15 ways to use your health savings account

HSAs, FSAs and HRAs let you put tax-free dollars toward fitness, transportation and even home renovations

If you have health insurance, you might also qualify for a tax-free health savings account — an HSA, HRA or FSA. Here’s a look at the 3 types of accounts you may be able to use to your advantage:

  • Health reimbursement account (HRA) — This is an account your employer opens on your behalf. Your employer makes contributions, and you can use it for premiums and qualified medical expenses. Depending how your employer set it up, you may need to spend the money before the year ends. Other times, the balance will roll over.
  • Health savings account (HSA) — This is a personal bank account to help you save and pay for covered health care services and qualified medical expenses. If you’re a member of UnitedHealthcare and have a high-deductible plan, you may be able to open an HSA through Optum Bank® (more information below).
  • Flexible spending account (FSA) — You and your employer can both make contributions. That allows you to save faster for a big medical event, such as a surgery. The catch is that the money must be used by the end of the plan year.

“For many people, selecting a health plan with a health savings account is an excellent option to help make accessing medical services more affordable,” says Rebecca Madsen, chief executive officer of advocacy at UnitedHealthcare. “HSA funds can help pay for deductibles, copays and other qualified out-of-pocket costs, such as dental, vision and prescription expenses, while lowering your federal taxable income by setting aside pre-tax money. Better yet, if you don’t need to use the funds, they can become an interest-bearing nest egg that grows over time, helping people pay for health care expenses later in life or during retirement.”

Once a person selects a health plan with an HSA, money can be automatically deducted from each paycheck and deposited into the account, in some cases supplemented by contributions from an employer. To pay for qualified medical care, a debit card associated with the HSA can be used. The other option is to pay out-of-pocket medical costs and then get reimbursed  from the HSA. In this scenario, it is important to keep receipts for tax-time reporting.

Most people think of using their HSA, HRA or FSA savings to pay for things like prescriptions, deductibles for appointments or expenses related to surgeries. But there are many more ways to use this money, including these 15 ideas:

1. Alternative health treatments

You may be able to use your account to pay for alternative health treatments that your insurance doesn’t cover, like homeopathy, ayurveda, electromagnetic therapy or reiki.

2. Cover the cost of travel for medical appointments

Long drive to the doctor’s office? Use your funds to pay for travel costs to and from medical appointments. That includes gas, tolls, parking, public transportation, taxi fares or even plane tickets. If you have to stay overnight near a hospital, you can put $50 toward a hotel room — or $100 if you’re traveling with a companion.

3. Cold and flu medicines

Before a nasty cold strikes, stock up on throat lozenges, cough syrup, nasal spray, decongestants and expectorants — an especially great idea if you have to spend money before the year ends.

4. Make health-related home improvements

Certain home improvement projects can be eligible for reimbursement through your health account, as long as their main purpose is to provide medical care to you or your dependents. This includes adding porch lifts; constructing entrance or exit ramps; widening doorways; installing railings, handrails, or grab bars; and lowering cabinets. You might even be able to pay for bigger renovations like in-home elevators or swimming pools to treat medical conditions such as multiple sclerosis. But, you’ll need a letter of medical necessity from your doctor, and you should consult with someone who specializes in tax-free health spending.

5. Reduce the cost of dental care

You can use your funds for things like braces, dental reconstruction, denture supplies such as adhesives and cleansers, tooth bonding, artificial teeth and veneers — if it’s necessary to prevent or treat disease or restore function and it’s not cosmetic.

6. Improve your vision

Pay for expenses related to eye care, including:

  • Eye exams

  • Eyeglasses

  • Contact lenses

  • Eyeglasses repair kits

  • Cleansing cloths

  • Contact lens cases

  • Contact solution

  • Eyedrops

7. Get new hearing aids and batteries

Use your HSA, FSA or HRA to buy hearing aids and batteries. If your hearing aids ever break, you can also use the funds to cover any necessary repairs.

8. Build your retirement fund

This doesn’t apply to FSAs or HRAs. But if you have an HSA, you can use it to prepare for retirement.

If you can contribute more than you spend, the money will grow tax-free for years. And you’ll have it waiting for you when you need care the most. You can use the money in an HSA to make investments in stocks, bonds and mutual funds, just like you would with an individual retirement account.1

The IRS re-evaluates the contribution limits for HSAs each year. In 2024, you can contribute up to $4,150 to your individual HSA, or $8,300 if you have family coverage.2

And if you’re 55 or older, you can tack on an extra $1,000 in catch-up contributions to your HSA. Since there is no reimbursement deadline, you can potentially invest your HSA funds and pay yourself back on decades-old medical expenses — so long as they were incurred after you opened the account. Just make sure to keep your receipts in case the IRS comes knocking.

9. Enlist a service animal

People with vision or hearing impairments or other physical disabilities can use their health accounts to get a service animal, such as a guide dog or other companion animal. And that goes beyond the cost of acquiring and training the furry helper. You can use your tax-free dollars to pay for food, grooming and veterinary care. If it helps maintain the health of the animal, you can use your tax-free funds to buy it.

10. Defray the cost of childbirth

Childbirth is a pivotal event in a person’s life. It’s also very expensive. But your tax-free health account can cover direct hospital expenses that may have added up during childbirth. It can also be used to pay for many expenses accrued before and during pregnancy, such as pregnancy tests, prenatal vitamins, Lamaze classes, even in vitro fertilization. 

11. Pay insurance premiums when you’re unemployed

If you have an HSA, this one is for you. Since the money never expires, you can take it with you if you leave your job or the health policy that came with it. And then you can use it to pay your insurance premiums.

If your company offers COBRA continuation coverage, you can use your HSA to pay for that. If not — and if you’re currently receiving unemployment benefits — you can use the funds to pay for traditional health insurance premiums.

12. Knock out some of your Medicare premiums

Medicare presents another opportunity to use your HSA to pay for insurance premiums. You can also pay your Medicare Advantage premium with HSA funds, but premiums for Medicare supplemental insurance policies are not eligible.

13. Supplement your yoga routine

Yoga is a wonderful way to boost mindfulness, relieve anxiety, and strengthen your body. And if your doctor prescribes it to treat a medical condition, such as arthritis, it becomes an eligible health account expense.

14. Pick up a blood pressure monitor

Nearly half of U.S. adults have hypertension (high blood pressure), according to the American Heart Association. If you think you may be at risk, a home blood pressure monitor is one of the best ways to stay on top of your heart health.

If your health insurance policy doesn’t cover the cost of a monitor, you can use your tax-free health account funds to buy one. The Optum Store offers several blood pressure monitors that can be delivered to your door.

15. Spend less on menstrual products

Use your HSA, FSA or HRA to stock up on period essentials. Eligible items include:

  • Pads

  • Liners

  • Tampons

  • Menstrual cups

  • Period underwear

  • Medications that help relieve menstrual pain, bloating and cramps 

How to open an HSA

During open enrollment, select a medical plan with an HSA. Plans that feature an HSA generally have lower premium costs and a higher deductible — which, for the plan year 2023, is at least $1,500 for an individual or $3,000 for a family.2

To open your HSA, you’ll need your:

  • Social Security number
  • Email address
  • Group number — from your health plan ID card
  • Identification number — from a valid driver’s license, state-issued ID card or passport

Eligible UnitedHealthcare members can open an HSA here.

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