That’s where the health savings account (HSA) comes in.

HSAs are pretty popular nowadays. Approximately 22 million people use them to save and pay for medical expenses.⁽¹⁾ But you may be asking, What is a health savings account? How does it work? And is it the best option for my family?

Let’s take a closer look at some of the most common questions people ask about health savings accounts—and learn how an HSA can help you save money on medical expenses!

What is an HSA?

HSAs are tax-advantaged savings accounts that can help you pay for medical expenses tax-free now and in the future. It’s like an extra emergency fund just for medical costs!

HSAs are tax-advantaged savings accounts that can help you pay for medical expenses tax-free now and in the future. It’s like an extra emergency fund just for medical costs!

You have to be enrolled in a high-deductible health plan (HDHP) to get an HSA. A higher deductible basically means you’ll need to pay more out of pocket before your insurance kicks in. But, in exchange, you get lower monthly premiums and the option to put money into an HSA to save up for your medical costs.

You have to be enrolled in a high-deductible health plan (HDHP) to get an HSA.

Am I eligible for an HSA?

As mentioned above, you must have a high-deductible health plan in order to open up an HSA or put money into one. No exceptions. You can find an HSA-qualified health plan through your employer (if they offer one) or an independent insurance agent.

For 2019, an HDHP must have a minimum annual deductible of $1,350 for single coverage and $2,700 for family coverage. The out-of-pocket maximum (which includes your deductible, copayments and coinsurance, but not your premiums) is $6,750 for singles and $13,500 for families. That’s the most you’ll pay for medical costs before your insurance covers 100% of the rest.⁽²⁾

If you’re enrolled in Medicare or someone claims you as a dependent on their tax return, sorry, you won’t be able to open or contribute to an HSA.

How does an HSA work?

In most cases, your HSA acts like a savings account at first and earns interest the same way a normal savings account does. Other HSAs let you invest the money in mutual funds right away—just like an IRA! Some providers require a minimum balance before you can start investing your HSA funds, so do your research ahead of time.

Investing your HSA funds and letting that money grow over the long haul can help you start building up enough savings to cover medical expenses during your retirement years. That’s huge!

Your HSA also comes with some great tax advantages:

1. You’re not taxed when you put money into your HSA.

Generally, there are two ways you can put money into an HSA. Your HSA contributions can come straight out of your paycheck through a pretax payroll deduction, or you could make deposits into your HSA on your own and claim them as tax deductions when you do your income taxes.

Either way, you won’t be paying taxes on the money you put into your HSA!

2. The money in your HSA also grows tax-free.

Once that money is in your account and starts earning interest, you won’t be taxed for growth like you might with other types of accounts that earn interest. Whenever you see the words tax-free and growth in the same sentence, your ears should perk up a little bit!

The ability to take advantage of tax-free growth makes the HSA a nice addition to your retirement portfolio. If you’re maxing out your 401(k) and IRA contributions and are looking for another place to invest, your HSA is a great place to start.

3. You’re not taxed when you take money out to pay for medical expenses.

As long as you use your HSA money to pay for qualified medical expenses, you won’t be hit with any taxes or penalties.

Another great thing about HSAs: Once you turn 65, your HSA acts like a traditional IRA. At that point, you can take out money for anything you’d like, but you’ll pay taxes on it when you do—just like a traditional IRA.

Another great thing about HSAs: Once you turn 65, your HSA acts like a traditional IRA. At that point, you can take out money for anything you’d like, but you’ll pay taxes on it when you do.

However, you can still pay for medical expenses in retirement from your HSA tax-free! That makes using an HSA the best option for covering health costs in your golden years.

When you combine tax-free contributions with tax-free growth and tax-free withdrawals for medical expenses, that’s like getting a government match on your health care savings!

What are qualified medical expenses?

Here are just some of the most common qualified medical expenses you can use your tax-free HSA dollars for:

• Dental treatment
• Doctor’s office visits and copays
• Surgery (except cosmetic surgery)
• Eye exams and eyeglasses
• Flu shots
• Physical therapy
• Drug prescriptions and over-the-counter medicines⁽³⁾

It’s also important to know what doesn’t count as a qualified health expense, because you’ll pay income tax and additional penalties for using your HSA dollars for those things.

Sorry, but your gym membership and those essential oils you use for aromatherapy don’t count as qualified medical expenses! If you have a question about whether or not something is a qualified health expense, get in touch with your HSA provider to clear up any confusion.

How much should I put into my HSA?

Trying to decide how much to contribute to your HSA? Well, if your company offers a match on your HSA contributions, getting that match is a great place to start!

But don’t start putting money into your HSA until you have a fully funded emergency fund, or unless you have a known medical event coming up. If you’ve got a baby on the way or a big surgery planned and you want to pile enough cash into your HSA to cover that event in a given year, go for it. Otherwise, make sure your regular emergency fund is taken care of first.

Is there a limit to how much I can contribute?

I know you’re probably thinking, All this sounds great, but there’s gotta be a catch! Well, there is one thing: Just like with a Roth IRA or 401(k), there are limits to how much money you can put into your HSA each year.

The chart above shows the maximum you can put in each year, including any money your employer contributes.⁽⁴⁾

What happens to my HSA if I leave my job or switch health plans?

The great thing about having an HSA is that it’s completely yours. So when you get a new job or change health plans, your HSA and all the money in it come with you. You can roll the account into your new employer’s HSA or leave it alone, but those funds are yours to use for qualified expenses either way.

The great thing about having an HSA is that it’s completely yours. So when you get a new job or change health plans, your HSA and all the money in it come with you.

Remember, you have to be enrolled in an HSA-qualified health plan to put money into an HSA. Keep that in mind when you’re changing jobs or health plans. When you switch from an HDHP to a traditional health plan that isn’t qualified for an HSA, you can no longer put money into your existing HSA. You can still use the funds that are in your HSA for qualified medical expenses, though!

What if I don’t use all my HSA funds by the end of the year?

No medical emergencies? No problem! Your HSA balance rolls over year to year, so you still have access to all the money in the account. If you really want to, you could max out your HSA contributions every year and stockpile as much money as you can. It’s up to you!

Does an HSA-qualified health plan work for me?

To figure out if an HSA-qualified health plan works best for your situation, you need to do a good old-fashioned break-even analysis. Time to dust off those calculators and crunch some numbers!

Let’s say your family would save $200 per month on premiums by switching from a traditional health plan to an HDHP. That means you’d save $2,400 each year up front. But, at the same time, you’re taking on $3,000 more risk in the form of a higher deductible. You might not max out your deductible in a given year—or you might. You’ll need to make the decision based on your health situation.

How would an HSA work in a medical emergency?

Having a well-funded HSA in place can at least take some of the sting out of having to max out your deductible.

Let’s say Jack gets a new job, enrolls in a high-deductible health plan, and starts saving $100 every month in his new HSA. Plus, his new employer matches up to $500 of his HSA contributions each year. Boom! That means $1,700 is going into his HSA every year.

Jack’s a pretty healthy guy, so he’s using his HSA to pay around $600 each year for regular health expenses like dentist appointments, eye exams and the occasional trip to the doctor’s office.

After five years, he has $5,500 saved up in his HSA. But then he hurts his knee in a company softball game. After a trip to the emergency room, a surgery and a few days in the hospital, he gets hit with a $40,000 medical bill.

Jack freaks out for a few minutes before he remembers his health plan has a $2,500 deductible with 20% coinsurance and an out-of-pocket maximum of $5,000.

1. First, he’ll need to pay $2,500 to meet the deductible.
2. His 20% coinsurance means he’s responsible for 20% of what’s left of the $37,500 medical bill. But since Jack’s out-of-pocket maximum is $5,000, he’s only on the hook for that amount ($5,000). His insurance company is going to cover the rest.

Jack will be able to pay for all those expenses with his HSA savings and still have $500 left in his HSA account. That HSA he’s been putting money into for years comes in handy when Jack needs it the most, helping him cover his deductible and out-of-pocket costs without having to dip into his regular emergency fund or other cash accounts.

That’s exactly what a well-funded HSA is designed to do!

Work With a Health Insurance Pro

Ready to find an HSA-qualified health plan that can help you start saving on health care costs? An independent insurance agent can find the best plan for your budget and your family’s needs.

They can also tell you if an HSA-qualified health plan is right for you and help you review and compare your health plan options.

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