Everyone knows about 401(k) plans and IRAs, but those with a high-deductible health plan (HDHP) have another option for building savings for retirement: the Health Savings Account (HSA). These are tax-advantaged accounts that help people save money for future medical expenses.

Some employers that provide high-deductible health plans for their employees offer HSAs as well. More generous employers will even match your contributions or make direct contributions to your account even if you don’t.

If you don’t get an HSA from your employer, HSAs are offered by many financial institutions. This tool can help you find the best HSA provider for you.

Key Health Savings Account Benefits

Health savings accounts offer three big tax advantages:

• Contributions to health savings accounts are tax-deferred like those of a pretax retirement account such as a 401(k), reducing your taxable income.
• Earnings on the investments in your HSA grow tax-free and are not subject to capital gains taxes.
• Withdrawals for qualified medical expenses are also tax-free.

In 2022, you can contribute up to $3,650 if you’re single (or up to $7,300 for families). If you’re 55 or older, you can put in another $1,000.

Additionally, you can use your HSA to reimburse yourself for out-of-pocket medical expenses from previous years as long as the account was already established when the expenses were incurred – just be sure to save your receipts! Let’s say you opened your health savings account in 2007 and paid out of pocket that year for a health care procedure. Now you can receive reimbursement for it from your HSA if you submit a claim with the receipt.

Health Savings Account Limitations and Restrictions

As is the case with other special purpose savings vehicles, HSAs are subject to specific limitations.

First, if you take money out for non-qualified expenses, you’ll have to pay regular income tax on it. And if you’re under 65, you’ll also pay a 20% penalty.

Second, you may no longer contribute to your HSA after you begin collecting Social Security.

Third, you must give some thought to your investment strategy in your HSA. Most HSAs offer a menu of mutual funds or exchange-traded funds (ETFs) in which you may invest. You should consider your risk tolerance and time horizon when picking funds for your HSA.

What is the Benefit for Retirement?

In addition to out-of-pocket expenses, retirees are able to use their HSA to pay for Medicare deductibles, prescription copays, and long-term care insurance premiums. That last one is particularly important since Medicare doesn’t cover long-term care.

That’s why some financial advisors say that HSAs should be a major component of their clients’ retirement plans. A few even tell their clients to max out their HSAs each year before contributing to other accounts.

Pre-retirees in good health and those that can pay their current medical pills out-of-pocket stand to benefit the most from contributing to an HSA as the money can sit in the account until it’s needed, even if that’s decades from now. The more money you have in your HSA when you begin taking Social Security and are no longer able to contribute, the longer you won’t have to pay out-of-pocket for your healthcare expenses in retirement.

Key Health Savings Account Mistakes to Avoid

If you’re nearing retirement, here are three things that you’ll want to avoid if you’re trying to maximize the benefits of an HSA:

1. Not Buying Insurance With Your HSA

Sure, you can use the funds in your HSA to pay for qualified medical expenses—think co-pays and vision and dental expenses— but if you use HSA funds to pay for qualified medical costs, you won’t be able to claim those costs as itemized deductions.

Instead, you can also use your HSA to pay for certain insurance premiums. These include COBRA premiums, long-term care insurance premiums, and, if you’re 65 or older, Medicare. However, Medigap premiums are NOT eligible expenses.

2. Incurring a Penalty Through Retroactive Social Security enrollment

If you wait until you reach full retirement age to claim your Social Security benefit, you’ll be given a choice to receive a lump sum of retroactive benefits that dates back six months.

However, if you choose to take that lump sum, that means you also have chosen to sign up for Medicare retroactively. That may be a problem if you’ve been making regular HSA contributions because you can’t do both. Contributing to a health savings account while enrolled in Medicare leads to excess contributions.

If this happens, you’ll need to withdraw the amount of excess contribution you’ve made before Tax Day, and they will be included in your taxable income, OR you’ll pay a 6% excise tax for every tax year the excess contributions remain in your account. Ouch.

3. Using Your Health Savings Account to Pay for Non-Medical Expenses

If you withdraw money from your HSA for non-qualified medical expenses before you turn 65, be prepared to pony up 20% for the withdrawal penalty, which is more than the 10% early withdrawal penalty from IRAs and 401(k) plans. You’ll pay the penalty PLUS regular income taxes on the withdrawn amount.

If you’re over 65, you’ll still have to pay income taxes on non-qualified HSA withdrawals, but you won’t have to deal with the 20% penalty.