Here’s the best way to use a health savings account

Here’s the best way to use a health savings account

Health savings accounts could be a highly effective way to construct wealth and put together for medical prices in previous age — in the event that they’re used the proper way.

HSAs carry a three-pronged tax profit. Contributions and funding progress are tax-free, as are withdrawals if used for qualified health expenses.

Even when a withdrawal is not health-related, the account proprietor would solely owe earnings tax on these funds — in impact turning the HSA into an account with tax advantages akin to a conventional 401(okay) plan or particular person retirement account.

“I almost don’t think of them as health savings accounts, but profoundly tax-beneficial retirement accounts,” stated Andy Baxley, a Chicago-based licensed monetary planner at The Planning Middle.

Ideally suited use

The perfect way for savers to use HSAs is by contributing the annual most, investing the cash and paying for present-day health prices out of pocket by way of different savings, in accordance to monetary advisors.

This permits time for HSA cash to develop tax-free. HSA investments are like these in every other retirement account, with diversified inventory and bond mutual funds, for instance.

Most individuals do not make investments their HSA savings, nevertheless. They as an alternative use HSAs like a financial institution account and withdraw money as wanted to pay for present medical prices.

Simply 9% of accountholders had been investing a portion of their HSA stability in 2020, in accordance to the Worker Profit Analysis Institute. The rest — 91% — held their full balance in cash.

But this offers virtually no upside growth — a disadvantage when health costs in retirement are expected to be about $300,000 for the average couple who retired in 2021, according to a Fidelity Investments estimate.

The IRS outlines a broad number of qualifying HSA health prices, like these related to dental care, imaginative and prescient, listening to, long-term care insurance coverage premiums (topic to limits) and medicines, for instance.

HSA reimbursement

Savers who pay out of pocket now for health prices can reap the benefits of one other HSA profit in future years: They will withdraw account funds to pay themselves again (tax-free) for these earlier bills.

As with withdrawals from a Roth 401(okay) or IRA, these HSA reimbursements can supply retirement earnings and assist somebody management their tax invoice.

Say you are on the cusp of leaping into a larger income-tax bracket in retirement however had spent $10,000 out of pocket over the years on medical payments. You may withdraw that $10,000 out of your HSA for previous prices with out elevating your taxable earnings.

(One necessary level: Bills incurred earlier than you determine your HSA aren’t considered qualifying medical prices.)

“I think [people] often don’t realize just how broad the list of things you can be reimbursed for is,” Baxley stated, citing fertility treatment for instance.

He recommends creating a spreadsheet of unreimbursed medical bills (to know the way a lot you’ll be able to pay your self later) and holding receipts for proof.


After all, many individuals do not have the monetary means to use HSAs in the ultimate way.

People reside longer and have had to undertake extra particular person accountability for his or her retirement savings, as corporations have switched pensions for 401(okay) plans, for instance.

Restricted money circulate could imply having competing monetary priorities: emergency funds, retirement plans and health savings, for instance. (People and households can contribute up to $3,650 and $7,300, respectively, to an HSA this year.) Paying out of pocket for current costs may also not be possible, depending on a person’s financial situation.

Further, only those with high-deductible health plans can save in an HSA. In 2021, 28% of workers covered by employer-sponsored health insurance were enrolled in a high-deductible health plan with a savings option like an HSA, according to the Kaiser Household Basis. (Enrollment is a bit larger in massive corporations with greater than 200 staff.)

Caveats apart, these with entry ought to strive utilizing them as optimally as potential, monetary advisors stated.

“An HSA is a no-brainer for almost everyone who has access to one,” in accordance to Carolyn McClanahan, a medical physician and CFP who’s founder and head of monetary planning at Life Planning Companions in Jacksonville, Florida.

A high-deductible plan — and, by extension, an HSA — won’t be the best alternative for everybody. For instance, somebody with a continual sickness that leads to frequent physician visits could get a larger monetary profit from a plan with decrease annual out-of-pocket prices.

How to make investments

Like every other funding account, it is crucial to perceive your monetary and psychological capability to take danger by investing your HSA funds, McClanahan stated.

Which means having the ability to face up to the ups and downs in the stock market, and aligning your strategy to your investment time horizon.

A young saver with the financial wherewithal to pay out of pocket for present-day health costs can afford to take risk, for example — perhaps in a low-cost broadly diversified stock fund, McClanahan said.

However, savers who don’t have the means to cover their annual deductible or out-of-pocket maximum with other savings should keep at least this amount in cash or something else conservative like a money-market fund before investing the rest, McClanahan said. (Some HSA providers require accountholders to keep a certain amount in cash before investing.)

This is especially the case for savers who aren’t healthy and need frequent health care, she added.

Similarly, someone closer to retirement age should likely reduce their stock allocations to avoid putting money at risk near the age at which they’ll start tapping their accounts.

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