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The ABCs of HSAs

The ABCs of HSAs

With a little planning, your HSA can do a lot more than fund short-term healthcare expenses.

What Is a Health Savings Account?

An HSA is what it sounds like – a bank account that lets you save for healthcare expenses. Written into law in 2003, it is designed to help those enrolled in a high-deductible health plan (but, importantly, not enrolled in Medicare) to put money away for medical expenses. Here’s how it works:
  • Pretax contributions. The amount you contribute to your HSA enters your account pretax, which means that amount is excluded from your taxable income. As an example, someone who saved $300/month in their HSA would lower their taxable income by $3,600 – if they’re in the 25% tax bracket, that would be a tax savings of $900.
  • Tax-deferred growth. The money you save in your HSA can grow in two ways. First, HSAs are interest-generating accounts, though their yield tends to be small (current HSA interest rates are below 0.10%). Perhaps more importantly, HSAs are also investment accounts: While you might need to maintain a minimum balance, you can use your HSA to invest in stocks, bonds, mutual funds and ETFs. Better still, any growth in the account is tax-deferred.
  • Tax-free withdrawals. When it’s time to use the money you’ve saved in your HSA, the money you withdraw is tax-free, provided you use it on qualified healthcare expenses.

How HSAs Can Build Wealth

Health savings accounts can be incredibly useful to cover short-term healthcare expenses. For example, you could use money saved in an HSA to cover your healthcare costs until you reach your plan’s deductible, and then use those funds to pay coinsurance and copays until you reach your out-of-pocket limit.

However, HSAs can be an important wealth-building tool over the long term as well. The maximum HSA contribution amounts for 2022 are $3,650 for individuals and $7,300 for families. If you treated your HSA as a long-term investment fund and paid for your healthcare expenses out-of-pocket, the account’s triple tax benefits can help you accrue wealth for retirement faster than taxable accounts. As an illustration, let’s say you as an individual saved the maximum (roughly $304 per month) and let it grow without taking withdrawals. Assuming a fairly conservative 6% rate of return, in 20 years you would have a balance of nearly $140,000. Plus, anyone over age 55 can contribute an additional $1,000, letting you ramp up your investments even more.

In addition to these benefits, there are no required minimum distributions at a certain age, and once you reach age 65, you can withdraw funds for any reason without penalty, though distributions for nonqualified healthcare expenses would be taxed as income. HSAs are also more liquid than IRAs or 401(k)s, in that you can withdraw funds at any time without penalty for qualified healthcare expenses. (This is true even for past expenses: If you have records of paying a qualified medical expense out-of-pocket 20 years ago, you can reimburse yourself today, without penalty or tax.) But there are caveats as well: If you use your HSA funds for anything other than qualified healthcare expenses, you will pay tax on the distribution – plus a 20% penalty if you’re under age 65.

Is an HSA Right for You?

The Employee Benefit Research Institute estimates that a couple who anticipates outsized drug and medical expenses should plan on spending $325,000 in retirement on healthcare alone. A health savings account could be a useful vehicle to build your healthcare savings, especially if you’ve fallen behind on retirement savings. But that doesn’t mean HSAs are a fit for everyone: For example, if you’re not interested in or eligible for a high-deductible health plan or anticipate enrolling in Medicare soon, an HSA might not be of much help to you.

If the tax benefits of an HSA appeal to you, though, the next step would be to explore how this vehicle would fit in with your current wealth management plan – a process that would include estimating your healthcare needs in retirement, stress testing your current budget after maxing out HSA allocations and paying for healthcare expenses out-of-pocket, and tweaking your existing investment plans. We can guide you through this process and make sure you’re maximizing the flexibility and potential benefits HSAs have to offer.


 The information reflected on this page are Baird expert opinions today and are subject to change. The information provided here has not taken into consideration the investment goals or needs of any specific investor and investors should not make any investment decisions based solely on this information. Past performance is not a guarantee of future results. All investments have some level of risk, and investors have different time horizons, goals and risk tolerances, so reach out to us before taking action.

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