What are Healthcare Savings Accounts?

Flickr - 401(K) 2012With the Affordable Care Act (“Obamacare”) becoming law in 2014 it is expected Healthcare Savings Accounts (HSAs) will get more attention.

An overview of HSAs are detailed below in the article from the Financial Planning Association®, but in summary if you are relatively healthy and have money set aside for emergencies they can significantly reduce your healthcare costs with tax benefits.  Recent rulings regarding the Affordable Care Act may impact the amount of savings going forward, but they do put consumers in charge of their healthcare expenses.

One benefit not discussed in detail below is the investment option with the money contributed to your HSA account.  Money contributed to a HSA is tax-deductible and can be invested in stocks and/or bonds.  At retirement, the money can be withdrawn tax-free to cover medical bills that occurred anytime the HSA was open.  All you need to do is keep detailed receipts of your medical bills.

It is important you discuss with your financial planner if you fit the criteria above and have the option of opening a Healthcare Savings Account.

What are Healthcare Savings Accounts?

HSAs are tax-advantaged savings accounts set up in conjunction with high-deductible health insurance policies. Enrollees or their employers make tax-free contributions to an HSA and typically use the funds to pay for qualified medical care until they reach their policy’s deductible.

HSAs are not for everyone, and it is important to understand how they work before considering them to help fund health care costs.

Understanding HSAs

You are eligible for an HSA if you meet all four of the following qualifying criteria:

1.     You are enrolled in a qualified high-deductible health insurance plan (known as a “HDHP”)

2.     You are not covered by another health plan (whether insurance or an uninsured health plan).

3.     You are not eligible for Medicare benefits.

4.     You are not a dependent of another person for tax purposes.

HSAs are generally available through insurance companies that offer HDHPs. Many employer-sponsored health care plans also offer HSA options. Although most major insurance companies and large employers now offer an HSA option under their health plan, it’s important to remember that most health insurance policies are not considered HSA-qualified HDHPs, so you should check with your insurance company or employer to see how an HSA plan might differ from your current plan.

There are maximum contribution limits that are adjusted annually. Contributions are made on a before-tax basis, meaning they reduce your taxable income. Note that unlike IRAs and certain other tax-deferred investment vehicles, no income limits apply to HSAs.

HSAs offer investment options that differ from plan to plan, depending upon the provider, and allow users to carry account balances over from year to year. Earnings on HSAs are not subject to income taxes.

Any medical, dental, or ordinary health care expense that would qualify as a tax-deductible item under IRS rules can be covered by an HSA. A doctor’s bill, dental procedure, and most prescriptions are examples of covered items. See IRS Publication 502 for a definitive guide of covered costs. If funds are withdrawn for any purposes other than qualifying health care expenses, you will be required to pay taxes on amounts withdrawn plus a 10% penalty (adjusted to 20% in 2014).

Here are some pros and cons of this product.


  • HSAs offer a significant annual tax deduction, making them particularly appealing to individuals in higher tax brackets.
  • Withdrawals for qualifying health care costs (including long-term care insurance) are tax free.
  • Investment income in HSAs is also tax free.


  • Since HSAs must be tied to HDHPs, their ultimate savings must be weighed against how such plans stack up against more traditional plans, which may offer significantly better coverage.
  • HSAs may not offer the flexibility and transportability that today’s mobile American family requires, especially given that health plan offerings differ significantly from employer to employer and many smaller institutions have yet to offer an HSA option.
  • For more information on HSAs, see the U.S. Treasury’s website at www.treas.gov (click on “Health Savings Accounts”).

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Photo credit: 401(K) 2012

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