What Are the Pros and Cons of a Health Savings Account (HSA)?

A well being financial savings account (HSA) is actually a private financial savings account that can be utilized just for medical bills. To be eligible, you have to be enrolled in a high-deductible well being plan (HDHP). HSAs have substantial tax benefits, a lot in order that some use them as retirement plans, alongside their 401(ok) or IRA accounts.

Contributions to an HSA are made with pretax {dollars}. Which means that you received’t pay earnings tax on the cash that you simply put instantly into your HSA and you will save on earnings taxes for the 12 months.

However, the cash that you simply put into your HSA is pricey to entry as soon as it’s already within the account if it isn’t used correctly. You’ll owe earnings taxes plus a 20% penalty when you withdraw funds out of your HSA for non-qualified bills earlier than you flip age 65.


Key Takeaways

  • The well being financial savings account (HSA) helps folks with high-deductible medical health insurance plans cowl their out-of-pocket medical prices.
  • Contributions to HSAs aren’t topic to federal earnings tax, and the earnings within the account develop tax-free.
  • Unspent cash in an HSA rolls over on the finish of the 12 months, so it’s accessible for future well being bills. That is in contrast to versatile spending accounts (FSAs), that are “use it or lose it.”
  • You’ll owe earnings taxes plus a 20% penalty when you withdraw funds out of your HSA for non-qualified bills earlier than you flip age 65. When you’re 65, you’ll owe taxes however not the penalty.
  • Excessive-deductible well being plans (HDHPs), that are a requirement for HSAs, aren’t at all times the most suitable choice for shoppers, particularly for individuals who have important healthcare bills.

Professionals And Cons Of A Well being Financial savings Account

Understanding Well being Financial savings Accounts (HSAs)

An HSA is a tax-exempt financial savings account that’s accessible solely to individuals who have high-deductible medical health insurance plans. The cash can be utilized solely to pay for certified medical bills. If the cash is spent for every other function, the account holder has to pay earnings tax on the withdrawal plus a 20% tax penalty (until the particular person is age 65 or older, by which case the penalty is waived).

Who Is Eligible for an HSA?

Individuals with an HDHP can open an HSA. The 2 are normally paired collectively, so that you’ll be provided an HSA if you take out a qualifying plan.

You could additionally meet the eligibility requirements set out by the Inner Income Service (IRS). An eligible particular person is somebody who:

  • Has a professional HDHP
  • Has no different well being protection
  • Shouldn’t be enrolled in Medicare
  • Shouldn’t be claimed as a depending on another person’s tax return

Is It Price It to Have an HSA?

It may be price it for the tax benefits alone. The cash that you simply contribute to an HSA is tax-free, so that you decrease your tax invoice by routing cash that you should utilize for medical bills via such an account. Your employer received’t withhold earnings taxes on this cash.

On the draw back, an HSA is open solely to folks with HDHPs, and a high-deductible plan shouldn’t be for everybody. The monetary advantage of an HDHP’s decrease premium and better deductible construction relies on your private scenario. Typically, wholesome folks with no ongoing points that require common remedy could discover them sufficient.

Does HSA Cash Expire?

No. The cash you set in your HSA has no expiration date and can keep in your account endlessly. Which means that unspent cash in an HSA rolls over on the finish of the 12 months and stays accessible for future well being bills.

That is in contrast to versatile spending accounts (FSAs), which can be found to many via their employers however that are strictly “use it or lose it.”

What Can HSA Funds Be Used For?

Cash that you simply withdraw out of your HSA isn’t taxed so long as it’s used for a professional medical expense. The checklist of permitted bills is kind of lengthy and consists of deductibles, dental providers, imaginative and prescient care, prescribed drugs, co-pays, psychiatric therapies, and different certified medical bills not coated by a medical health insurance plan.

Insurance coverage premiums don’t rely as a professional medical expense with some exceptions: the premiums are for Medicare or different healthcare protection for folks 65 or older; for healthcare continuation protection (COBRA) whereas receiving unemployment compensation, or for long-term care insurance coverage, topic to yearly adjusted limits.

Premiums for Medicare supplemental or Medigap insurance policies will not be handled as certified medical bills.

In the event you use your HSA to pay for something apart from a professional medical expense, that quantity is topic to each earnings tax and a further 20% tax penalty until you’re age 65 or older. In that case, you simply must pay earnings tax on the quantity withdrawn.

Annual Contribution Limits

For 2021, the restrict is $3,600 for people and $7,200 for households plus a further $1,000 catch-up contribution for anybody age 55 or older by the tip of the tax 12 months.

For 2022, the restrict will rise to $3,650 for people and $7,300 for household protection—a couple of 1.4% improve. There isn’t any change within the catch-up contribution quantity for 2022.

For 2023, the contribution restrict is $3,850 for people and $7,750 for household protection.

Benefits of HSAs

Entry to an HSA is meant to take among the stress out of sudden well being prices. However these accounts produce other benefits.

Many Bills Qualify

Eligible bills embrace a variety of medical, dental, and psychological well being providers. They’re defined intimately in IRS Publication 502, Medical and Dental Bills.

Over-the-counter drugs and menstrual merchandise are actually certified HSA bills. It is a results of the CARES Act handed in 2020.

Others Can Contribute

Contributions can come from you, your employer, a relative, or anybody else who needs so as to add to your HSA.

Employers select whether or not or to not contribute. And, after all, it is not an element for a self-employed particular person funding an HSA.

Pretax Contributions

Contributions are made with pretax {dollars} via payroll deductions by your employer. In different phrases, your employer received’t withhold taxes on these {dollars}.

That implies that the cash shouldn’t be included in your gross earnings and isn’t topic to federal earnings taxes. In most states, contributions will not be topic to state earnings taxes.

Tax-Deductible After-Tax Contributions

In the event you make a contribution with after-tax {dollars}, you’ll be able to deduct the cash out of your gross earnings in your tax return, lowering your tax invoice for the 12 months. For instance, when you’re a person underneath the age of 55, your most allowed contribution in 2021 is $3,600, with a slight improve to $3,650 in 2022 and to $3,850 in 2023.

So, when you deposit solely $2,600 into your HSA via payroll deductions by the tip of 2022, you could select to deposit a further $1,050 to additional decrease your tax legal responsibility. You usually have till the IRS tax submitting deadline to contribute.

Tax-Free Withdrawals

Withdrawals out of your HSA will not be topic to federal (and most often, state) taxes when you use them for certified medical bills.

In the meantime, the stability in an HSA might be invested. You should purchase shares, bonds, and different varieties of property to spice up your potential returns. Most monetary advisors will strongly counsel conservative investments reminiscent of U.S. Treasury bonds. This account is, initially, a nest egg for sudden medical bills.

Tax-Free Earnings

Any curiosity or different earnings on the cash within the account is tax free. Most HSAs earn a minimal quantity of curiosity, lower than 0.1%.

Annual Rollover

When you have cash left in your HSA on the finish of the 12 months, it rolls over to the following 12 months.

It is a large benefit over FSAs, which usually can solely be carried over in an quantity as much as $550 or 2½ months into the next plan 12 months.


The cash in your HSA stays accessible for future certified medical bills even when you change medical health insurance plans, go away for a unique employer, or retire.

Primarily, your HSA is a checking account in your title, and also you resolve how and when to make use of the funds.

HDHPs are required to set a minimal deductible and a most for out-of-pocket prices.

  • In 2022, the minimal deductible is $1,400 for a person and $2,800 for a household. The utmost for out-of-pocket prices is $7,050 for people and $14,100 for households.
  • In 2023, the deductible have to be no less than $1,500 for a person and $3,000 for a household whereas out-of-pocket prices are restricted to $7,500 for people and $15,000 for households.


Most HSAs concern a debit card so you’ll be able to pay for prescription drugs and different eligible bills. In the event you anticipate a invoice to come back within the mail, you’ll be able to name the billing middle and make a cost over the cellphone utilizing your HSA debit card. You can even reimburse your self out of an HSA when you’ve got paid a medical invoice with one other type of cost.

Disadvantages of HSAs

In the event you qualify for an HSA, there are some disadvantages to think about.

Excessive-Deductible Requirement

An HDHP, which you’re required to must qualify for an HSA, can put a higher monetary burden on you than different varieties of medical health insurance. Though you’ll pay much less in premiums every month, it may very well be troublesome—even with cash in an HSA—to give you the money to satisfy the deductible for a pricey medical process.

That is one thing to think about for anybody who is aware of they may have hefty medical payments in a selected plan 12 months.

The deductibles for HDHPs are sometimes considerably increased than the minimums required and might be as excessive as the utmost out-of-pocket prices allowed.

Stress to Save

Some folks could also be reluctant to hunt healthcare once they want it as a result of they don’t wish to spend the cash of their HSA accounts.

Taxes and Penalties

In the event you withdraw funds for non-qualified bills earlier than you flip age 65, you’ll owe earnings taxes on the cash plus a 20% penalty. When you’re 65, you’ll owe taxes however not the penalty.

This may be onerous on an individual who faces an sudden expense that’s something however medical. They’ve saved the cash however cannot entry it with out taking a monetary hit.


You could maintain receipts to show that your withdrawals have been used for certified well being bills. This shall be obligatory in case you are audited by the IRS.


Some HSAs cost a month-to-month upkeep charge or a per-transaction charge, which varies by establishment. Whereas usually not very excessive, the charges are virtually actually increased than any curiosity that the account could earn and reduce into your backside line.

Typically these charges are waived when you preserve a sure minimal stability.

What Is the Primary Good thing about a Well being Financial savings Account (HSA)?

Having a well being financial savings account alleviates among the stress of sudden and unpredictable medical bills. Higher but, the cash you save on this account is tax-free.

You possibly can declare a deduction in your tax return in your HSA contributions no matter whether or not or not you itemize deductions. You possibly can declare a tax deduction even when somebody apart from your employer makes a contribution to your HSA.

In case your employer contributes to your HSA, these contributions are excluded out of your gross earnings. This consists of contributions that you simply obtain by way of a cafeteria plan.

Withdrawals out of your HSA which can be used for medical bills will not be topic to taxation.

You don’t even pay taxes on the earnings and curiosity you obtain from the property you maintain in your HSA.

What Is the Primary Draw back of an HSA?

The primary draw back of an HSA is that you have to have a high-deductible medical health insurance plan to get one. A medical health insurance deductible is the amount of cash you have to pay out of pocket every year earlier than your insurance coverage plan advantages start.

You can be answerable for developing with the money to pay in your deductible earlier than your insurance coverage plan begins paying your healthcare prices. You’ll must pay for visits to the physician, medical procedures, and prescriptions till you fulfill your deductible.

In 2022, you’ll must pay a deductible of no less than $1,400 for a person and $2,800 for a household. The figures for 2023 are $1,500 and $3,000.

Some plans have increased deductibles, and also you’ll additionally must think about further prices reminiscent of co-pays.

In the event you anticipate needing to make use of your medical health insurance for costly procedures—reminiscent of remedy for a continual sickness or surgical procedure—you’ll must pay the prices till you fulfill your deductible.

In the event you would discover this financially troublesome, you would possibly wish to have a look at several types of healthcare plans that supply a decrease deductible. Meaning forgoing entry to an HSA.

What Are the Advantages of a Excessive-Deductible Insurance coverage Plan With an HSA?

The primary advantages of a high-deductible medical plan with an HSA are tax financial savings, the power to cowl some bills that your insurance coverage doesn’t, the power to have others contribute to your account, and the comfort of utilizing the account to pay for healthcare bills.

One other advantage of an HSA is the portability of the account. You roll over any funds left in your account on the finish of the 12 months to the next 12 months.

The cash is yours endlessly. You possibly can permit it to develop in your HSA. Some folks use their HSA as a part of their retirement planning technique.

How Can I Test the Stability on My HSA?

Most monetary establishments that present HSAs supply their prospects numerous methods to examine their account balances. These embrace:

  1. On-line entry. Your HSA supplier gives you entry to your account on-line, and you’ll log in simply as you’d for an internet financial institution or brokerage service. You’ll be capable of log in to view your account statements, stability, and transactions.
  2. Printed assertion. Some folks choose to have a printed copy mailed to them. In the event you select this feature, your stability and up to date transactions shall be included in your assertion.
  3. Cellphone app. Test to see in case your HSA supplier gives an app that means that you can examine your account stability out of your cellphone.
  4. Customer support. Your HSA supplier may have a customer support quantity which you could name for help.

The Backside Line

For many who select high-deductible well being plans (HDHPs), an HSA has actual benefits. It may well offset your medical prices, scale back your taxes, and offer you a long-term tax-advantaged financial savings account.

However an HDHP is not the most suitable choice for everybody, and having one is the one approach to get entry to an HSA account.

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