I’m not completely confident, and I may have misunderstood the posts I read, but I think I read on a FIRE board that it may not be required to pay the medical expenses with the HSA and the money in the HSA is allowed to grow tax free. This is a real nice option to save for future health expenses. Especially if one does plan to FIRE. Clearly I’m not good at Quotes.
This isn't a direct answer to your question, but in case anyone reading isn't aware, you can also use the HSA as a retirement account. You can invest HSA money in more than just a savings account (investment options depend on what is available through your employer though) so that it grows over time. As long as the money is eventually used for a qualified health expense, HSA money is not taxed when it is contributed or when it is withdrawn, even if it's been growing for decades.
Since we are on the topic of HSA, just remember not everyone is eligible for a HSA, you need to have a high deductible insurance plan. Even if your company does not offer an option to have a HSA through direct deposit you can still open an account on your own and then get the positive tax savings on your tax return. If you are eligible it is a great idea, even if you use it for healthcare costs, instead of planning to eventually use it for retirement. Look at your options when opening an account, some have fees if you don't have a minimum amount.
I feel a lot of people confuse the HSA with a FSA. Excellent point to call out!
A few things to add about HSA (This information is current, but given tax laws/etc, it could change at any point in the future):
- You can't have both a HSA and a "general medical" FSA (only "dependent" or "limited use" FSA, for example, the FSA can only pay for dental and vision expenses).
- HSA can act like a retirement account because there's no "use it or lose it" rule like FSA, so funds roll over year to year.
- Treating HSA as a retirement account gives you a triple tax-free benefit: pre-tax contributions, tax-free withdrawals, and tax-free growth.
- Before age 65, withdrawals are only tax free if you use it for qualified medical expenses. Otherwise, there's a 20% penalty AND you also have to pay tax (however, there is a loophole of sorts to this, see below).
- After age 65, still tax-free withdrawals for medical expenses OR you can spend the money on anything as there is no more 20% penalty, but you'll have to pay tax like a regular IRA distribution (unless you use the loophole).
- You can use HSA as tax-free savings as well: There is no reimbursement deadline, so if you stockpile medical receipts throughout the years, you can cash them out all at once if you need to access your HSA savings. Just make sure to keep METICULOUS records/receipts for qualified expenses. Since technically you're withdrawing for medical expenses, this is a loophole to avoid paying the 20% penalty & taxes on the distribution.
Last edited: