HSA & FSA Coach
Use it. Don\'t lose it.
Quick difference
- HSA (Health Savings Account) — only available with high-deductible health plans. Money rolls over forever. Triple tax advantage. AFTER 65, you can use it for non-medical expenses too (like an IRA).
- FSA (Flexible Spending Account) — through your employer. Use it or LOSE IT each year (with small carryover or grace period).
- Limited-Purpose FSA — for dental and vision only. Pairs with HSA.
- Dependent Care FSA — for child / elder care. Different from regular FSA.
What they pay for (more than you think)
- Doctor copays, hospital stays, surgeries.
- Prescription drugs.
- Over-the-counter meds (since 2020) — Tylenol, Advil, Sudafed, allergy meds.
- Menstrual products (since 2020).
- Glasses, contacts, eye exams.
- Dental — checkups, fillings, crowns.
- Hearing aids ($2,000-7,000 each — biggest single use).
- Mental health therapy.
- Acupuncture, chiropractor.
- Sunscreen (SPF 30+).
- First aid kits, thermometers, BP monitors.
- CPAP machines and supplies.
- Crutches, walkers, mobility aids.
- Mileage to medical appointments (21¢/mile in 2025).
- Long-term care insurance premiums.
- Medicare Part B/D premiums (HSA only, after 65).
- Even some gym memberships if doctor-prescribed for a condition.
HSA at retirement = secret IRA
After 65, HSA money can be used for ANYTHING (not just medical). You pay regular income tax — same as withdrawing from a traditional IRA. Difference: medical expenses are still TAX-FREE. So an HSA is a "best of both worlds" account — best to MAX OUT in your working years.
2025 HSA contribution limits: $4,300 single, $8,550 family, plus $1,000 catch-up if 55+.
Use FSA before December
FSA money typically expires Dec 31 (some employers allow $640 carryover or a 2.5-month grace period). End-of-year ideas:
- Stock up on contact lenses, prescription glasses.
- Get the dental work you\'ve been putting off.
- Buy a year\'s worth of OTC meds and first aid.
- Get hearing aids or check up.
- Get the BP monitor or CPAP your doctor mentioned.
- Buy massage gun or back support.
Where to shop
- FSA Store / HSA Store (fsastore.com) — only sells eligible items. No guessing.
- Amazon — has an "FSA/HSA Eligible" filter.
- Pharmacy — most automatically charge HSA/FSA card for eligible items.
- Doctor\'s office — pay copays directly with the card.
Save receipts (HSA)
For HSAs, you don\'t have to USE the money the year you spend it. Save medical receipts forever. Years later, you can REIMBURSE yourself tax-free for them — letting your HSA grow as an investment.