Why You Should Treat Your HSA Like an IRA

Would you raid your Roth IRA or 401(k) to pay for car repair bills? I suppose if you have no other choice, you might. But ordinarily, we want to use our tax-advantaged retirement accounts only as a last resort because we want that money to grow tax-free or tax-deferred for as long as possible. The HSA is the only account that allows us to make pre-tax contributions and withdraw them tax-free. Why then are we so willing to tap into our HSAs for medical expenses?

Yes, there’s no tax or penalty on those withdrawals since that’s what they’re meant to be used for. But HSAs can also be a tax-free retirement account since the money grows to be tax-free if used for medical expenses at any time, including retirement. Since there’s a pretty good chance you’ll have some health care costs in retirement, you can count on being able to use that money tax-free. (If you keep the receipts for health care expenses you pay out-of-pocket, you can also withdraw that amount tax-free from the HSA later since there’s no time limit between the medical expense and the withdrawal.) You can also use the money penalty-free for any expense after age 65, although it would be taxable just like a pre-tax retirement account.

Let’s say you contribute $3k per year to an HSA and don’t touch the money for 30 years. If you just earn an average of 1% in a savings account, you will have over $105k. But if you invest that $3k each year and earn a 7% average annual return, you’ll end up with over $300k or almost 3 times as much!

That’s why I recently decided to take advantage of our company’s switch to a new HSA custodian by transferring my HSA funds from a savings account to an HSA brokerage account. Since I don’t intend to touch this money for a few decades, I can invest it more aggressively and hopefully earn a higher rate of return. In the meantime, I’ll just pay my health care costs out of my regular income and savings.

One little hiccup that I noticed is that my custodian charges a $3 fee for the brokerage account if I don’t keep at least $5k in the savings account. At first glance, it’s tempting to keep $5k in the savings account to avoid that fee but the $36 a year in fees is only .72% of the $5k. That means if I can just earn more than an extra .72% in the brokerage account, I’ll be ahead. Given historical returns, I think that’s a pretty good bet.

Here are some guidelines to make the best use of your HSA:

1) First, make sure you have an adequate emergency fund to cover health care expenses. If not, ignore everything in this blog post until you do

2) If you have the option of a health care plan with an HSA, consider getting it. The premiums are lower so you generally save money in the long run if you’re in good health.

3) Try to max out your contributions. (If you do it through payroll deductions into a section 125 cafeteria plan, you can also avoid FICA tax on the contributions). Aside from getting the match on your 401(k) and paying off high interest debt, this is generally the best use of your money because the contributions are both pre-tax and can be withdrawn tax-free (for health care expenses).

4) If you have a brokerage option, invest as much of your HSA as you can in a portfolio that’s appropriate for your time horizon and risk tolerance. (Make sure your expected returns justify any fees you may have to pay.)

5) Don’t touch your HSA money unless you absolutely need to. Instead, use a health care FSA (if you don’t use it, you lose it at the end of the year) or your regular savings (see #1) to cover medical expenses.

6) Keep the receipts for any health care expenses you pay out-of-pocket since you can withdraw those amounts from your HSA tax-free anytime.

7) Have tax-free money to help cover health care expenses in retirement!