Health savings accounts (HSAs) are often easy to misunderstand and underutilize. Too often, people view and use them as their distant cousin, the flexible spending arrangement (FSA) for healthcare expenses. In reality, the HSA is a powerful and tax-efficient savings vehicle when used correctly. Allow me to clarify the differences between HSAs and FSAs — and provide you with tips for maximizing the value and use of your HSA.

Understanding the Differences Between HSAs and FSAs

HSAs and FSAs are both tax-advantaged accounts designed to help you save and spend for medical expenses. But key differences that impact their long-term value and usage.

Eligibility: To open an HSA, you must be enrolled in a qualifying high-deductible health plan (HDHP). FSAs, on the other hand, are available to anyone with an employer-sponsored healthcare plan, regardless of the plan’s deductible (assuming the employer also sponsors the FSA plan).

► Pro tip: A common hang-up is that you can only have an HSA if you’re enrolled in an HDHP. While this is true, many people equate “high-deductible” with “bad” or “risky,” which is not necessarily the case. In fact, HDHPs can be a smart choice for those who are generally healthy and do not require frequent medical care.  Even for high-utilization situations, HDHPs can still provide robust and more affordable coverage in comparison to things like copays and out-of-pocket maximums of non-HDHP alternatives. HDHPs come with lower premiums, allowing you to save money on a monthly basis. Of course, when you pair an HDHP with an HSA, you can unlock numerous financial advantages.

Contribution Limits: HSAs have higher annual contribution limits than FSAs. For 2023, HSA contribution limits are $3,850 for individuals and $7,750 for families. FSA limits, on the other hand, are $3,050 for individuals.

Carryover: Unused HSA funds carry over from year to year, allowing you to build up your savings over time. In contrast, FSAs operate on a “use it or lose it” basis, meaning you must spend your entire FSA balance each year … or forfeit the unspent funds.

Ownership and Portability: Individuals own HSAs, meaning you can take your HSA with you if you change jobs or retire. However, employers own FSAs, so you generally can’t transfer your FSA balance if you change employers.

Investment Options: If you have an HSA, you can often invest your funds in a variety of assets, such as stocks, bonds, or mutual funds. This allows your balance to grow tax-free over time. FSAs, on the other hand, do not offer investment options.

Tips for Maximizing the Value and Use of Your HSA

1. Prioritize HSA contributions.
To maximize the long-term value of your HSA, make it a priority to contribute the maximum amount allowed each year. By contributing the maximum, you can take full advantage of tax-deductible deposits, tax-free growth, and tax-free withdrawals for qualified medical expenses.

2. Invest your HSA funds.
You may wonder, “Should I invest my HSA funds?” Absolutely! Investing your HSA funds in a diversified portfolio can help you grow your account tax-free over time. By treating your HSA as a long-term investment account, you can potentially build a significant nest egg for future medical expenses or retirement.

Employer’s HSA bank doesn’t allow you to invest? You have other options! You can continue to contribute to your employer-sponsored HSA through payroll to avoid paying Medicare and Social Security taxes on these dollars. Once they’re available in your account, simply transfer them to an HSA account at a different custodian that allows you to invest HSA funds. This is especially great if your employer contributes to your HSA so you don’t miss out on “free HSA money”! Just keep in mind that you can have multiple HSAs but still have to stay at or under the maximum annual limit for all of your contributions combined.

3. Delay reimbursements.
Instead of using your HSA to cover immediate medical expenses, consider paying for them out of pocket and saving your receipts. This allows your HSA funds to continue growing tax-free while still giving you the option to reimburse yourself for past expenses at any time in the future.

4. Use your HSA for retirement planning.
Once you become eligible for Medicare (typically at age 65), you can use your HSA for non-medical expenses without incurring a penalty (though you’ll still pay taxes on non-medical withdrawals). This makes your HSA an effective tool for retirement planning, allowing you to save for future expenses and supplement your retirement income.

5. Optimize your HSA investment strategy.
As with any investment account, it’s important to periodically review and adjust your HSA investment strategy to ensure it aligns with your risk tolerance and financial goals. By staying proactive and optimizing your HSA investment strategy, you can help maximize the growth of your funds over time.

6. Utilize the one-time funding rollover opportunity from an IRA.
Another way to maximize the value of your HSA is to take advantage of the one-time funding rollover opportunity from an individual retirement arrangement (IRA) to your HSA. This single-use rollover allows you to transfer funds from your IRA to your HSA tax-free, up to the annual HSA contribution limit. This one-time rollover can help you boost your HSA balance and increase the funds available for tax-free growth and qualified medical expenses. Keep in mind that you can only make use of this rollover once in your lifetime, so it’s essential to carefully consider the timing and the amount you wish to transfer.

7. Plan for your family’s future.
You can also use your HSA to cover qualified medical expenses for your spouse and dependents — even if they’re not covered by your HDHP. This makes the HSA a powerful tool for protecting your family’s financial well-being. As you plan for your family’s future, consider incorporating your HSA into your overall financial strategy to ensure their medical needs are covered.

Take Action

Don’t let misconceptions about HDHPs or the limitations of FSAs hold you back from making the most of this powerful financial tool. Instead, as the name implies, embrace the saving opportunity an HSA represents.

By understanding the key advantages of an HSA and not using it like an FSA, you can unlock its full potential as a tax-efficient savings vehicle. With proper planning and management, your HSA can become an integral part of your financial plan, helping you save for medical expenses, retirement, and more — completely tax-free!