Editor's Note: This story originally appeared on Boldin.
A health savings account or HSA is a medical savings account that is attached to a high-deductible health insurance plan (HDHP).
It can be a savvy way to save money by reducing your overall medical spending. It can also have compelling retirement savings benefits.
Money can be deferred into an HSA account on a pre-tax basis just like a traditional 401(k) or IRA contribution. When money is withdrawn to cover qualified medical and dental expenses, withdrawals are tax-free.
Here’s how an HSA saves you money in compelling ways.
HSA contributions are tax-free
Contributions to your HSA are made before your income is taxed. So, you are taxed as if you make less money.
(For example, if you make $75,000 a year, and you put $4,150 into an HSA, you are only taxed on $70,850.)
Money in an HSA grows tax-free
Any interest or investment returns you earn on your HSA are tax-free. You do not pay any taxes on growth in the account.
Withdrawals for eligible medical expenses are tax-free
Any money you withdraw from the account to be used on eligible medical expenses is tax-free.
High-deductible health plans are usually less expensive
Most high-deductible health plans have lower monthly premiums than other kinds of plans. Typically, the higher the deductible, the lower the premium.
(However, these plans are not the best type of insurance for everyone.)
So, money in an HSA is truly tax-free — you do not pay taxes on that money anywhere in the cycle.
And, you could potentially save money on a lower cost health plan.
An HSA retirement savings account is probably the most tax-advantaged way to save
Health savings accounts have an interesting side benefit as being a potential source of tax-free retirement savings.
Because money in an HSA can be carried over from one year to the next, you could carry these very tax-free funds into retirement.
An HSA is clearly the most tax-advantaged investment option available. And, as yet another retirement benefit, there are no minimum required distributions at 72 as there are with other kinds of retirement accounts.
The key to this strategy is using other funds to cover out-of-pocket medical expenses while you are working, letting the HSA funds grow until retirement.
HSA investment options
Many company HSA plans have investment options. Additionally, many banks and investment custodians offer HSA accounts with investment options similar to IRAs.
Once you get to retirement, funds can be withdrawn from the HSA to cover a wide range of qualified medical and dental expenses.
In addition, the cost of long-term care and Medicare premiums are considered to be qualified expenses.
Any funds not used for qualified medical expenses can be withdrawn after age 65 without a penalty. Just like an IRA, these withdrawals will be subject to taxes. There is a wide range of expenses that are considered as qualified.
With the ever-increasing cost of medical care in retirement, an HSA can be a valuable addition to your retirement savings efforts.
How Do You Qualify for an HSA? What Is a High-Deductible Health Insurance Plan (HDHP)?
You can open an HSA if you have a high-deductible health insurance plan (HDHP). An HDHP is an insurance plan that has minimum deductibles as defined by the IRS.
For 2025 those minimums are:
$1,650 for a single person
$3,300 for a family
A plan with deductibles lower than this does not qualify as high deductible per the IRS, and an HSA can’t be used with it.
What are deductibles?
A deductible is the amount of money you need to pay toward your health costs before your insurance starts picking up the bill. After you have met your deductible, then you are usually still required to pay a copay for services until your out-of-pocket maximum is met.
So, if you have a $2,000 deductible with a $5,000 out-of-pocket maximum, then you will fund your medical costs until you have spent $2,000. Thereafter, you will probably have a copay until you have spent $5,000.
The general rule of thumb is that high-deductible plans are good for people who are generally healthy. However, they can be problematic if you have a sudden and serious medical issue.
What are the contribution limits to an HSA?
The IRS also sets the amount that can be contributed to an HSA on a pre-tax basis. The 2025 annual limits are:
- $4,300 for an individual in 2025
- $8,550 for families in 2025
- Those who are 55 or over can contribute an extra $1,000
What are the out-of-pocket maximums in 2025?
There are also limits on the amount of out-of-pocket expenses, including coinsurance, copayments and deductibles. For 2025 these are:
- $8,300 for individual coverage (compared to $8,050 in 2024)
$16,600 for family coverage (compared to $16,100 in 2024)
What’s the difference between an HSA and a flexible spending account (FSA)?
You may have also heard of a flexible spending account (FSA).
Both the HSA and the FSA are accounts where your contributions are made on a pre-tax basis. They also share the ability to use the funds in the account to cover qualified medical and dental expenses on a tax-free basis.
The key difference between the two accounts is that the FSA is “use it or lose it.” This means that money contributed to the FSA must be spent in that year or it will be lost.
Money contributed to an HSA can be carried over from year-to-year, hence the reason it can be used as another retirement savings vehicle.
Is an HSA right for you? HSAs are great if you have high-deductible health insurance.
If you are not sure about the implications of an HSA, you can model one as part of your Boldin Plan and see the tax implications. Try a scenario with an HSA and another without and compare.
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