US HSA Calculator

Health Savings Accounts get unique triple tax treatment under US tax law: contributions are pre-tax, growth is tax-free, and withdrawals for qualified medical expenses are tax-free. After age 65, withdrawals for any reason are taxed like a traditional IRA (no penalty). No other US tax-advantaged account combines all three benefits - 401(k)s and IRAs are 'double-advantaged' (pre-tax in, tax-deferred growth, then taxed out).

2024 contribution limits: $4,150 self-only coverage, $8,300 family coverage, plus $1,000 catch-up for age 55+. Contributions made via payroll also dodge the 7.65% FICA tax (Social Security + Medicare), giving an effective tax saving of 25-40% on every dollar contributed depending on your bracket.

HSA eligibility requires enrollment in a high-deductible health plan (HDHP). 2024 HDHP definition: minimum $1,600 deductible / $3,200 family, max out-of-pocket $8,050 / $16,100. You also can't have other 'first-dollar' coverage (regular FSA, traditional health plan via spouse, Medicare).

The HDHP+HSA combo only makes sense if you can absorb the high deductible cash. With chronic conditions or expected high medical use, a traditional PPO with regular co-pays often costs less in total. For healthy savers, HDHP+HSA produces lower premiums plus the HSA tax advantage - net winner.

If you can pay current medical expenses out of pocket, the HSA becomes a stealth retirement account. Contribute the max each year, invest aggressively (most HSA providers offer mutual funds and ETFs once balance crosses $1-2k), and let it grow tax-free for decades. Save medical receipts and reimburse yourself any time in the future, tax-free.

Contribute $8,300/year for 30 years at 7% growth = roughly $850,000. Withdraw tax-free for medical expenses any time, or after 65 use it like a traditional IRA. Many financial advisors now recommend prioritizing HSA contributions over 401(k) contributions beyond the employer match because of the unique tax treatment.

Wide range: doctor visits, prescriptions, hospital, dental, vision, mental health, physical therapy, medical equipment, contraception, fertility treatments, breast pumps. Over-the-counter medicines became eligible after CARES Act 2020. Premiums generally NOT eligible (with exceptions: COBRA, Medicare premiums for retirees over 65, long-term care insurance up to limits).

Save every receipt - audit risk is real. The IRS doesn't track which withdrawals are medical; they audit and ask for documentation if challenged. Most HSA providers have receipt-storage features in their portals. The [US Health Insurance Estimator](/us-health-insurance-estimator) helps compare HDHP vs PPO total cost; the [US 401(k) Calculator](/us-401k-calculator) covers the retirement-account stack.