7 Ways an HSA Can Help You Now and In Retirement

Ah, retirement! Traveling, volunteering, or just being happy not having to work. Whatever your retirement dreams are, paying for medical expenses is usually not one of them. It should be, though, because health care will be a significant cost. A health savings account (HSA) could be the ticket to enjoying your retirement savings the way you want, while at the same time, saving taxes.

“You are going to have to take on the financial burden of health care.”

Health care costs are a daily news item. Employer retiree coverage is disappearing, out-of-pocket costs are soaring, and the ability to retire before Medicare eligibility is becoming more difficult. You’re probably sick of hearing it, but the fact is most people are unprepared for the costs.

An HSA to bridge the gap

An HSA is a medical expense account only available to those enrolled in a high-deductible health plan (HDHP). What is an HDHP? In 2022, A plan with a deductible of at least $1,400 for an individual or $2,800 for a family with a max out-of-pocket expense of $7,050 for an individual and $14,100 for a family.

For 2022, individuals can contribute up to $3,650, and families, $7,300, plus an additional $1,000 a year if you’re 55 or older. You can make prior-year contributions until April 15, just like an IRA.

Beyond the HDHP requirement, you also cannot contribute to an HSA:

  • After you enroll in Medicare
  • If you contribute to a Flexible-Spending Account (FSA) unless the FSA is for a “limited purpose” such as vision or dental expenses.

“Cannot contribute,” does not mean “cannot own.” It is possible to own an HSA when you are enrolled in Medicare or are no longer a participant in an HDHP. That is an essential fact in the overall strategy.

The benefits

If you’re one of the increasing numbers of people who have an HDHP, you are in luck. An HSA is a deceptively, powerful tool with numerous benefits.

1. HSA distributions are tax-free for qualified medical expenses

Yes, I’m sure you knew this, but did you know you can reimburse yourself for medical expenses incurred years before, provided the medical expense was accrued while the HSA was open. There isn’t even a time limit, but you can’t reimburse expenses incurred before you had the account.

For example, let’s say you just opened an HSA, and there’s a balance of only $2,000. It was a rough year, and you had an unexpected medical expense of $20,000. You can use the $2,000, and then in future years you can take distributions and reimburse yourself for that $20,000 medical expense. There’s no time limit so you can reimburse yourself over ten years if you need to.

Let’s not forget you can use an HSA in retirement for Medicare premiums (excluding Medigap plans). If you’re enrolled in Medicare, you can pay your spouse’s Medicare premium with your HSA as well.

A nonqualified distribution is subject to income tax and a 20% penalty. Unless…

2. The HSA retirement income option

Once you reach age 65, you can withdraw money from an HSA for any purpose, not just medical expenses, and not be subject to the 20% penalty. You will have to pay income tax on nonqualified distributions. I don’t recommend this, however, especially since you’ll have Medicare expenses anyway.

3. HSA can sit there and grow until the cows come home

Unlike an FSA, there’s no use-it-or-lose-it rule. You can keep on contributing money until you need it. The entire balance carries over and grows, year, after year, after year (Hint, Hint). You can even retroactively reimburse yourself for previous expenses, as long as the HSA was open and you still have your receipts.

4. Investment options

HSA accounts can be invested just like a retirement account. That can be good and bad.  The decision to invest depends on how soon you’ll need the funds. If you know you’ll need the funds within the next few years, then it’s wise to keep it in cash.

5. You Own your HSA

An HSA goes with you, even if you retire, are fired, or just quit. That’s not the case with an FSA.  Your FSA account does not belong to you; it’s your employer’s. When your employment ends, so does the FSA (Note: you can still use it if you purchase COBRA). That’s a little nugget of info most people don’t realize.

6. Transfer/Rollover Options

HSA to HSA: Unfortunately, HSAs often have high fees for maintenance and other charges that reduce their benefit. The good news? There is a way to get out of a high-cost HSA by regularly rolling over the HSA assets into a lower-cost plan of your choosing.

There are two ways to do this. The first is a direct transfer from one HSA to another. You can do direct transfers multiple times per year without being subject to taxes. The second is a rollover where the HSA sends you the funds, and then you forward the funds to the new HSA custodian. You are allowed one rollover per year.

IRA to HSA: The IRS allows a once-per-lifetime transfer from an IRA account to an HSA, but the amount, when combined with other HSA contributions for the year, may not exceed your maximum annual contribution.

7. Triple the fun

HSAs are one sweet savings option. Contributions to them are tax-free, the investment earnings grow tax-free, and the funds can be withdrawn tax-free anytime when used for qualified health care expenses. Triple-tax advantages like this don’t come down the pike very often.

Let’s not forget that after age 65 contributions and earnings can be withdrawn for any reason without penalty, although income tax rates do apply, and there are no Required Minimum Distributions (RMDs) at age 72.

Yes, I mentioned these benefits earlier, but I think they are so beneficial they deserved a second shout out as a retirement savings tool.

Putting it all together

When you compare HSAs to IRAs, Roth IRAs, 401(k)s, Roth 401(k)s, heck even 529s, they stand up well. Taxes in those plans are assessed either going in or going out, some have RMDs, and 529s can only be used for education regardless of age.

The average couple, age 65, will spend $260,000 on health care in retirement. (Fidelity)

The trick is knowing how to make the most out of your HSA. If you look at the benefits of an HSA with an eye toward retirement, it’s like a lightbulb being turned on. Let’s assume you’re able to contribute $4,000 to an HSA annually for 20 years and earn a conservative 3% annual return. That would give you approximately $110,000.

If you spend $5,000 on all health and medical expenses each year and have an effective tax rate of 18%, you’ll save over $900 per year, and I think I’m low-balling the amount you’ll spend. The more you spend, the higher the tax benefit. Don’t forget I did not include the tax benefit when you make contributions to an HSA.

If an adverse medical condition would require significant resources in retirement and require withdrawals from an IRA or 401(k), there is a possibility those withdrawals would push you into a higher tax bracket. An HSA could prevent that.

There would be income tax due to the withdrawals for non-health care expenses after age 65,  but no penalty. Worst-case scenario, you would be using the HSA like an IRA without the required minimum distributions. That’s not the end of the world.

If funds are remaining in your HSA when you die,  it will go to your spouse and become theirs, or if you’re not married, it will cease being an HSA and pass to your beneficiary.

An HSA is a win-win situation

Most people don’t have the resources to use their HSA as a retirement savings tool. To think that you won’t ever need any of your funds for medical expenses isn’t realistic. An HSA will help you cover medical expenses without having to deplete emergency funds or use credit cards. That’s a win in my book.

The key is to balance your current needs with an eye to the future. Keep a portion of your HSA assets in cash to cover short-term needs, and invest the rest in a mix of stock and bond funds for the long term.

Everything in financial planning comes down to cash flow. The more you can save in a tax-efficient manner before and during retirement, the more significant your financial benefit. An HSA is a unique tool that can accomplish that goal and prepare you for the cost of health care in retirement.

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