HSA Tax Advantages
Your contributions may be 100 percent tax-deductible, meaning contributions can be deducted from your gross income. All interest earned in your HSA is 100 percent tax-deferred, meaning the funds grow without being subject to taxes unless they are used for non-eligible medical expenses.
Verification of expenses is not required for HSAs. However, total withdrawals from your HSA are reported to the IRS on Form 1099-SA. You are responsible for reporting qualified and non-qualified withdrawals when completing your taxes.
Drawbacks of HSAs include tax penalties for nonmedical expenses before age 65, and contributions made to the HSA within six months of applying for Social Security benefits may be subject to penalties.
One benefit of the HSA is that after you turn age 65, you can withdraw money from your HSA for any reason without incurring a tax penalty.
If you've mistakenly used HSA funds for nonqualified expenses, you must repay the distribution amount back into your HSA by the tax filing deadline for the year in which the distribution occurred. By reimbursing your HSA, you can avoid the income tax and the 20% penalty on nonqualified distributions.
The Last Month Rule
There is a testing period of twelve months. This means you must stay eligible through the end of the next year, or else you will face taxes and penalties.
Once you turn 65, you can use the money in your HSA for anything you want. If you don't use it for qualified medical expenses, it counts as income when you file your taxes.
When health savings accounts aren't used for their intended purposes, account holders are often assessed penalties. When an account holder under the age of 65 uses their health savings account's funds for non-medical expenses, they have to pay income tax on the money spent plus a 20-percent penalty.
One of the great advantages of an HSA is that you're not required to take money out of it by any given date, such as the end of the year — you can save and may even be able to invest your balance until you need it.
Does HSA spending trigger an audit? The IRS doesn't monitor how you spend your HSA funds throughout the year, but that doesn't mean they won't ask for proof that your expenses were eligible. And if your tax return contains unrelated IRS audit red flags, your risk for an HSA audit could increase.
In addition, if HSA funds are withdrawn before age 65 and not used for eligible medical expenses are generally subject to an additional 20% tax penalty. In other words, you may lose the tax benefits when you use HSA for non-medical expenses. There may also be a significant tax fee or penalty.
In general, vitamins are not considered an HSA eligible expense unless they are prescribed by a doctor for a specific medical condition.
For 2024, if you have self-only HDHP coverage, you can contribute up to $4,150. If you have family HDHP coverage, you can contribute up to $8,300.
Keep in mind that you can reimburse yourself for any expense at any point, as long as it was incurred after your HSA was established. So if you had an expense that you paid out-of-pocket last year after your HSA was established, but want to reimburse yourself for it this year, you can do so without penalty.
When you contribute money to an HSA, it decreases your adjusted gross income (AGI) which determines your taxable income. Since the U.S. runs on a tax rate system based on your income, the lower your AGI, the lower your tax bill.
Yes, you read that correctly—even if you accidentally paid for a burger with your HSA debit card, you will have to report it on your annual income tax return and pay taxes on it. If you're under 65 and spend the money on unqualified purchases, you must also pay a 20% penalty on top of the income tax.
Gym memberships. While some companies and private insurers may offer discounts on gym memberships, you generally can't use your FSA or HSA account to pay for gym or health club memberships. An exception to that rule would be if your doctor deems fitness medically necessary for your recovery or treatment.
You can withdraw funds from your HSA at any time to cover qualified medical expenses, which are listed below. The amount you can withdraw in a given year varies based on your medical costs.
Can I cash out my HSA when I leave my job? Yes, you can cash out your HSA at any time. However, any funds withdrawn for costs other than qualified medical expenses will result in the IRS imposing a 20% tax penalty.
Your HSA also covers expenses for standard dental cleanings and dental check-ups. One thing to keep in mind is that some of these procedures may have a co-payment, so it's important that you check with your dental insurance provider to find out exactly what you'll have to pay out of pocket.
HSAs can reduce taxable income in retirement, which may affect Medicare premiums and the portion of Social Security benefits subject to federal income tax.
By using untaxed dollars in an HSA to pay for deductibles, copayments, coinsurance, and some other expenses, you may be able to lower your out-of-pocket health care costs. HSA funds generally may not be used to pay premiums.
If you are retiring at the age of 65 ½ or older, to avoid potential tax issues, you want to STOP YOUR HSA CONTRIBUTIONS so that you have 6 months of NO contributions before you FILE FOR MEDICARE. Please keep in mind that the EMPLOYEE and EMPLOYER contributions do appear in the “look-back period”.
HSA distributions are reported to the account owner on Form 1099-SA. This form is issued by the financial institution. Form 8889 must be filed with your annual Form 1040 federal tax filing if you make contributions to or take distributions from an HSA.