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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 $3,050 in 2023 and $3,200 in 2024.

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 $610 from 2023 to 2024. The $610 limit rises to $640 in 2024.

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 2023, to qualify, a plan must have a deductible of at least $1,500 if you’re single and $3,000 if the coverage is for a family. In 2024, these figures rise to $1,600 for individuals and $3,200 for families. If you have a qualifying plan, you can make tax-deductible contributions in 2023 of as much as $3,850 to an HSA if you’re single and $7,750 if you have a family plan. The 2024 limits are $4,150 for individuals and $8,300 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 73.

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James McGlynn CFA RICP®

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
3 years 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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