Health Accounts

THERE ARE TWO popular types of tax-favored health care account, and they’re sometimes confused. First, your employer may offer a flexible spending account, or FSA, which you can use to pay for health care expenses—such as deductibles and co-payments—that aren’t covered by your employer’s health plan. These accounts are funded out of pretax income, so you avoid income taxes and payroll taxes on the money involved. Each year, employees commit to funding these accounts up to a dollar amount they choose, though that sum can’t be greater than $2,850 in 2022 and $3,050 in 2023.

Keep in mind that, with money in these accounts, it’s “use it or lose it.” The accounts typically need to be emptied by Dec. 31, though employers are allowed to offer a grace period that extends until mid-March. Alternatively, employers can stick with the Dec. 31 cutoff but allow employees to roll over as much as $570 from 2022 to 2023. The $570 limit rises to $610 in 2023.

What’s the second popular type of account? If you have a high-deductible health insurance policy, you may get the chance to fund a health savings account, or HSA. In 2022, to qualify, a plan must have a deductible of at least $1,400 if you’re single and $2,800 if the coverage is for a family. In 2023, these figures rise to $1,500 for individuals and $3,000 for families. If you have a qualifying plan, you can make tax-deductible contributions in 2022 of as much as $3,650 to an HSA if you’re single and $7,300 if you have a family plan. The 2023 limits are $3,850 for individuals and $7,750 for families. You can contribute an additional $1,000 if you’re age 55 or older.

Withdrawals used for qualifying medical expenses are tax-free. But every year, unlike an FSA, you don’t need to empty the account largely or entirely. Instead, you can leave the money to grow and use it tax-free for future medical expenses, including medical expenses in retirement.

You can also use the money for other reasons, though you’ll have to pay income taxes on your withdrawals and, if you are under age 65, a 20% tax penalty. Unlike with a traditional IRA or other retirement accounts, you aren’t required to take minimum annual distributions starting at age 72.


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James McGlynn CFA RICP®
James McGlynn CFA RICP®
1 year ago

Sunil I am just finishing an article on HSA’s for Humbledollar. I get in “the weeds” on some of the details-some of them are strange.

Sunil Sharma
Sunil Sharma
1 year ago

A retirement account, such as an IRA or a 401k account, has a distinct deaccumulation phase that begins at retirement. Do HSAs have a distinct deacumulation phase? Can I continue to accumulate assets in an HSA in the early years of retirement and, if so, what are the benefits of doing so? What health care expenses in retirement would I be able to fund more easily if I continue to accumulate assets in an HSA in the early years of retirement? Can HSAs be passed on to one’s heirs? Thanks.

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