What Is a Health Savings Account?

A Health Savings Account (HSA) is a tax-advantaged savings account designed to help individuals and families save for and pay for qualified medical expenses. HSAs provide a way to save pre-tax dollars, grow investments tax-free, and receive tax-free distributions for eligible medical costs.

This article will delve into the details of health savings accounts, their benefits, eligibility, and the process of opening and managing an HSA.

man visiting doctor

How Health Savings Accounts Work


Health Savings Accounts have annual contribution limits set by the Internal Revenue Service (IRS). For 2023, the limits are $3,650 for self-only coverage and $7,300 for family coverage. Account holders aged 55 or older can make an additional catch-up contribution of $1,000 per year.

Tax Advantages

HSAs offer a triple tax advantage:

  • Contributions are tax-deductible, reducing your taxable income.
  • The growth of your investments within the HSA is tax-free.
  • Withdrawals for qualified medical expenses are tax-free, reducing your overall health care costs.

Qualified Medical Expenses

Qualified medical expenses are those that are primarily used to alleviate or prevent a physical or mental defect or illness. Examples of eligible expenses include:

  • Doctor visits and copays
  • Prescription medications
  • Dental and vision care
  • Mental health services

Non-qualified medical expenses, such as cosmetic procedures and gym memberships, are not eligible for tax-free HSA distributions.

Account Ownership

HSAs are individually owned, meaning you control the account even if you change jobs or health plans. This portability ensures that you can continue to use and grow your HSA throughout your life.

Eligibility for Health Savings Accounts

To be eligible for a health savings account, you must meet the following requirements:

  1. Be enrolled in a high-deductible health plan (HDHP) with a minimum deductible of $1,400 for self-only coverage or $2,800 for family coverage.
  2. Have no other health coverage, including Medicare or other tax-favored health plans.
  3. Not be claimed as a dependent on someone else’s tax return.

How to Open a Health Savings Account

Researching HSA Providers

There are various types of HSA providers, including banks, credit unions, insurance companies, and specialty HSA providers. When selecting a provider, consider factors such as fees, investment options, and customer service.

Comparing HSA Providers

Before opening an HSA, compare the offerings of different providers to find the best fit for your needs. Consider:

  • Fees: Some providers may charge monthly maintenance fees, transaction fees, or investment fees.
  • Investment options: Some providers offer a range of investment options, including mutual funds and individual stocks.
  • Customer service: Look for a provider with a strong track record of customer satisfaction and responsive support.
  • Account features: Features such as online access, mobile apps, and debit cards can make managing your HSA more convenient.

Opening an HSA

To open a health savings account, you’ll need to provide personal information, including your Social Security number and proof of HDHP coverage. You may also need to make an initial deposit and designate a beneficiary for your account.

Contributing to an HSA

You can contribute to your HSA through direct contributions, payroll deductions, or transfers from another HSA or IRA. Payroll deductions allow you to save pre-tax dollars, maximizing your tax savings.

Managing Your Health Savings Account

Tracking Contributions

Keep track of your HSA contributions to ensure you stay within the annual contribution limits set by the IRS.

Recordkeeping for Tax Purposes

Maintain records of your HSA contributions and qualified medical expenses to support your tax deductions and tax-free distributions. This documentation will help you avoid potential issues with the IRS.

Investing HSA Funds

Investing your HSA funds can help your account grow faster, increasing your ability to cover future medical expenses. Many HSA providers offer a range of investment options, including mutual funds, stocks, and bonds.

Keeping Track of Medical Expenses

Monitor your medical and dental expenses throughout the year to determine when it makes sense to use your HSA funds. You can also save receipts for other qualified medical expenses not covered by your insurance plan.

When to Use HSA Funds

Using HSA funds to pay for qualified expenses can help reduce your out-of-pocket costs. However, consider whether it might be more beneficial to let your account grow tax-free and cover current expenses through other means.

HSA Rollovers and Transfers

Rollover Rules

You can roll over funds from one HSA to another once every 12 months without incurring tax penalties. Rollovers must be completed within 60 days to avoid taxation.

Transfer Rules

Transfers between HSAs can occur more frequently than rollovers and do not have the same 60-day requirement.

Reasons for Rollovers and Transfers

You may choose to roll over or transfer funds between HSAs to take advantage of better investment options, lower fees, or improved customer service.

Health Savings Accounts and Retirement

Using HSA Funds for Retirement

HSAs can be a valuable tool for retirement planning. After age 65, you can use HSA funds to pay for non-medical expenses without incurring a penalty, although you will have to pay income tax on these withdrawals.

Withdrawal Penalties and Taxes

Before age 65, non-qualified withdrawals are subject to a 20% penalty and income tax. After age 65, the penalty is waived, but you’ll still need to pay income tax on non-medical withdrawals.

HSA and Medicare

Once you enroll in Medicare, you can no longer contribute to an HSA. However, you can still use your funds to pay for qualified medical expenses, including Medicare premiums and out-of-pocket expenses.


Health Savings Accounts offer significant tax advantages, helping individuals and families save pre-tax dollars and receive tax-free distributions for qualified medical expenses. To maximize the benefits of an HSA, research providers, compare fees and investment options, and consult with a tax advisor or registered investment adviser.

By taking these steps, you can make informed decisions about your health coverage and better prepare for future medical and dental expenses.

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