The Learning Center | DiMercurio Advisors

What is a Health Savings Account?

Written by John Kirkland | Apr 11, 2025

If you’re enrolled in a high-deductible health plan (HDHP), one perk you should be taking advantage of is a health savings account. A health savings account, or HSA, is a tool that can let you lower your taxable income, make tax-free withdrawals on qualified medical expenses, grow investments tax-free and more.  

Understanding how HSAs work and their requirements, benefits and drawbacks can help you learn how to save for medical expenses as a business owner while paying less in taxes compared to other plans.  

Contents

What is an HSA? 
What counts as a High Deductible Health Plan? 
If I change insurance plans, what happens to my money? 
Can I invest the money in my HSA?
How can having an HSA help me save on taxes? 
What are the alternatives to having an HSA? How do they compare to an HSA from a tax perspective? 

 

What is an HSA? 

An HSA is exactly what it sounds like – a savings account that you can use toward eligible medical costs. Those include many common expenses, annual exams, prescription drugs, lab fees, hospital fees and more.  

What makes HSAs unique are their tax advantages compared to other similar medical plans like flexible spending accounts (FSAs) and health reimbursement accounts (HRAs). There are three main ways that HSAs offer tax benefits: 

  • Your HSA funds aren’t taxed while sitting in your account 
  • Withdrawals for eligible medical expenses won’t be taxed 

HSAs are not available to everyone, though. In order to use one, you need a high-deductible health plan (HDHP).  

What counts as a High Deductible Health Plan? 

A high-deductible health plan is a health insurance plan with a relatively high annual deductible, and, conversely, lower monthly premiums. If you’re healthy and typically just get preventative care, a HDHP may be a good option for you.  

You can look for HSA-eligible HDHPs by visiting HealthCare.gov and browsing through all available plans. Look for the Filters tab and check the box that says “Eligible for an HSA.” After that, eligible plans will populate and you can filter the list down more based on other features and prices. 

A HDHP is the only type of health insurance plan you should have if you want to qualify for an HSA.  

If I change insurance plans, what happens to my money? 

Even if you change insurance plans, you can always keep the funds in your HSA, and the plan itself.  

If you work for or start a new business, you’ll need another HDHP if you want to continue to put funds in. You won’t be able to make contributions if your new role’s plan is not an HDHP.  

Regardless of your plan, the same withdrawal rules still apply: Eligible withdrawals are tax-free, and you may face penalties for non-medical expenses if you’re under 65 years old.  

Can I invest the money in my HSA? 

Your HSA’s tax benefits can make it a powerful retirement tool as well as a savings tool. You can invest a portion of the money in your HSA, and enjoy the same tax advantages on what you earn as you do your contributions.  

HSAs come with varying rules on when and how you can invest your funds. Plans may come with automatic and/or manual investment options. Some plans will let you start investing as soon as you make contributions to the account, while others require the balance in your account to meet a certain threshold.  

Regardless of how and when you invest, your earnings will always grow tax-free – which is why you should consider investing with your HSA if you do open one. Since there are varying investment rules between different plans, it’s best to compare several HSAs to see which one might fit your needs best.  

How can having an HSA help me save on taxes? 

If an HSA fits well with your health and financial situation, then you could stand to save a lot on taxes for you and your business. HSAs are tax advantaged in three ways: your contributions are pre-tax, your funds and investments grow tax-free and eligible medical distributions – which are wide-spanning – are also tax-free.  

Those tax rules combined with the HSA structure can result in long-term savings. For example, you are allowed to roll over your unused funds from year-to-year which is not an option with some other health savings plans. Plus, HSAs have a relatively higher contribution limit compared to other plans, which provides more opportunity to lower your taxable income:  

  • 2024 limits: $4,150 for yourself or $8,300 for your family 
  • 2025 limits: $4,300 for yourself or $8,550 for your family 

A HSA’s tax benefits doesn’t necessarily mean that it’s always the best option for you, but it is worth exploring especially if you are a business owner – since other options may not even be available to you.  

What are the alternatives to having an HSA? How do they compare to an HSA from a tax perspective? 

A common alternative to a health savings account is a flexible savings account (FSA), which is also an account that helps you save for medical costs.  The main advantages that FSAs have over HSAs are: 

  • You’re not beholden to a high-deductible health plan 
  • You have immediate access to your full FSA funds at the beginning of the year – which is not the case with HSAs 
  • You may be able to cover more types of expenses with an FSA 

Beyond that, HSAs generally have more advantages than FSAs. For example, FSAs may not travel with you when you change jobs because your employer is in control of it. (This also means FSAs are not available to self-employed people.) You may also not invest your FSA, while you can invest with your HSA. FSA funds operate on a use-it-or-lose-it basis.

These two accounts also have different tax rules. While both account contributions are made with pre-tax dollars and therefore lower your taxable income, only HSA contributions are tax-deductible (along with investment earnings made with the HSA and eligible distributions) – which means they could potentially save you more.  

It’s important to discuss with a tax expert before you choose a type of plan, since there are both health and financial factors to consider. 

The bottom line

Part of being a business owner is looking for tax savings wherever you can so you have more resources to invest in yourself and your business. A health savings account (HSA) is an often-overlooked tool that can help you do just that.  

If you’re healthy and your medical expenses mostly consist of preventative care, then a high-deductible health plan that allows you to utilize a HSA is likely an option worth exploring. An HSA will help you save for medical expenses all while being contributed tax-free, growing tax-free and being withdrawn-tax free.  

HSAs are powerful tools if you know how to find them and work with them. If you need help determining whether they’re the right fit for you and your business, contact DiMercurio Advisors today.