In the complex landscape of health insurance and medical expenses, two terms often stand out: Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs). While both HSAs and FSAs offer unique benefits for managing healthcare expenses, understanding their differences is crucial in making an informed decision that aligns with your financial and healthcare needs.

Whether you're navigating the maze of health insurance plans for the first time or looking to optimize your existing healthcare expenses, this guide will provide you with the clarity and insight needed to choose between an HSA and an FSA. Let’s dive into the nuances, benefits, and limitations of these accounts.

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What is an HSA?

A Health Savings Account (HSA) is a tax-advantaged savings account designed for individuals with a high deductible health plan (HDHP); the funds that you contribute to it can be used to pay for qualified medical expenses (QME), like birth control, acne medication, acupuncture or even SPF 15+ lip balm!

HSAs are considered “tax-advantaged” because the contributions are made pre-tax, reducing your taxable income. The money in your HSA can be invested, and any interest or earnings are tax-free. Notably, HSA funds roll over year to year, and the account remains with you even if you change jobs or retire.

It’s important to note that there is a limit on how much you can contribute to your HSA each year. According to the IRS, the 2024 HSA contribution limit is $4,150 if you are single, and $8,300 for families.

Let’s take a look at an example:

• Suppose you have a yearly income of $50,000 and you decide to contribute the annual max of $4,100 to your HSA. With the HSA contribution, your taxable income reduces from $50,000 to $45,900. This reduction can lower your tax bracket or reduce the amount of income tax you owe!
  
• If you have a qualified medical expense, you can then use your HSA balance to cover those costs. This withdrawal is not taxed, unlike withdrawing from a taxable account where earnings might be subject to capital gains or other taxes.
  
• Over time, the funds in your HSA also grow due to interest or investments, and this growth is also not taxed.
  

In summary, an HSA offers a triple tax savings advantage: you save on taxes when you contribute, as the account grows, and when you make qualified withdrawals. This makes HSAs a highly efficient tool for managing healthcare expenses, especially for those with high-deductible health plans.

What is an FSA?

A Flexible Spending Account (FSA) is another type of tax-advantaged account. It's typically offered by employers and allows employees to set aside pre-tax dollars for healthcare expenses. Just like HSAs, FSA funds can cover various out-of-pocket healthcare costs, from copays to prescriptions.

However, FSAs have a "use it or lose it" rule, meaning you need to use the funds within the plan year, though some plans offer a grace period or allow a small amount to roll over into the next year. This means that if you have unused funds in your FSA at the end of the year and you don’t spend them, the unused money goes back to your employer.

It’s important to note that there is a limit on how much you can contribute to your FSA each year. According to the IRS, the 2024 HSA contribution limit is $3,200.

Let’s take a look at an example:

• Suppose your annual salary is $50,000, and you decide to contribute the 2024 annual max of $3,200 to your FSA. With your FSA contribution amount, your taxable income is reduced to $46,800. This income reduction can lower your tax bracket or reduce the amount of income tax you owe.
  
• If you have a qualified medical expense, you can then use your FSA balance to cover those costs. This withdrawal is not taxed, unlike withdrawing from a taxable account where earnings might be subject to capital gains or other taxes.
  
• If you only end up spending $1,000 of the $3,200 that you contributed to your FSA, the remaining $2,200 will go back to your employer at the end of the plan year.
  

This example illustrates how contributing to an FSA can lower your overall tax burden. You're taxed on a lower income, and the money you use from the FSA for medical expenses effectively comes out tax-free.

Key differences between HSAs and FSAs

Although both HSAs and FSAs are tax-advantaged savings accounts, there are several nuances that separate them from each other. Here are the key differences between HSAs and FSAs:

• Eligibility: HSAs are available only to those with a qualifying HDHP, while FSAs are typically employer-based.
  
• Contribution Limits: HSAs have higher contribution limits compared to FSAs.
• Rollover: All HSA funds can roll over and accumulate year after year, while FSA funds must be used before the end of the year (or the end of the grace period, if your plan has one).
  
• Ownership: HSAs are individually owned and portable across jobs, whereas FSAs are employer-owned.
  
• Investment options: HSA funds can be invested, potentially growing over time, unlike FSA funds.
  
  

HSA vs FSA: Which is Right for You?

If you’re struggling to choose between an HSA and an FSA, take a step back and think about factors like your health insurance plan, financial situation and healthcare needs. If you're enrolled in a high-deductible health plan and want a long-term savings option for healthcare costs, an HSA might be ideal. For those with more immediate healthcare spending needs and less interest in long-term savings, an FSA can offer immediate tax benefits and easy access to funds.

HSA and FSA Spending on Sesame

Whether you opt for an HSA or FSA, both accounts offer significant tax advantages and can help you manage your healthcare expenses more effectively. You can also pay for medical care on Sesame - from imaging to labs to primary care appointments - with your HSA or FSA cards, ensuring that your healthcare costs are covered in a tax-efficient way. Remember, the choice between an HSA and an FSA depends on your individual healthcare needs and financial goals. Plan wisely, and you can make the most of these valuable employee benefits and take control of your healthcare expenses with confidence.

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Sources:

• Health Savings Account 2023-2024 HSA contribution limits and guidelines. Healthequity.com.
  
• IRS: 2024 Flexible Spending Arrangement contribution limit rises by $150. IRS.gov.
  
• Understanding HSA-eligible plans. Healthcare.gov.