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6 benefits of an HSA in your 20s and 30s

Key takeaways

  • A health savings account (HSA) isn't only for emergency medical savings. It can also help pay for qualified medical expenses and even help you save for retirement.
  • Thanks to multiple tax advantages, you may get more out of your money now and in the future.
  • One key to maximizing your HSA is contributing early and often.

A health savings account (HSA) might be saving's best-kept secret. It can help you save for medical expenses and create a financial cushion for the future.

If you're covered by an HSA-eligible health plan (a high-deductible health plan), you can open and contribute to an HSA. Even if you're still on your parents' health insurance (but not claimed as a dependent on someone else's tax return) you may be eligible to open an HSA. In an HSA, you can contribute pre-tax dollars from your paycheck automatically, and your employer might match those contributions, tax-free. Then, you can invest contributions without paying federal income taxes on any growth. The money you take out won't get taxed either, as long as it goes toward qualified medical expenses where conditions are met, for example, doctor visits and prescriptions.1

What does this have to do with retirement? Starting at age 65, there's no penalty to use HSA money for nonmedical expenses. You will have to pay income tax though, similar to pre-tax withdrawals from your 401(k). An HSA is another way to save if you've maximized your 401(k) or IRA savings.

Read on to better understand the benefits of opening and contributing to an HSA in your 20s and 30s.

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1. HSAs can be your emergency medical savings

Health care costs are likely to be lower in your 20s and 30s than when you're older,2 but that doesn't mean you won't ever get hit with a big bill. Medical expenses often come when you least expect. In fact, about a quarter of millennials and Gen Zers have medical debt because of an accident or injury.3

Money contributed to an HSA can avoid federal income tax. Because potential investing gains can be tax-free, your HSA savings can potentially grow, easing a financial blow and sparing your emergency savings, if an expensive health issue surfaces.

2. HSAs can also help you pay for certain health care, vision, and dental costs

Even if you don't have a big bill, HSAs can be helpful for covering everyday health expenses. Over-the-counter products such as pain relievers, allergy medicine, and acne treatments can be paid with HSA funds. Copays for doctors' visits and prescriptions, dental cleanings and braces, eye exams, and contacts also count. Even LASIK eye surgery can be paid for out of an HSA.4 Check out a list of eligible expenses.

3. HSAs can help you save for future medical expenses

Unlike flexible spending accounts (FSAs) that may have a "use it or lose it" rule, money in an HSA rolls over year after year. If you're saving for something big, for example fertility procedures or medically necessary surgery—HSA money could help you with funding. Whatever's left can be used in retirement. 

On average, according to the 2024 Fidelity Retiree Health Care Cost Estimate, a 65-year-old individual may need $165,000 in after-tax savings to cover health care expenses.

Contributing to your HSA early and often and investing those savings can help you better afford medical care later. 

The contribution limit for 2024 is $4,150 for individual coverage and $8,300 for family coverage.

4. HSAs can grow on their own over time

Funds in an HSA can be invested, giving that money the potential to grow like any other investment account. If you invest early, you could benefit from compound growth. The new money you've made has the potential to grow if you keep it invested. Even though investing isn't without risk of loss, the longer you keep your money in the market, the greater potential for growth.

To learn more, read our guide to HSA investing: Ways to invest in your health savings account.

5. Employers may help fund your HSA

Many employers match contributions made to HSAs, which means for every dollar you add, they too will either match or add money up to a certain limit. Some employers may opt to contribute a lump sum to your HSA, often at the beginning or end of the year.  

In 2023, 31% of all dollars contributed to an HSA came from employers, with the average employer contribution being $726.5 Employer contributions can jump start your savings.

You're not tied to the HSA your employer provides. You can shop around and compare different options, but make sure any matching from your employer still applies if you opt for another HSA provider.

6. HSAs offer a cushion when you change jobs

Potential medical expenses can be especially scary when you're in between jobs or doing freelance work. A healthy HSA can help pay for qualified medical expenses if you lose your health insurance. Also, if you're changing jobs, HSAs are portable. 

If your new employer offers an HSA-eligible health plan with an HSA, it's possible to keep your old HSA or roll your funds into the new one. 

If your new employer doesn't offer an HSA-eligible health plan, you can still keep your old HSA; you just won't be able to contribute to it.

Interested in learning more about HSAs? Visit our HSA homepage. If you have an employer-sponsored Fidelity HSA, you can log in to NetBenefitsLog In Required to access your account.

Consider a health savings account (HSA)

With an HSA, you can pay for qualified medical expenses in a tax-advantaged way.

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​The Retiree Health Care Cost Estimate is based on a single person retiring in 2024, 65-years-old, with life expectancies that align with Society of Actuaries' RP-2014 Healthy Annuitant rates projected with Mortality Improvements Scale MP-2021 as of 2022. Actual assets needed may be more or less depending on actual health status, area of residence, and longevity. Estimate is net of taxes. The Fidelity Retiree Health Care Cost Estimate assumes individuals do not have employer-provided retiree health care coverage, but do qualify for the federal government’s insurance program, original Medicare. This calculation takes into account Medicare Part B base premiums and cost-sharing provisions (such as deductibles and coinsurance) associated with Medicare Part A and Part B (inpatient and outpatient medical insurance). It also considers Medicare Part D (prescription drug coverage) premiums and out-of-pocket costs, as well as certain services excluded by original Medicare. This estimate does not include other health-related expenses, such as over-the-counter medications, most dental services and long-term care.

1. With respect to federal taxation only. Contributions, investment earnings, and distributions may or may not be subject to state taxation. Please consult with your tax advisor regarding your specific situation. 2. "Why are Americans paying more for healthcare?" PGPF.org, January 3, 2024, Peter G. Peterson Foundation, https://www.pgpf.org/blog/2022/02/why-are-americans-paying-more-for-healthcare. 3. Dan Grunebaum, "One in four Gen Z, millennials, skip rent or mortgage due to medical debt: Survey," HealthCare.com, March 15, 2022, https://www.healthcare.com/gen-z-millennials-medical-debt-484813. 4. Publication 969, IRS. 5. Ted Godbout, "HSA Assets Saw Strong Growth During First Half of 2023", American Society of Pension Professionals and Actuaries (ASPPA), September 27, 2023, https://www.asppa-net.org/news/hsa-assets-saw-strong-growth-during-first-half-2023

This information is intended to be educational and is not tailored to the investment needs of any specific investor.

Views expressed are as of the date indicated, based on the information available at that time, and may change based on market or other conditions. Unless otherwise noted, the opinions provided are those of the speaker or author and not necessarily those of Fidelity Investments or its affiliates. Fidelity does not assume any duty to update any of the information.

The information provided here is general in nature. It is not intended, nor should it be construed, as legal or tax advice. Because the administration of an HSA is a taxpayer responsibility, customers should be strongly encouraged to consult their tax advisor before opening an HSA. Customers are also encouraged to review information available from the Internal Revenue Service (IRS) for taxpayers, which can be found on the IRS Web site at www.IRS.gov. They can find IRS Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans, and IRS Publication 502, Medical and Dental Expenses (including the Health Coverage Tax Credit),online, or you can call the IRS to request a copy of each at 800.829.3676.

Keep in mind that investing involves risk. The value of your investment will fluctuate over time, and you may gain or lose money.

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