HSA money covers deductibles, copayments, coinsurance, prescriptions, many over-the-counter items, and dental and vision care, with tax breaks going in, while growing, and coming out.
Unlike an FSA there is no use-it-or-lose-it: balances roll over forever, the account follows you between jobs, and you set contributions up to the yearly limit. After 65, non-medical withdrawals are taxed like retirement income rather than penalized. Two valid strategies: spend it as health costs arrive, or pay out of pocket, save receipts, and let it grow. Eligibility requires a high-deductible health plan.
What to do
Common questions
What can I buy with my HSA?
HSA money buys the same broad family of health costs as FSA money, with much better account rules. HealthCare.gov lays out the basics: you can contribute to a Health Savings Account when enrolled in an eligible high-deductible health plan, and the money pays for health care costs like deductibles, copayments, and coinsurance, with the triple tax benefit of lowering your taxable income when it goes in, growing untaxed, and coming out untaxed for qualifying expenses. The eligible purchase list mirrors the FSA world: prescriptions, many over-the-counter medicines and health products, dental and vision care, and the IRS-defined category of qualifying medical expenses. The differences that make people love HSAs: there is no use-it-or-lose-it, since unused money simply rolls over year to year; the account is yours, not your employer's, so it follows you between jobs; you decide how much to contribute up to the yearly limit, with no minimum; and after 65, non-medical withdrawals are taxed like a regular retirement account rather than penalized. The strategies people use: pay small costs out of pocket and let the HSA grow as a stealth retirement fund, or use it as a health-cost checking account as bills arrive. Either way, keep receipts for anything you pay yourself, since you can reimburse yourself years later, tax-free.