An HSA offers triple tax savings by reducing taxable income upon contribution, earning tax-free gains and income while invested, and allowing tax-free withdrawals for qualified medical expenses. This can be extremely beneficial to employees should they need to pay off a hefty bill for a medical emergency. An HSA will also cover a variety of health expenses that aren’t covered by traditional employee health insurance. While it sounds great to have a plan that offers such valuable tax savings and a wide array of services, it’s important to understand all of the details of an HSA before determining whether it’s right for you. 

1. Who Can Establish an HSA?

Employees of an employer-sponsored plan can often select an HSA from a menu of options. Anyone who is self-employed can also select this type of plan. However, it is important to understand that whether you are an employee or self-employed, you must be covered by a high-deductible health plan (HDHP) in order to establish an HSA. An HDHP is a medical insurance plan that has a higher-than-average specified minimum deductible. In 2022, the HDHP minimum deductible is $1,400 for an individual and $2,800 for a family. In 2023, the minimum is $1,500 for an individual and $3,000 for a family.

2. To Whom Is an HSA Most Appealing?

It seems that an HSA would be most appealing to an individual or family that has relatively modest medical care expenses, can afford a high-deductible medical plan, and could take advantage of the substantial tax benefits of a health savings account. It is important for each employee to compare an HSA to other medical plan options. 

3. Annual Contribution Limits

The annual contribution limits for HSA contributions in 2022 are $3,650 for an individual and $7,300 for a family. For 2023, the annual limit is $3,850 (individual) and $7,750 (family).

4. Catch-up Contributions

Individuals aged 55 and older can make $1,000 in additional catch-up contributions. All contributions to an HSA must stop once the individual becomes enrolled in Medicare.

5. Tax-Deductible Contributions

The most attractive feature of an HSA is the ability to make tax-deductible contributions that can earn a return. This is the first of three tax-related benefits for HSAs.

6. Earnings in the HSA Are Not Taxable

Another tax benefit is that you can avoid taxes on HSA investment gains. You could keep HSA funds in cash, but you may also have the opportunity to invest it in mutual funds or other securities. That can allow you to grow your savings more rapidly, and as an added bonus, those earnings are not considered taxable income.

7. Tax-Free Withdrawals

The third aspect of the triple tax savings offered by HSAs is that withdrawals can be made on a tax-free basis as long as they are used to pay for qualified medical expenses. If not used for medical expenses, withdrawals are taxable income.

8. Non-Qualified Withdrawal Penalties

If the owner of an HSA makes withdrawals prior to age 65 for non-medical expenses, an additional 20% tax penalty is imposed on the amount of the non-qualified withdrawal.

9. Use It or Lose It?

Unlike many employer-sponsored savings plans, an HSA allows you to roll over any money that you do not spend by Dec. 31. That means you can continue to accumulate savings in your account until you need it for health care expenses.

10. Approved Health Expenses

There are hundreds of IRS-approved health expenses and some health insurance deductibles and co-insurance are covered. For example, non-cosmetic dental treatments, crutches, hearing aids, laser eye surgery, contact lenses, eyeglasses, chiropractic care, acupuncture, and physical therapy are all covered by an HSA.