Newbie question: talk to me about flexible spending accounts and orthodontics

[Anonymous]

We'd like to use our FSA to cover the amount not covered by insurance. Have you done this for a medical/dental problem that spanned more than a year, as opposed to a one-time situation? Do they pay directly to the provider, or is a reimbursement to yourself thing? I'd love to just have the money go to the orthodontist.

[Anonymous]

We used our medical fsa to pay for our portion of DD's orthodontia not covered by insurance. The way our plan worked was we paid the orthodontist and then submitted the receipts to the fsa admin and we were reimbursed.

[Anonymous]

I have a FSA Master Card. I can use the card to pay for funds then submit receipts. For our ortho I just used the card.

[Anonymous]

I did it for braces in 2006. Not sure if the rules have changed as I heard you can no longer get Rx sunglasses and my braces we adult - cosmetic.

Anyway I got a cash discount for paying up front and submitting to insurance myself. I told them I wanted to use my HSA account. I had a consult in October and paid a large deposit in December. Braces went on in January and I paid the balance in February. My Ortho charged a flat fee for the job until it was done.

[Anonymous]

Anonymous wrote:I did it for braces in 2006. Not sure if the rules have changed as I heard you can no longer get Rx sunglasses and my braces we adult - cosmetic.

Anyway I got a cash discount for paying up front and submitting to insurance myself. I told them I wanted to use my HSA account. I had a consult in October and paid a large deposit in December. Braces went on in January and I paid the balance in February. My Ortho charged a flat fee for the job until it was done.

I paid, got checks back from HSA and a direct deposit for insurances portion.

[Anonymous]

Anonymous wrote:We'd like to use our FSA to cover the amount not covered by insurance. Have you done this for a medical/dental problem that spanned more than a year, as opposed to a one-time situation? Do they pay directly to the provider, or is a reimbursement to yourself thing? I'd love to just have the money go to the orthodontist.

In my experience, I had to pay first and then be reimbursed; the money didn't go directly to the provider. I did have an FSA Mastercard but it seemed like at least half the time, I was told that I would need to submit additional information for the claim to be accepted. So I got annoyed with the card and just went back to the old method of paying up front and getting reimbursed. It's pretty fast; they direct-deposit the money into my account.

As for medical bills spanning one year -- you can set aside $2,500 each year, and I think there is usually a 3 month grace period at the end (check with your plan administrator, though!!) So that gives you 15 months to spend that money. I wouldn't put more in the account than you expect to spend during that time period, because you'll lose it.

[Anonymous]

Anonymous wrote:I did it for braces in 2006. Not sure if the rules have changed as I heard you can no longer get Rx sunglasses and my braces we adult - cosmetic.

Anyway I got a cash discount for paying up front and submitting to insurance myself. I told them I wanted to use my HSA account. I had a consult in October and paid a large deposit in December. Braces went on in January and I paid the balance in February. My Ortho charged a flat fee for the job until it was done.

Off topic but you can still get Rx sunglasses via FSA. I just did it in April.

[Anonymous]

We just did this. We prepaid the entire amount (got a small discount that way) and were able to get $2500 back right away. FSA required proof of payment as well as a copy of the contract and treatment plan. I was very nervous about the process, but it went smoothly.

[Anonymous]

Anonymous wrote:We just did this. We prepaid the entire amount (got a small discount that way) and were able to get $2500 back right away. FSA required proof of payment as well as a copy of the contract and treatment plan. I was very nervous about the process, but it went smoothly.

That is one way to do it.
However, might not be the best from financial standpoint.
FSA covers up to max during the year of payment if all treatment paid in full in the beginning, or monthly fees over the time of treatment.
Ortho doctors offers both way too, with slight discount for lump-sum payment.
However, with lump-sum payment you can only pay $2.5K pretax, whereas with monthly payments - you can get up to 5K pretax (2*2.5K)
So, do the math carefully when planning ortho treatment and FSA contribution.