Navigating Health Savings Accounts (HSAs)

June 28, 2024

As a working professional, managing your finances can be complex due to your demanding career and lifestyle needs. One powerful yet often underutilized tool in your financial strategy is the Health Savings Account (HSA). HSAs provide significant tax advantages and can help manage both current and future medical expenses effectively. In this post, we’ll explore the benefits of HSAs, clarify common misconceptions, and provide strategies to maximize their potential. 

Understanding Health Savings Accounts (HSAs)

Health Savings Accounts (HSAs) are tax-advantaged savings accounts designed specifically for medical expenses. Contributions to your HSA are tax-deductible, the growth on your savings is tax-free, and withdrawals for qualified medical expenses are also tax-free. This combination of tax advantages makes HSAs a powerful tool for managing healthcare costs both now and in the future. All of these benefits require the owner of the account to follow rules around contributions and withdrawals.

Eligibility Criteria for Opening an HSA

To open an HSA, you must be enrolled in a High Deductible Health Plan (HDHP). These plans have higher deductibles and lower premiums compared to traditional health insurance plans, making the HSA/HDHP an attractive option for those willing to take on more out-of-pocket healthcare costs in exchange for tax benefits.

Differences Between Self-Directed and Employer-Sponsored HSAs

Self-directed HSAs are accounts you open independently, while employer-sponsored HSAs are provided as part of your benefits package. Employer-sponsored HSAs often come with contributions from your employer, providing an additional financial boost.

Tax Advantages of HSAs

Pre-Tax Contributions:

Contributions to an HSA can be made pre-tax, reducing your taxable income. This means that every dollar you contribute lowers your overall tax burden, making HSAs an effective tax-saving tool.

Tax-Free Growth:

The funds in your HSA grow tax-free, meaning any interest, dividends, or capital gains earned within the account are not subject to taxes. This allows your savings to grow more efficiently over time.

Tax-Free Withdrawals for Qualified Medical Expenses:

When you withdraw funds from your HSA for qualified medical expenses, those withdrawals are not taxed. This applies to a wide range of medical expenses, including doctor visits, prescriptions, and even some over-the-counter medications.

Common Misconceptions

Self-Directed vs. Employer-Sponsored HSAs:

Many people are unaware that the IRS treats self-directed and employer-sponsored HSAs differently in terms of reporting. Employer-sponsored HSAs often involve Cafeteria Plans, which reduce your taxable income directly on your W-2, whereas self-directed HSAs may require more detailed tax reporting. Typically, this results in an employer sponsored HSA being more tax efficient due to the inclusion of employment related taxes.

Importance of Accurate Tax Reporting:

Accurate tax reporting of your HSA contributions and distributions is crucial to avoid issues with the IRS. Missteps can lead to penalties and additional taxes. Always verify your tax forms to ensure they reflect your HSA contributions correctly. An important note is that an employer sponsored HSA will reduce your taxable income, and thus not be counted again on form 8889 with your taxes, while self-directed HSA contributions would be recorded on form 8889. Ensure you consult your tax advisor for this important reporting step.

Maximizing Your HSA

The IRS sets annual contribution limits for HSAs. For 2024, the limit is $4,150 for individuals and $8,300 for families. Those 55 and older can contribute an additional $1,000. 

Older couples may contribute the family maximum, then $1,000 for each spouse that turns 55 or older in that year. Thus, some families will be able to put $10,300 into their HSA. The spouse who owns the HSA and HDHP would contribute a maximum of $9,300 while the other spouse would contribute $1,000 into their own (separate) HSA. 

An employer’s contribution directly reduces the amount a person may contribute into their own HSA. Thus, if a single person (annual limit is $4,150) is offered a $1,000 match to their HSA, they would only be able to contribute $3,150.

Tips for Using HSA Funds Effectively

Use HSA funds for current medical expenses when needed, but also consider saving for future healthcare costs, including retirement healthcare expenses. Some HSA providers offer investment options, allowing your savings to grow even more effectively.

A more advanced strategy involves investing HSA funds aggressively, with the intention of using them 20+ years into the future. This allows you to save receipts over an extended period of time, and make a large (tax-free) withdrawal in the future. This maximizes the tax free growth opportunity of the account. However, it requires the use of taxable (non-HSA) funds for medical expenses during the delay period.

Common Issues & Resolutions

Common issues include mistakes in contribution limits, incorrect tax reporting, and misunderstanding what qualifies as a medical expense. If you encounter any issues, consult your HSA provider and a knowledgeable financial advisor to resolve them.

One frequent mistake is double-counting HSA contributions, which can happen if contributions from both personal and employer sources are not tracked properly. Another is failing to report HSA distributions accurately, leading to unwarranted tax liabilities. Before implementing any tax strategies, consult a tax professional.


Health Savings Accounts (HSAs) offer significant benefits, providing a tax-advantaged way to save for medical expenses. By understanding how to maximize your HSA and integrating it into a broader financial plan, you can achieve greater financial stability and efficiency. Ready to maximize your HSA benefits? Contact Mainstay Capital today to consult with an expert.

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