Paying for Dental Work: HSAs, FSAs and Tax Deductions

Dental implants, dentures, crowns and most other dental treatment count as qualified medical expenses for HSAs and FSAs, and may be tax deductible if you itemize. Purely cosmetic work, such as teeth whitening, generally doesn’t qualify. This applies whether you have the treatment in the US or in Mexico. This is general information, not tax advice; check with a tax professional for your situation.

HSAs and FSAs

You can use a Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for qualified dental care tax-free. That generally includes:

• Dental implants and the crowns on them
• Dentures, partials and relines
• Crowns, bridges, root canals, fillings and extractions
• Orthodontic treatment for medical reasons

Teeth whitening is generally not eligible. Veneers are a gray area: if they repair damage they may qualify, but if they’re purely cosmetic they usually won’t. Ask your plan administrator.

For treatment abroad, keep itemized receipts in English showing the treatment, the date and the amount paid. Travel costs such as flights and hotels are generally not reimbursable from an FSA, though some lodging and transport for medical care can count toward the tax deduction under IRS rules.

The medical expense tax deduction

If you itemize deductions, you can deduct qualified medical and dental expenses that exceed 7.5% of your adjusted gross income (AGI). For example, with an AGI of $60,000, only expenses above $4,500 count. You can’t deduct anything you paid with tax-free HSA or FSA money or that insurance reimbursed.

IRS Publication 502 lists what counts. It includes dental treatment and artificial teeth, and excludes cosmetic procedures and medicines bought outside the US.

Dental insurance and foreign treatment

Some US dental plans reimburse part of the cost of treatment abroad at their out-of-network rate. Call your insurer before you go, ask for the rules in writing, and ask exactly what documentation they need.

Keep good records

• Itemized invoice with the clinic’s name, address and tax ID if available
• Treatment plan describing each procedure
• Proof of payment (card statement or receipt)
• Your X-rays and treatment notes

See our dental costs guide for typical prices in Mexico.