Is cosmetic dentistry an allowable expense under a medical FSA?

[Mary C]

Other than Publication 502, does anyone know of any other information regarding expenses that can be reimbursed under a medical FSA? Specifically, we are receiving questions regarding cosmetic dentistry - such as bleaching, caps, bonding, etc. Since cosmetic surgery isn't an allowable expense, is cosmetic dentistry? Any ideas on how we could determine if caps are cosmetic or not?

Mary

[Lisa Hand]

For a procedure to be reimbursed under a Medical FSA, it needs to be medically necessary. For procedures usually considered cosmetic to be medically necessary, they must impact the function of the body, not simply the appearance. While bleaching is always considered cosmetic since it has no impact on the function of the teeth, some of the other items you listed could be restorative or part of the treatment of a condition. On any procedure in question, documentation that the it is medically necessary and not cosmetic should be requested from the provider. If the documentation can not be provided, then it isn't eligible.

[KIP KRAUS]

Mary

Is it correct to assume that you do not have a dental plan? If you do, however, the claim should be processed first through the dental plan and if it determines that the procedure is not medically necessary then I'd apply the dental plan's not medically necessary determination to the FSA.