Artificial Teeth: HSA Eligibility

Artificial teeth reimbursement is eligible, unless they are for a cosmetic purpose, with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA) or a limited care flexible spending account (LCFSA). Artificial teeth reimbursement is not eligible with a dependent care flexible spending account (DCFSA).

What are artificial teeth?

As we grow older, the debilitating effects of age will take its toll on our hair, skin and various physiological functions, and our teeth are certainly not spared from the test of time. Over time, tooth loss can occur from the emergence of gum disease, trauma or other dental maladies, which may require major dental surgery and other procedures to alleviate the problem. Luckily, artificial teeth have advanced by leaps and bounds over the past several decades and now look almost indistinguishable from real teeth.

Artificial Teeth Types

If individuals happen to lose teeth as a result of legitimate medical condition, artificial teeth will be eligible for reimbursement with an FSA, HSA or HRA. Account holders have a wealth of options available to them to treat a wide variety of potential dental ailments, including:

  • Partial Dentures: These removable false teeth are among the most common forms of artificial teeth available meant to replace multiple missing teeth. Partial dentures are made with false replacement teeth attached to pink or gum-colored plastic bases, and they are affixed inside the mouth with either a metal framework and clasps that connect to teeth or with precision attachments that connect to one's natural teeth.
  • Full Dentures: When an individual's tooth loss has advanced to the point that dental implants and bridges are not feasible, full dentures may be necessary. This full removable denture is custom designed to fit the wearer's mouth and gum line, and typically this is done after the remaining teeth have been removed and the tissues have healed.
  • Partial Bridge: When an individual is missing one or more teeth, dental surgeons will aim to "bridge" this gap with a dental bridge to recreate the look of the pre-existing teeth. A bridge is made up of two or more crowns to form the foundation of the bridge, and false teeth are inserted and anchored by the remaining natural teeth or additional implants.
  • Dental Implants: These artificial teeth are implanted into the jaw and hold either a fake tooth or a bridge. Dental implants fall into two categories: endosteal, which are implanted into the jaw bone with screws, cylinders or blades, or subperiosteal implants, which are placed on top of the jaw bone and held in place with a metal framework.

Do artificial teeth require a Letter of Medical Necessity (LMN)?

When submitting documentation to a benefits administrator, it can be difficult to prove that artificial teeth are purchased in response to a legitimate medical condition rather than for cosmetic purposes. To ensure that account holders are fully reimbursed for dental surgery or implants, a Letter of Medical Necessity from a physician can make the reimbursement process much easier.

This letter must outline how an account holder's medical condition inhibits his/her ability to perform daily tasks or diminish quality of life, which would require artificial teeth to alleviate. The letter must outline how the treatment will be used to alleviate the issue and how long the treatment will last. If the treatment plan exceeds the current plan year, another LMN will have to be provided to the benefits administrator to cover the duration of the treatment.

Artificial Teeth: Best Sellers


Eligibility Table

Flexible Spending Account (FSA) Limited Care FSA Dependent Care FSA Health Savings Account (HSA) Health Reimbursement Account (HRA)

Eligible

Eligible with Rx

Eligible with LMN

Not Eligible

Specifically Not Covered

Eligible expenses for Limited FSAs can vary. To find out exactly what your Limited FSA covers, contact your FSA administrator.

Legal Information / Regulations

Treas. Reg. '1.213-1(e)(1)(ii)

 


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