Orthodontia

FSA Reimbursement for Orthodontia

Health FSA expenses are incurred when the participant is provided with the medical care and not when the participant is formally billed, charged for, or pays for the medical care. However, orthodontia expenses are different. Unlike other health FSA expenses, orthodontia expenses are incurred when paid. Consequently, participants must make the payment while they are covered by the plan and during the plan year from which the reimbursement is requested. The participant must also demonstrate that the payment was actually made. This rule provides for two options for reimbursement. If a participant pays a lump sum up front then that payment can be reimbursed in full (provided the lump sum is paid during the same plan year from which reimbursement is requested and while the participant was covered under the plan). Second, participants that do not pay up front and opt for monthly payments can be reimbursed as those monthly payments are made (provided the monthly payment is paid during the same plan year from which reimbursement is requested and while the participant was covered under the plan). Again, proof of payment is required.