HSA/FSA Resources

Frequently Asked Questions About HSA and FSA: Eligible Items, Benefits & Rules

Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) let you pay for certain medical expenses tax-free. You add money to the account and can withdraw it tax-free for approved medical expenses. While both are typically offered as part of an employer-sponsored benefits package along with health insurance, you can sometimes get an HSA even if you don't have an employer or your employer doesn't offer one.

Check with your plan administrator for a complete list of qualified medical expenses and any specific rules or restrictions.

What Is an FSA (Flexible Spending Account)?

With an FSA, you can choose to contribute money directly from your paycheck before taxes are taken out so you can use tax-free money on qualified out-of-pocket medical expenses. An FSA is only available through an employer. Eligible expenses are determined by the plan administrator and may include deductibles, copays and over-the-counter medication and products. Money left in the account at the end of the year typically doesn't roll over and is lost. The limit for FSA contributions in 2025 is $3,300.

What Is an HSA (Health Savings Account)?

An HSA is a type of account funded with pre-tax contributions that's available with an HSA-eligible high-deductible health plan and if other IRS requirements are met. With an HSA, the account isn't tied to your employer, so you may be able to get one even if you are self-employed or work for a company that doesn't offer an HSA. You can also keep the money in your HSA indefinitely because it rolls over to the next year. Yearly HSA contributions as of 2025 are limited to $4,300 for individuals and $8,550 for families. People over 55 can take advantage of an additional $1,000 catch-up contribution.

HSA vs. FSA: Key Differences

Key differences between an HSA and FSA are:

• Contribution limits: As of 2025, FSAs have a yearly limit of $3,300, and HSAs have a yearly limit of $4,300 for one person and $8,550 for a family, plus a $1,000 catch-up contribution for those aged 55 and older.

• Access: An FSA is tied to your employer, so you can only get one if your employer offers it. HSAs may be available outside of an employer-sponsored benefits plan if enrolled in an HSA-eligible high-deductible health plan and other IRS requirements are met.

• Tax benefits: Contributions to FSAs and HSAs are pre-tax if taken from your paycheck and tax-deductible if eligible, and withdrawals are tax-free when used for approved medical expenses. Money in an HSA can grow over time and be used as a tax-free investment dedicated to qualified medical expenses.

• Flexibility: You can hold onto an HSA if you leave your employer, switch jobs, or retire. FSAs are less flexible because they're tied to your employer.

How Do I Use My FSA or HSA Dollars?

Most FSAs or HSAs come with a debit card to pay for qualified medical expenses. In some cases, you can get reimbursement from your FSA or HSA by submitting your receipt.

The entire annual FSA contribution is typically available at the start of the year, even if you haven't made the actual payment from your paychecks into the account yet. For example, if you sign up for an FSA with a total contribution of $1,500, all that money is available from the first day and contributions to the account are made from payroll deductions over the course of the year.

HSA dollars aren't available until they're in the account. For instance, if you've put in $500 so far, you can only use up to $500. You can pay out of pocket and reimburse yourself once your account has the necessary amount.

What Items Are FSA- and HSA-Eligible?

Your FSA and HSA can be used on qualified medical expenses. This includes deductibles, copays, qualified vision and dental services, prescriptions and over the counter (OTC) medication or medical supplies. You can purchase HSA and FSA eligible OTC items in-store or online.

How Do I Pay for FSA- and HSA-Eligible Items?

You can often pay for FSA- and HSA-eligible items directly using your account-linked FSA or HSA debit card. If your order has eligible and non-eligible items, the items identified as eligible are charged to the card, while ineligible items must be paid for with a different card. You may be required to pay out of pocket for some items and submit the receipt for reimbursement from your account.

What Happens to Unused HSA and FSA Funds at the End of the Year?

Money in an HSA rolls over and remains available for use. Money remaining in an FSA is returned to your employer at the end of the year. You also lose any FSA funds accrued in your account if you leave your job.

Can I Have Both an HSA and an FSA?

In most cases, you can have either an HSA or an FSA but not both simultaneously. IRS rules prohibit you from having both, with some limited exceptions. One exception occurs when an employer offers a limited-purpose FSA tied to specific uses, such as vision and dental care. You can have this type of limited-purpose FSA along with a separate HSA.

Can I Use an HSA or FSA to Buy Over-the-Counter Medication and Products?

In 2020, the CARES Act eliminated the requirement that over-the-counter medication needed a prescription to qualify as an HSA or FSA purchase. Now, you can use your account to buy eligible over-the-counter medications and products, including:

• Analgésicos

• Allergy medication

• Cold and flu medicine

• Antacids and laxatives

• Acne medication

• Menstrual care products

• Broad-spectrum sunscreens

• Diagnostic tests

• Anticonceptivos

• Curitas

• First aid supplies

Some items may be eligible if you have a letter of medical necessity from your health care provider. These may include weight loss programs, supplements and home accessibility aids

*Los artículos elegibles para la cuenta de ahorros para la salud (HSA) y la cuenta de gastos flexibles (FSA) pueden variar según el administrador de los beneficios y los cambios en las regulaciones del Servicio de Ingresos Internos (IRS). Consulte con su administrador de beneficios.