HSA stands for Health Savings Account. It's a type of bank or financial account you can use to set aside money to pay for certain medical costs. The money you put into your HSA isn't taxed, so you can lower your income tax by contributing to an HSA.
Let's get into the basics of HSAs to help you understand what they are, how to get one, and whether they may be right for you.
What is an HSA, and how does it work?
The purpose of an HSA is to help you save and pay for healthcare costs you would typically need to pay out of pocket.1
If you get health insurance coverage through an employer, an HSA is a health benefit that may be offered to you through your plan. It's a savings account that lets you set aside money to pay for qualified medical expenses.1
One of the biggest perks? You don't have to pay income tax on the amount you contribute to your HSA. There's also no tax on any growth and no tax to withdraw it for qualified medical expenses.1
Your HSA is a flexible pool of money you can use to pay for:1
- Healthcare deductibles
- Copayments
- Coinsurance
- Other healthcare expenses like over-the-counter (OTC) medicines, first aid kit supplies, and more
What are the rules for HSA accounts?
You must have an HSA-eligible plan, also called a High Deductible Health Plan (HDHP), to have an HSA.2
Certain other health coverage may disqualify you, so be mindful of any other programs you're enrolled in.3
To qualify for an HSA, you may not be a dependent listed on someone else's tax return.4
Maximum out-of-pocket costs
All HSA-eligible plans come with minimum out-of-pocket costs you pay for healthcare, whether the plan is for your family or you as an individual.2
This is the amount of money you need to pay per year for qualifying healthcare costs before your health insurance starts to pay.2
Plans also have a maximum out-of-pocket cost. This is the highest amount you'd have to pay out-of-pocket for yearly healthcare costs.2
What are the qualified medical expenses?
You can use your HSA to pay for out-of-pocket medical and health-related expenses beyond doctor visits and prescription medicines.
Common healthcare expenses you may not have thought about include:3
- OTC medicines
- First aid items, like gauze
- Menstrual products
- Sunscreen
- Qualified long-term care
- Acupuncture
- Qualified mental health therapy
- Ambulance costs
- Hearing aids
Use the this medical expense eligibility tool to find out which expenses qualify.
You may also be able to use your HSA to pay for out-of-pocket medical costs for your dependents or spouse. This is true even if your HSA-eligible plan does not cover them.3
Contribution limits
There's a limit to how much money you can put into your HSA each year. It depends on the year and whether you have self-only or family coverage.3
These limits are adjusted annually with inflation.5
If you're 55 years or older, you can deposit more "catch-up" contributions to your HSA of up to $1,000 per year.3
For 2025, an individual with a qualifying high-deductible health plan with a deductible not less than $1,650 can contribute up to $4,300 for the year to their HSA, and the maximum out-of-pocket is capped at $8,300.
For an individual with family coverage, they can contribute up to $8,550 for the year, and the maximum out-of-pocket is capped at $16,600.
Find out more about specific limits.
Using an HSA on Medicare
Once you get Medicare, you can't contribute more to your HSA. But you can still withdraw from your existing HSA to cover qualified medical expenses that aren't covered by Medicare or Medicare Supplement Insurance (Medigap).3
Once you have an HSA, anyone can contribute
If you have an HSA, anyone can put money into it, including your employer, family members, or friends, up to your contribution limit.3
Finding an HSA-eligible plan
You can find the right HSA-eligible plan for your needs by searching the Health Insurance Marketplace or Small Business Health Options Program (SHOP). Choices may also be available outside the Marketplace.3
What are the downsides of having an HSA?
When deciding whether an HSA is right for you, think about the following.
Deductibles may be higher
An HSA is a tool to save money and cover deductibles, but it can take time to grow your balance.
Deductibles on an HSA-eligible plan can be higher.2 Though you'll have a higher amount to pay out of pocket before your plan starts to cover expenses, you can use your HSA dollars to cover the deductible.
But you typically can't use an HSA to pay your insurance premiums.3
You'll need to keep your receipts
It's a good idea to make sure you keep all your medical records and receipts to show you used your HSA correctly.3 If you're ever audited, the Internal Revenue Service (IRS) may require proof of your expenses.
Here's what to do:
- Save every receipt and medical record tied to your HSA spending.
- Keep it all organized — whether in a dedicated folder, a spreadsheet, or a budgeting app.
Penalties
If you use your HSA as intended, it can be a helpful savings tool. But here's where you can get into trouble: withdrawing funds for non-medical expenses or expenses that don't qualify for HSA coverage.
If you're under age 65, you'll have to pay federal income tax on the amount you withdrew, plus a 20% tax penalty.3
If you do the same thing but are older than age 65, you won't have to pay the extra penalty. But you'll still have to pay federal income tax on the amount you withdrew.3
See if your health expenses qualify with our free medical expense tool.Search expenses
What happens to your HSA if you don't use it?
Once you have an HSA, you keep it and the money in it.
If you save money in your HSA but don't use it in one calendar year, it simply rolls over to the next year. Money in your HSA never expires. You keep it until you need it.3
Your HSA will stay in place even if you change jobs or employers. You also keep your HSA even if your insurance plan changes. You just can't contribute to it when you don't have an active qualifying high-deductible health plan. 3
Bottom line
An HSA isn't just another savings account. It's a smart way to save on healthcare expenses and lower your tax bill.