Orthodonia and FSA questions

[SleepyatDVC]

Thanks for any help navigating this maze.

Will be paying all orthodontic work OOP. However, will be able to contribute the max (which is currently $3,541.37 annually) to a FSA account at work.

Quotes from different Orthodontists are all around $6400-$6500 so far for DD12. Treatment will take approximately 1 year or so.

No rush to start the work. All the Orthodontists say DD12 can wait up to a year or so because her teeth aren't too bad. It is recommended that the work be completed before HS (she's in 7th grade) but only because the child will be more comfortable because that is the "norm" of when most kids get them off. I guess if we go with the Invisalign option, we can wait longer?

DD10 is being monitored and won't know how her teeth will be until all her baby teeth fall out in a few years. Bottom line - neither kid has awful teeth - short, straight forward treatment - NOT 100% needed because of problems - mostly cosmetic because of crooked teeth and slight crowding and tiny over/under bite.

So, I have time to fund our FSA account and time the treatment and payments correctly IF we decide to get DD12 into braces.

FSA plan year is 6/1 to 5/31 and the max is $3,541.37 annually.

We have about $1100 left this year (6/1/11-5/31/12). We can start treatment anytime including summer of 2012. I do use the FSA for doctor and dental co-pays but may scramble to use it all by 5/31/12 - extra dental cleanings, etc. I will find a way to use it all but won't have to if I spend some towards the orthodontia care. Preliminary x-rays, etc. are part of the $6400+ quote but are billed first and separately in the beginning (around $300ish) once we give the go ahead for treatment ( I think) so maybe I can schedule that before 5/31/12 to get the expense into this FSA year.

After that, my brain is having a hard time figuring out the best way to structure the payments to maximize using the FSA. I know that the different payment plans are pretty flexible (one time pmt in advance with 4% discount, monthly installments, etc.) but I haven't made any decisions yet. I'm thinking the one time payment won't work because of the annual caps of around $3500. But if I start treatment sometime in 6/1/12-5/31/13 and end treatment in 6/1/13-5/31/14, I can use 2 years worth of FSA caps?

Let's hope DD10 won't need braces until well after 5/31/14! Lol.

Tell me how you paid for braces with FSA funds successfully!

Below is a cut and paste from our FSA FAQ about long-term treatment reimbursements. Not that informative.

I'm in my planning stage to see how to make this work and then I will call to see how the dental office can work with me. But I wanted to see how others worked out the payment plans and using a FSA account.


Submitting Long-Term Expenses

Some healthcare services, such as orthodontia, are provided over an extended period of time. As a result, it can be difficult to determine how these expenses should be claimed for reimbursement. In most cases, you will either pay these items in full at the beginning of the treatment period or you will pay in designated installment amounts (monthly, weekly, quarterly).



You should submit your claims for long-term services based on your method of payment as outlined below. Be sure to include the Supporting Documentation Form for orthodontia expenses.



· Installments – You should submit these claims each time an installment payment is made. Your claim date will be the payment date shown on your receipt. Be sure the receipt also indicates the type of service.

· In Full – If you pay for the entire treatment in advance, submit the contract with the plan of treatment and the receipt for the amount paid. Note: When paying a long-term service in advance, the entire payment amount will be deducted from your current plan year balance, even if the treatment is spread over multiple years.

 

[tlbwriter]

Have you talked to your orthodontist's business office about this? They might be able to help. A friend of mine got braces as an adult and they had worked with patients using FSA and knew exactly how to time things (well, as "exact" as such things can be).

 

[aprilgail2]

I worked it out so my daughter got braces in Jan- I made one payment in Jan of half the braces amount and then one payment the following Jan for the balance. My flex account comes with a visa debit type card so I just paid with that the two januarys. Worked out great!

 

[drinkme]

Here's how I did it with our FSA for dd12's braces:

She got them in Jan 2011. Our cost after insurance is $4750. I put $1000 down from our FSA. Our FSA runs June 1 to May 31. On June 1, I started with a monthly payment. I believe it is $137 a month. It is taken out of our FSA every month. DD will get her braces off in August 2012. I will probably just pay it off with the FSA on June 2012.

DS11 gets his braces in June 2012. So, this will start all over.

 

[SleepyatDVC]

Thanks for all the advice and experiences. It helped. And yes, I will work it out with the office once we make the decision of which one and when to start.

I'm leaning towards one office. I still have one orthodontic consultation scheduled coming up. The one coming up is the one with the closest office to us which was the attraction and I think most people in the town send their kids there.

However, it was the hardest one to get an appointment with and they are upfront about the fact that their afternoon and holiday slots are booked months and months in advance, so most people have to take their kids out of school for a few hours in the morning and take them back afterwards. It is literally down the road and around the corner from school. I want to say 2 miles?

I currently have a consult scheduled DURING a school day (I scheduled it DURING the summer) that I'm going to cancel it and just see what non-school day/afternoon they can fit us in even if it is next YEAR.

The orthodontic office I really liked is actually the farthest away in the next town but I timed it and it was only a 17 minute drive from my house. It might be a few minutes farther from the school or with some traffic. But they were soooooo patient with me and the facilities were top notch and they seemed really flexible with scheduling. They literally opened the office on a Saturday morning with a pretty big skeleton staff (dentist, office manager, 2 receptionists, a lab tech, and someone in the cleaning staff) just to do consultations.

And they open late at least one day a week and were already able to schedule us in one of those late appointments for a few months down the road for a follow-up consultation to check on DD12 remaining baby tooth before I approve the procedure and sign any contracts (I assume on that date).

I'll probably go over the payment schedule and working it with my FSA funding at that time. All the offices we visited gave us the "standard" payment plans and pre-payment discount options and knew that I was waiting to fund our FSA before starting work. But no one got into "specifics" because we were still shopping around.

Unless this last consultation (assuming I can get in an appointment) changes my mind, we are probably going to go with the office in the next town. At which time I'll discuss the payment schedule with the office manager.

I'm thinking I'll probably charge all the x-ray and preliminary work to this year's FSA balance and maybe some extra (partial down payment ) just to use up the remaining balance in the FSA, then monthly payments of about $295 in 6/1/12-5/31/13, then larger monthly payments in 6/1/13-5/31/14 or a lump sum when the braces come out during that FSA period. Sound reasonable? Have to know what to ask for when I try to work out the schedule with the office manager.

Thanks again all.

 

[Straitlover]

This is how I did mine:

I had insurance that paid 50% up to $500 per year, $1,500 max lifetime. My flex plan runs Jan-Dec, as does my insurance. My contract was for 16 months. I did my x-rays and prelim work and had the braces put on in December. I had tgo pay for the xrays/prelim stuff in December separate from the contract, plus I paid my contract down payment. I started my contract payments in January and made 16 payments through May of the following year. That way, I hit three different years and my insurance paid almost all of the $1,500 max (my Dec bills were not quite $1,000, so it didn't pay the whole $500 for that year).

Everything that the ins did not pay, I ran through my flex (FSA) for the tax savings. So for my braces that cost approx $5,800, I paid only around $3,400 OOP.

 

[mjkacmom]

Lucky me, I have 2 in braces, 1 in an expander, 2 waiting for their baby teeth to fall out, so we can put braces on them. We put $5000 in the account (our max), and never have to worry about not using it all, with monthly payments (not to mention other medical bills). Aren't we lucky?!