Does my Invisalign treatment qualify for HSA medical expense if it started before ?

[tsmalls]

I started orthodontic treatment 8/19/24 and made my 1st down payment for $1500. I received a interest free Auto pay plan for the rest of the cost of Invisalign ($4000) which is  where I pay $225 each month for 18 months. I didn't have a HSA at the time or the HDHP until 12/1/24. I already made contributions when I opened HSA towards the Dec monthly payment and distributed after for it which showed up on my tax form assuming it would be covered but now second guessing myself and don't want to end up paying penalties if audited. Are payments made for the treatment after Dec 1st eligible or should I stop contributing towards this?  I have the Autopay plan receipt paperwork that shows how much will be taken out each month. This is also getting charged to my credit card where I will reimburse myself. I use Fidelity HSA.

I wasn't eligible for HSA from my new job until Dec and didn't know much about how HSA's work until now. From my understanding orthodontic treatment is a qualified medical expense but maybe not in my situation since I started treatment before. 

[Vanessa A]

No.  You cannot use your HSA to pay for procedures or expenses that were incurred before the plan started.  Even though you are still making the payments, this does not count as the procedure was done prior to the plan. 

If you have additional procedures related to orthodontic treatment that occur while you have the plan in place, you can then use your HSA for that. 

[tsmalls]

The procedure is still ongoing and I’m paying for it each month so that’s why it seems like it would be eligible. Although I did start treatment and made initial payment before the HSA was established. So I haven’t filed taxes yet if I fill out the form and repay the funds will the IRS get an updated 1095 so they don’t think I filed wrong?

[Vanessa A]

If the procedure is ongoing, you can use the HSA for the parts of the treatment that happen AFTER the HSA was established. But the parts of the procedure that occurred BEFORE the plan was in place is not eligible to be covered. 

You would only be able to deduct it as the expense was incurred.  For example.  If you paid $1,500 in august for your first treatment and then $4,000 is the cost of the rest of the treatment, but you were 75% complete with the treatment BEFORE you started the HSA, then the $1,500 would not be eligible and neither would the $3,000 ($4,000 x 75%).  But, if you finished the remaining 25% of the treatment after the HSA was established, then that $1,000 remaining amount would be eligible to be covered by the HSA funds.  

It is all about timing of each procedure or visit.