HSAs and FSAs at a Glance
HSAs and FSAs: the whole thing in five minutes, for when you want the numbers and nothing else.
Tax-advantaged accounts that let you set aside money for medical costs: a Health Savings Account (HSA) or a Flexible Spending Account (FSA).
Key takeaways
- HSA eligibility: requires an HSA-eligible high-deductible health plan
- HSA money: is yours, rolls over every year and stays with you if you change jobs
- Most useful single change: Estimate predictable costs, such as glasses, prescriptions and copays, before choosing an FSA amount.
- Commonest mistake: Putting more into an FSA than you are likely to spend.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
The numbers, in one place
| Measure | Figure |
|---|---|
| HSA eligibility | requires an HSA-eligible high-deductible health plan |
| HSA money | is yours, rolls over every year and stays with you if you change jobs |
| FSA money | is set up through an employer and is generally use-it-or-lose-it, though some plans allow a grace period or small carryover |
| Contribution limits | set by the IRS and updated each year |
| Medicare and HSAs | you cannot contribute to an HSA once you are enrolled in Medicare |
In one paragraph
Used well, they lower the real cost of care, but the rules differ and FSA money can be lost if it is not spent in time.
Worth doing
- Estimate predictable costs, such as glasses, prescriptions and copays, before choosing an FSA amount
- Keep receipts for every HSA or FSA purchase
- Check your FSA deadline and grace period before the plan year ends
- Ask a tax professional how an HSA fits your situation if you are near Medicare age
Worth avoiding
- Putting more into an FSA than you are likely to spend
- Using HSA money for non-medical costs, which can trigger taxes and penalties
- Contributing to an HSA after enrolling in Medicare
Related topics
- What the Guidance Really Says About Dual Eligibility (Medicare and Medicaid)
- What the Guidance Really Says About Benefits and Financial Support (Long-Term Conditions)
- What the Guidance Really Says About Caregivers and Work (Carers)
- The Evidence on Travel Insurance and Healthcare Abroad, Without the Hype (Travel Health)
Where to go next
- HSAs and FSAs: What to Do, in Order
- Myths About HSAs and FSAs, Checked Against the Guidance
- HSAs and FSAs — the reference entry
- Health Insurance: The Complete Guide
- Surprise Medical Bills: Sorting the Evidence From the Noise
- Lowering Prescription Costs: What Published Guidance Supports
When to speak to a doctor
Account balances should never decide whether you get urgent care; call 911 for an emergency. Talk with your doctor about lower-cost options if costs are stopping you from following a treatment plan.
Where this comes from
- HealthCare.gov — Health Savings Account (HSA)
- HealthCare.gov — Flexible Spending Account (FSA)
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.
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