Health savings accounts are often misunderstood and confused with their peer medical accounts, health reimbursement accounts (HRAs) and health flexible spending accounts (FSAs). That’s too bad, because as a savings tool, HSAs have distinct advantages beyond these other accounts. Here’s what you need to know about this attractive savings tool.
What is an HSA?
A health savings account (HSA) is a trust or custodial account created for individuals who are covered under high-deductible health plans (HDHPs). Designed to help pay for medical expenses that HDHPs do not cover, HSAs offer triple tax-free benefits related to federal, and often state, income taxes. Contributions are made on a before-tax basis, grow tax deferred and there is no tax upon distribution–as long as it is used to pay for qualified medical expenses. These expenses include most medical care such as doctor visits, hospitalization, dental, vision and prescription drugs.
Amounts that are contributed to an HSA may be accumulated over a number of years. Unlike a healthcare FSA, there is no “use‐it‐or‐lose‐it” rule. The account is also portable because it is owned and controlled by the individual for whose benefit it is established.
Who can establish an HSA?
An HSA can be established by an individual who:
- Is covered by a high-deductible health plan
- Is not covered by a health plan other than a high-deductible plan (excluding certain "permitted coverage" or "permitted insurance")
- Is not eligible to be claimed as a dependent on another person’s tax return
- Is not entitled to Medicare benefits, either because the person has reached age 65 or is disabled
- Has not received health benefits from the Veterans Administration in the last three months
Married couples cannot have a joint HSA, however distributions from one spouse’s account can be used to pay for the other’s qualified expenses and for the expenses of an eligible dependent.