Navigating HSA and FSA payments in your membership-based dental practice
As the new year rolls in, dental practices often see a wave of patients eager to make the most of their refreshed benefits, including Health Savings Accounts (HSAs) and Flexible Spending Arrangements (FSAs). However, many of these patients will have questions about how their programs apply to their dental care expenses — including your dental membership plan.
Understanding these payment options and how they apply to your practice’s specific model will help your team provide the best patient experience and ensure you’re able to collect the appropriate membership fees.
How do HSA and FSA payments work in the dental field?
HSAs and FSAs are accounts that allow patients to set aside pre-tax dollars for healthcare expenses, including dental care. However, the rules about what qualifies as a covered expense can vary depending on the specific program. Participants are permitted to use HSA and FSA funds to pay for qualified medical expenses (or QMEs).(See IRS Publication 502 for details on includible qualified medical and dental expenses for HSA and FSA purposes.)
Generally, QMEs are the cost of health care, including payments for medical and dental services (i.e., diagnosis, treatment, mitigation, and preventive care), as well as equipment and supplies. While direct payments for treatments like cleanings, fillings, and x-rays clearly qualify, some dental services and expenses (including purely cosmetic services like whitening) may not be covered.
Can patients pay for their dental membership plan with HSA or FSA funds?
The short answer: it depends.
Does your membership plan platform support HSA/FSA payments?
While it’s important to make sure your membership plan platform supports HSA and FSA payments, it actually isn’t determinative as to whether patients can use these funds for membership plan payments. The real deciding factor lies in the specifics of the patient’s HSA or FSA program.
Are fees for a dental membership plan considered a QME?
What is considered a QME may vary based on each HSA/FSA administrator’s determination or policy. This includes dental membership plans.
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Some administrators may specifically exclude fees for dental membership plans and similar arrangements (e.g., discount plans, concierge medicine, etc.) from their list of covered expenses.
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Others may not address membership plans at all, leaving room for interpretation.
If the patient would like to use their HSA or FSA card for their dental membership plan, your team should encourage them to check their specific program’s rules. Ultimately, some HSA or FSA plans may allow membership plan payments to go through, while others may not.
If the patient does use these funds, they may need to keep a receipt as documentation. With a membership platform like Kleer and Membersy, members can easily access their receipt from the Patient Portal, without relying on your team to provide it.
Membership plan fees vs. payments for services
Keep in mind that this guidance only applies to the fee for the membership plan itself. When the patient is paying your practice directly for dental treatment — even if they receive a discount as a result of their membership — that is separate and may be considered a QME.
By guiding patients to review their plan details and remaining transparent about these distinctions, your practice can help patients make informed decisions.
Lean on the experts to find success through a dental membership plan
Building a membership-based practice can transform your dental office, providing consistent revenue and enhancing patient loyalty. But, you don’t need to be an expert in membership plans to find success. By relying on an experienced partner like Kleer and Membersy, you’ll gain 20+ years of combined experience to navigate every facet of membership — from compliance to renewal payments, and everything in between.
If you’re ready to make your membership plan a part of your practice’s growth strategy, connect with our team today.
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