Yes, you can offset the health insurance refund of $118.99 against a portion of the $600 you paid in 2018, for your son's orthodontic charges, as long as your son is your dependent.
If you received the health insurance refund in 2020, you may use it for any IRS approved medical and dental expenses that you paid with out of pocket monies, in 2020. See IRS Publication 502 Medical and Dental Expenses.
Another option is to put the money back into your Health Savings Account (HSA). You'll need to contact your HSA administrator and inform them that this is a return of a previous withdrawal. Simply depositing the money into your HSA may be considered a new HSA tax deductible contribution. For additional information see IRS Publication 969 Health Savings Accounts & Other Tax-Favored Health Plans.
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