Healthcare Benefits

Employee Benefits

Your Healthcare FSA and Orthodontia

It’s easy to use your WageWorks® Healthcare Flexible Spending Account (FSA) to pay for eligible orthodontia expenses for you, your spouse, and your eligible dependents. Eligible orthodontia expenses are those not paid by your dental insurance or any other insurance plan.

Convenient Payment Options

Simply find out in advance what portion of your orthodontia expenses your dental insurance plan covers. Then pay only your out-of-your pocket costs with your Healthcare FSA using one of several convenient payment options.  

Pay Your Orthodontist Directly

Pay your orthodontist directly from your Healthcare FSA using the convenient Pay My Provider feature of your WageWorks account. Make a single payment to your orthodontist, or set up recurring payments—it’s up to you. 

Monthly Payments

A recurring Pay My Provider payment is the easiest way to pay monthly orthodontia expenses. This option ensures your payments are spread out across multiple plan years so you can make the most of your insurance plan coverage. 

Setting up recurring monthly Pay My Provider payments through your WageWorks account is easy. Instructions are here. Please remember to set up payments up to 10 days before you want your first payment to be made to your orthodontist. 

You’ll need to submit a copy of your orthodontia service contract through your WageWorks account when you set up monthly recurring payments. Please make sure your contract includes: 

  1. The provider’s name
  2. The patient’s name
  3. A description of the service provided
  4. A payment schedule (including dates of service)
  5. The payment amount

One-Time Payments

Make a one-time Pay My Provider payment to your orthodontist through your WageWorks account is easy. Instructions are here. Please remember to set up your payment soon as your orthodontia service has started.

Your orthodontist will be paid as soon as you submit your payment documentation (usually a detailed receipt and an orthodontia service contract) and your documentation is verified.  

Pay Yourself Back for Payments You’ve Already Made

Get reimbursed for eligible orthodontia expenses you’ve paid out of pocket using the convenient Pay Me Back feature of your Healthcare FSA. 

If you paid a lump sum to your orthodontist in the prior calendar year and were reimbursed a prorated amount, you can be reimbursed for the unclaimed amount in the current plan year (if you are still receiving orthodontia services) by providing: 

  • A copy of the payment information;
  • A claim form; and

A letter indicating the amount you were reimbursed in the prior year 

Pay with Your WageWorks Healthcare Card

If you’re paying for eligible orthodontia expenses on the day you receive services, the easiest way to pay is with your WageWorks Healthcare Card. Just be sure to save the detailed receipt and payment contract provided by your orthodontist. In some cases the IRS may require you to verify your card transactions, submit a claim, and verify expenses.

If you use your card to pay for services received in the past, you most likely will have to provide additional card use verification. Avoid that hassle! If you’re paying bills you received after the service date, don’t use your card—use the Pay My Provider instead.   

Tips for Using Your Healthcare FSA to Pay for Orthodontia

Here are a few tips for getting the most out of your Healthcare FSA when it comes to orthodontia: 

  • Make sure your Healthcare FSA balance sufficient is to cover the amount of each orthodontia payment. WageWorks doesn’t issue partial payments, and insufficiently funded requests will be canceled.
  • Make one-time or recurring Pay My Provider payments for orthodontia services provided during the current plan year.
  • One-time Pay My Provider payments can be made once the service has begun, but not before.

Recurring Pay My Provider payments can be made 10 days prior to the beginning of the service date, but not before.

 

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