How to Use Your HSA or FSA for Dental and Vision Expenses

Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) are two of the most effective tools for paying dental and vision expenses with tax-free dollars. Yet many people do not take full advantage of these accounts because they are unsure which expenses qualify or how the accounts differ.

According to IRS Publication 502, a wide range of dental and vision costs count as eligible medical expenses. By understanding what is covered and planning your contributions wisely, you can save hundreds or even thousands of dollars in taxes each year. This guide covers everything you need to know about using your HSA or FSA for dental and vision care in 2026.

HSA vs. FSA: Understanding the Basics

Before diving into specific dental and vision expenses, it helps to understand how these two accounts work and how they differ. Both allow you to set aside pre-tax money for medical costs, but the rules and benefits are not the same.

A Health Savings Account (HSA) is available to individuals enrolled in a high-deductible health plan (HDHP). You own the account, and any money you contribute stays in the account until you spend it, even if you change jobs or retire. HSAs offer what is often called a triple tax advantage: contributions are tax-deductible, the money grows tax-free through interest or investments, and withdrawals for qualified medical expenses are not taxed.

A Flexible Spending Account (FSA) is offered through your employer. You elect a contribution amount at the start of the plan year, and that money is deducted from your paycheck before taxes. The key difference is that FSAs generally follow a use-it-or-lose-it rule. Any unspent funds at the end of the plan year may be forfeited, although some employers offer a grace period or limited carryover.

Here is a quick comparison of the two accounts:

• Ownership: You own an HSA. An FSA is tied to your employer.
• Rollover: HSA funds roll over indefinitely. FSA funds generally do not (limited carryover of up to $660 may apply).
• Eligibility: HSAs require a high-deductible health plan. FSAs are available with most employer health plans.
• Investment: HSA funds can be invested and grow tax-free. FSA funds cannot be invested.

2026 Contribution Limits

Both HSAs and FSAs have annual contribution limits set by the IRS. Knowing these limits helps you plan how much to set aside for dental and vision expenses each year.

HSA contribution limits for 2026:

• Individual coverage: $4,300
• Family coverage: $8,550
• Catch-up contribution (age 55 and older): Additional $1,000 per year

FSA contribution limit for 2026: The maximum employee contribution to a health care FSA is $3,300 per year. Your employer may set a lower limit. Unlike HSAs, there is no catch-up contribution for FSAs.

These limits are adjusted annually for inflation. If your employer also contributes to your HSA, the total of your contributions and your employer's contributions cannot exceed the annual limit.

Eligible Dental Expenses for HSA and FSA

The IRS defines eligible medical expenses in Publication 502. A wide range of dental services qualify, including both preventive and restorative care. Here are the dental expenses you can typically pay for with your HSA or FSA:

• Routine dental exams and cleanings
• Dental X-rays
• Fillings, crowns, and bridges
• Root canals and tooth extractions
• Dental implants
• Dentures and partial dentures
• Braces and orthodontic treatment
• Dental sealants and fluoride treatments
• Periodontal (gum) treatment
• Dental anesthesia

If you have dental insurance, you can still use your HSA or FSA to pay for out-of-pocket costs like deductibles, copays, and coinsurance. This is especially valuable for major procedures that insurance only partially covers. For more information on dental costs, see our guide on how much dental insurance costs.

Eligible Vision Expenses for HSA and FSA

Vision care is another area where HSA and FSA funds can make a real difference. Many common vision expenses are considered eligible medical expenses by the IRS:

• Eye exams (including contact lens fittings)
• Prescription eyeglasses (frames and lenses)
• Prescription sunglasses
• Prescription contact lenses and contact lens solution
• Reading glasses (including over-the-counter)
• LASIK and other corrective eye surgery
• Glaucoma and cataract treatment
• Anti-glare and progressive lens coatings (when part of a prescription)

Combining your vision insurance benefits with HSA or FSA funds is one of the best ways to reduce your total spending on eye care. You can learn more strategies in our guide on how to maximize your vision insurance for glasses and contacts.

What Is Not Eligible for HSA or FSA

Not every dental or vision expense qualifies. The IRS excludes items that are primarily cosmetic or not medically necessary. Knowing what is not eligible helps you avoid mistakes that could result in taxes and penalties. Here are some common ineligible expenses:

• Teeth whitening: Considered a cosmetic procedure and not eligible for reimbursement.
• Cosmetic veneers: Veneers placed solely for appearance are not eligible, although veneers for a damaged tooth may qualify.
• Non-prescription sunglasses: Regular sunglasses without a prescription are not eligible.
• Dental insurance premiums (with FSA): You generally cannot use FSA funds to pay insurance premiums. HSAs have a similar restriction, with limited exceptions like COBRA premiums.
• Cosmetic surgery: Any procedure that does not treat a medical condition or correct a deformity is considered cosmetic and ineligible.

If you use HSA or FSA funds for a non-eligible expense, the amount may be treated as taxable income. For HSAs, there is also an additional 20% penalty if you are under age 65. Keeping receipts and documentation is important in case of an IRS audit.

The HSA Triple Tax Advantage for Dental and Vision

HSAs are widely considered the most tax-efficient savings tool available because of their triple tax advantage. Understanding how this works can help you see why an HSA is especially powerful for managing dental and vision costs over time.

1. Tax-deductible contributions: The money you put into your HSA reduces your taxable income for the year. If you contribute through payroll deductions, you also avoid FICA taxes (Social Security and Medicare taxes) on those contributions.
2. Tax-free growth: Any interest or investment gains in your HSA are not taxed. Over time, this can significantly increase your account balance if you invest your HSA funds.
3. Tax-free withdrawals: When you use HSA funds to pay for eligible dental and vision expenses, you pay no taxes on the withdrawal. This means the money is never taxed at any stage.

For example, if you are in the 22% federal tax bracket and contribute $4,300 to your HSA in 2026, you could save approximately $946 in federal income taxes alone, plus additional savings on state taxes in most states. Using those funds for dental cleanings, a new pair of glasses, or even LASIK surgery means you are paying for those expenses with pre-tax dollars.

FSA Use-It-or-Lose-It Rule and How to Plan Around It

The biggest drawback of FSAs compared to HSAs is the use-it-or-lose-it provision. If you do not spend all of your FSA funds by the end of the plan year (or grace period), you may lose the remaining balance. This makes careful planning essential.

Your employer may offer one of two accommodations, but not both:

• Grace period: An extension of up to 2.5 months after the plan year ends to use remaining funds.
• Carryover: The ability to roll over up to $660 of unused funds into the next plan year.

To avoid losing money, review your FSA balance in the fall and plan any remaining dental or vision purchases accordingly. If you have funds left over toward the end of the year, consider scheduling a dental cleaning, ordering a backup pair of glasses, or purchasing a year's supply of contact lenses.

Strategies for Maximizing Your HSA or FSA

With some planning, you can get the most value from your HSA or FSA for dental and vision expenses. Here are some practical strategies:

• Estimate your annual dental and vision costs: Review your past expenses to decide how much to contribute. Include expected cleanings, exams, glasses, contacts, and any planned procedures.
• Coordinate with insurance: Use your dental or vision insurance first, then pay any remaining out-of-pocket costs with your HSA or FSA. This stretches both benefits further.
• Time major procedures wisely: If you know you will need a major dental procedure or LASIK, consider building up your HSA balance in advance. Since HSA funds roll over, you can save for a year or two before the procedure.
• Use FSA funds before year-end: Schedule dental cleanings, buy new glasses, or stock up on contacts before your FSA plan year ends. This prevents you from forfeiting unused funds.
• Consider a limited-purpose FSA with your HSA: If your employer offers a limited-purpose FSA, you can use it exclusively for dental and vision expenses while reserving your HSA for other medical costs or long-term growth.
• Invest your HSA for the long term: If you can afford to pay for dental and vision expenses out of pocket now, consider letting your HSA grow through investments. You can reimburse yourself later from the HSA for expenses you paid out of pocket, as long as you keep receipts. There is no time limit on HSA reimbursements.
• Take advantage of the catch-up contribution: If you are 55 or older and have an HSA, you can contribute an extra $1,000 per year. This is helpful as dental and vision needs tend to increase with age.

The Bottom Line

HSAs and FSAs are valuable tools for managing dental and vision expenses with tax-free dollars. Most routine and necessary dental and vision services qualify, including cleanings, fillings, crowns, eye exams, glasses, contacts, and corrective surgery like LASIK. Cosmetic procedures and non-prescription items generally do not qualify.

For 2026, HSA contribution limits are $4,300 for individuals and $8,550 for families, with an additional $1,000 catch-up for those 55 and older. The FSA limit is $3,300. By estimating your expected costs, coordinating with your insurance, and timing your purchases strategically, you can make the most of these accounts.

If you have an HSA, take advantage of the triple tax benefit and the ability to roll over funds year after year. If you have an FSA, plan your spending carefully to avoid leaving money on the table. Either way, these accounts can significantly reduce what you pay for dental and vision care.

This article is for educational purposes and does not constitute tax or financial advice. Consult a tax professional for advice specific to your situation. Plans, limits, and eligible expenses may change. Check IRS.gov for the most current information.