthodontists offer the option of a “payment plan” that allows you to pay in equal installments over the course of the treatment. In other cases, you may simply get a monthly statement showing what you owe for that month. Some orthodontists may charge interest if you finance your services, while others may offer a discount if you pay the entire cost of the treatment up front. Whatever your situation, it’s important to know how to use your FSA correctly so you can manage your expenses with ease.

The most important thing to keep in mind is that you cannot use your FSA to pre-pay for services that have not occurred yet. In order for an expense to be eligible under the FSA, it must have actually happened; services scheduled for future dates are not eligible until they occur, even if you paid for them in advance. 

Here are a few examples to explain how you can use your FSA to pay for orthodontia in different scenarios.

Pay Up Front

Scenario: Mrs. Smith’s daughter, Jane, needs braces. Jane is expected to have braces for a total of 18 months, and the total fee will be $5,000. If Mrs. Smith pays for entire treatment up front, she will receive a $500 discount.

How the FSA Works: If Mrs. Smith decides to pay for the full amount up front, she will have to pay out-of-pocket for the total and then file claims for reimbursement as the services occur. Mrs. Smith FSA cannot use her FSA to pre-pay for expenses that are scheduled to occur in the future, but she can use her FSA to reimburse herself as each service occurs. At each visit, she will need to request an itemized statement for the services that were provided during that appointment, and file a claim either in her Consumer Portal or in the 24HourFlex Mobile App to be reimbursed.

Pay in Contracted Monthly Installments

Scenario: Mrs. Smith’s daughter, Jane, needs braces. Jane is expected to have braces for a total of 18 months, and the total fee will be $5,000. Mrs. Smith is offered the option to pay for the treatment in equal, monthly installments over the course of the 18 months.

How the FSA Works: If Mrs. Smith decides to enter into a contract with her orthodontist and pay monthly, she can use her 24HourFlex debit card to pay for the expense each month. She will need an itemized statement from the orthodontist showing the services that were provided, which she will be able to upload in her Consumer Portal or using the 24HourFlex Mobile App after she swipes her card. Unlike other FSA expenses, the date you pay for an orthodontic expense is considered the date of service, allowing you to pay for expenses across plan years. For example, if you receive your monthly orthodontic bill for December in January, and your FSA plan year ended on December 31, you can pay for your bill in January using the funds from your new plan year.

Pay As You Go

Scenario: Mrs. Smith’s daughter, Jane, needs braces. Jane is expected to have braces for a total of 18 months, and the total fee will be $5,000. Mrs. Smith is offered the option to pay for the treatment at each visit for the cost of the services for that appointment.

How the FSA Works: If Mrs. Smith decides to pay for the services provided at each visit, she can use her 24HourFlex debit card to pay for the expense each time. She will need an itemized statement from the orthodontist showing the services that were provided, which she will be able to upload in her Consumer Portal or using the 24HourFlex Mobile App after she swipes her card.

For a brief overview of how to pay for orthodontic treatments using your Medical FSA, watch the short video below!