What is a potential downside of HSA?

Asked by: Prof. Marielle Ernser II  |  Last update: October 9, 2025
Score: 4.7/5 (3 votes)

One potential downside is that you must be enrolled in a health insurance plan with a high deductible to contribute to an HSA, leaving you responsible for more costs before coverage kicks in. (If you prefer a plan with a lower deductible, you wouldn't be eligible to fund an HSA.)

What are the negatives of HSA?

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.

What is 1 potential downside of investing in an HSA?

The main downside of an HSA is that you must have a high-deductible health insurance plan to get one.

Can my HSA lose money?

Myth #2: If I don't spend all my funds this year, I lose it. Reality: HSA funds never expire. When it comes to the HSA, there's no use-it-or-lose-it rule. Unlike Flexible Spending Account (FSA) funds, you keep your HSA dollars forever, even if you change employers, health plans, or retire.

Why is my HSA negative?

If the account should become overdrawn you will be charged the NSF charge in effect at that time. However, an HSA should never have a negative account balance. If you ever notice a negative balance on your HSA, it is the account holder's responsibility to make the account positive as soon as possible.

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Why not to choose HSA?

HSAs might not make sense if you have some type of chronic medical condition. In that case, you're probably better served by traditional health plans. HSAs might also not be a good idea if you know you will be needing expensive medical care in the near future.

What triggers an HSA audit?

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.

Is it better to use HSA or save it?

It's all about balance: Spend when you need to and save as much as you can to take advantage of the benefits of your HSA that can help you be ready for the future. Source: Employee Benefits Research Institute, Issue Brief, no. 549, January 20, 2022.

Can I ever cash out my HSA?

As a practical matter, you are allowed to withdraw funds from your HSA at any time for any reason. But if you aren't using the funds to cover a qualified medical expense, then you'll be stuck paying a penalty tax.

Can I use HSA for dental?

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.

What happens to your HSA when you turn 65?

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.

What disqualifies you from contributing to an HSA?

If you can receive benefits before that deductible is met, you aren't an eligible individual. Other employee health plans. An employee covered by an HDHP and a health FSA or an HRA that pays or reimburses qualified medical expenses can't generally make contributions to an HSA. FSAs and HRAs are discussed later.

Is HSA worth it?

One of the biggest advantages of an HSA is that it offers a triple tax advantage, which means: Contributions to an HSA are federally tax-deductible, reducing your taxable income. Depending on where you live, you may also get a break on state income taxes. Assets in an HSA can potentially grow federal tax-free.

Is investing HSA risky?

If you have a health savings account (HSA), investing that money can help you maximize the tax benefits the account offers. But depending on your situation, investing your HSA funds could leave you with more risk than you're willing to take on.

Is HSA better than 401k?

Comparing HSAs and 401(k)s

The triple-tax-free aspect of an HSA makes it better for tax management than a 401(k). However, since HSA withdrawals can only be used for healthcare costs, the 401(k) is a more flexible retirement savings tool. The fact that an HSA has no RMD gives it more flexibility than a 401(k).

What are the disadvantages of a high deductible health plan?

Disadvantages of a high deductible health plan
  • You pay all costs for nonpreventive care until you've paid the high deductible.
  • Possible unplanned high out-of-pocket costs when you receive covered services.
  • Worries about money might influence your health care decisions.

Can I borrow from my HSA and pay it back?

No.

Are HSA withdrawals tax-free after 65?

At age 65, you can take penalty-free distributions from the HSA for any reason. However, in order to be both tax-free and penalty-free the distribution must be for a qualified medical expense. Withdrawals made for other purposes will be subject to ordinary income taxes.

Can I use HSA for Invisalign?

Many patients are surprised to learn that you can use your Flexible Spending Account (FSA) or Health Spending Account (HSA) to pay for orthodontic treatment, including braces and Invisalign, for children and adults, which makes this the “most wonderful time of the year” to get started on your dream smile.

What are the disadvantages of HSA?

HSA Cons. The big drawback of an HSA is that you have to sign up with a high deductible health plan to be eligible for one. It is difficult to forecast medical expenses accurately.

Can I use my HSA for gym membership?

Generally, the IRS doesn't allow pretax dollars in HSAs or FSAs for gym memberships. This is because they see them as expenses for general well-being rather than medical necessity. However, with a Letter of Medical Necessity (LMN), your HSA or FSA could be used to fund those expenses.

What is the average HSA balance?

What Is the Average HSA Balance By Age? The average HSA balance for a family is about $7,500 and for individuals it is about $4,300. This average jumps up to $12,000 for families who invest in HSAs. Here's a breakdown of the average HSA balance by age.

How does IRS know what you spend HSA on?

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.

Why do companies push HSA?

1. HSAs lower insurance premiums. One of the primary reasons why you may want to offer an HSA to your employees is because they can help you save on health insurance premiums. HSAs are only eligible for those with HDHPs, which carry high deductibles but have much lower monthly premiums.

Can you pay yourself back on HSA?

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.