Financial Education Series

Health Savings Accounts

The Triple Tax-Advantaged Healthcare & Retirement Tool

Health Savings Accounts (HSAs) offer a unique combination of tax benefits not found in any other financial account. Beyond helping with current medical expenses, HSAs can be a powerful tool for long-term financial planning and retirement preparation, providing substantial tax advantages along the way.

Why This Matters

Healthcare costs are among the largest expenses in retirement, with estimates suggesting couples may need $300,000 or more just for medical expenses. HSAs provide unparalleled tax efficiency for funding these costs, allowing you to set aside pre-tax dollars, grow investments tax-free, and withdraw funds tax-free for qualified medical expenses.

HSA Basics

What Is an HSA?

Definition

A tax-advantaged savings account specifically designed for medical expenses. Unlike Flexible Spending Accounts (FSAs), HSA funds roll over year to year and remain yours even if you change employers or health insurance plans.

Eligibility Requirements

To open and contribute to an HSA, you must:

Be enrolled in a High-Deductible Health Plan (HDHP)
Have no other health coverage (with some exceptions)
Not be enrolled in Medicare
Not be claimed as a dependent on someone else's tax return
High-Deductible Health Plan (HDHP)

For 2024, an HDHP is defined as having:

Minimum annual deductible: $1,600 (individual) / $3,200 (family)
Maximum out-of-pocket expenses: $8,050 (individual) / $16,100 (family)

Note: These limits are adjusted annually for inflation.

Triple Tax Advantage

1. Tax-Deductible Contributions

Contributions to your HSA are tax-deductible, reducing your taxable income for the year. If contributed through payroll deduction, they're also exempt from FICA taxes (7.65%).

2. Tax-Free Growth

Interest, dividends, and capital gains within your HSA accumulate tax-free. Unlike 401(k)s or traditional IRAs, there are no required minimum distributions (RMDs).

3. Tax-Free Withdrawals

Distributions used for qualified medical expenses are completely tax-free. After age 65, you can also withdraw funds for non-medical purposes by paying only ordinary income tax (no penalty).

Comparison: 401(k)s and traditional IRAs offer tax-deductible contributions and tax-deferred growth, but withdrawals are taxed. Roth IRAs provide tax-free withdrawals and growth, but contributions are made with after-tax dollars. Only HSAs offer all three tax advantages.

Contribution and Usage Rules

Key Guidelines

Contribution Limits

For 2024, the annual HSA contribution limits are:

$4,150 for individual coverage
$8,300 for family coverage
Additional $1,000 catch-up contribution if age 55 or older

Note: These limits apply to total contributions from all sources (you, your employer, and others).

Qualified Medical Expenses

You can withdraw tax-free for a wide range of healthcare expenses, including:

Deductibles and copayments
Prescription medications
Dental and vision care
Certain over-the-counter items
Mental health services
Long-term care premiums

See IRS Publication 502 for a complete list of qualified medical expenses.

Penalties and Non-Qualified Withdrawals

Using HSA funds for non-medical expenses has these consequences:

Before age 65: Subject to income tax plus a 20% penalty
Age 65 and beyond: Subject only to regular income tax (no penalty)

The 20% penalty is waived in case of death, disability, or when you reach age 65.

HSA Investment Strategies

Maximizing Long-Term Growth

The Investment Approach

Rather than using HSA funds for current healthcare expenses, consider paying those costs out-of-pocket while investing your HSA balance for long-term growth. This strategy maximizes the potential of the triple tax advantage.

Investment Options

Many HSA providers offer investment options similar to 401(k)s, including:

Index funds and ETFs
Target-date funds
Mutual funds
Cash Reserve Strategy

Consider keeping a portion of your HSA in cash for near-term medical expenses while investing the rest for long-term growth. This balances liquidity needs with growth potential.

The HSA as a Retirement Tool

Retirement Planning Potential

An HSA can function as a supplemental retirement account, offering more flexibility than a 401(k) or IRA for healthcare expenses while providing similar tax benefits for non-medical withdrawals after age 65.

Reimbursement Strategy

Save medical receipts for expenses you pay out-of-pocket. You can reimburse yourself from your HSA at any point in the future — even years later — allowing your HSA investments to grow tax-free in the meantime.

Contribution Priority

For many investors, an optimal contribution strategy might be:

1. Capture employer 401(k) match
2. Max out HSA contributions
3. Then contribute more to 401(k) or IRA

Tips for Choosing an HSA Provider

Selection Criteria

Key Features to Evaluate:
Fee structure (monthly maintenance, investment fees)
Investment options and quality
Minimum balance required to invest
User interface and mobile app quality
Customer service reputation
Account Access Options:
Debit card for direct payments
Online bill payment features
Reimbursement process efficiency
Receipt tracking and storage
Integration with expense management tools

This content is educational in nature and updated as of 2024. HSA rules, contribution limits, and tax treatments may change. The information provided is not tax, legal, or accounting advice. Please consult with a qualified professional regarding your specific situation.