Can I have one?
You need a high-deductible health plan (HDHP), and no other health coverage except things like dental, vision or accident cover. You can’t have one once you’re enrolled in Medicare, and nobody else can claim you as a dependent.
| HDHP limits | 2026 | 2027 |
|---|---|---|
| Minimum deductible, self-only | $1,700 | $1,750 |
| Minimum deductible, family | $3,400 | $3,500 |
| Out-of-pocket maximum, self-only | $8,500 | $8,700 |
| Out-of-pocket maximum, family | $17,000 | $17,400 |
How much can I put in?
| HSA limits | 2026 | 2027 |
|---|---|---|
| Self-only coverage | $4,400 | $4,500 |
| Family coverage | $8,750 | $9,000 |
| Extra from age 55 | $1,000 | $1,000 |
The limits include anything your employer puts in. With family coverage, spouses share the family limit, and each can add the $1,000 catch-up to their own HSA.
How much tax does it save?
An HSA has three tax breaks: contributions are deducted, growth isn’t taxed, and withdrawals for qualified medical costs aren’t taxed.
If you contribute through payroll, you also skip Social Security and Medicare tax. Single, earning $75,000, putting the full $4,400 in through payroll saves:
- $968 of federal income tax (22%)
- $336.60 of Social Security and Medicare (7.65%)
That’s $1,304.60 a year, plus state tax in most states. California and New Jersey tax HSA contributions, so there’s no state saving there.
Using the money
- Medical costs: deductibles, copays, prescriptions, dental and vision costs, for you, your spouse and dependents, tax-free at any age.
- Other spending before 65: income tax plus a 20% penalty.
- Other spending from 65: income tax only, just like a traditional IRA. Medical costs stay tax-free.
There’s no deadline to reimburse yourself: you can pay a medical bill from your own pocket today, keep the receipt, and take the money out of your HSA years later, as long as the cost came after you opened the HSA.
Using it for retirement
Because the money rolls over and can be invested, an HSA can be one of the best retirement accounts there is. If you can afford to pay medical bills from your normal budget, leaving the HSA invested lets it grow tax-free for decades, and health costs in retirement are usually large.
- HSA, through payroll No tax in, on growth or out
- $161,857
- Traditional 401(k) Taxed at 22% when it comes out
- $126,248
- Taxable brokerage Paid in after tax; 15% on the gains
- $106,072
An illustration for a single filer at 22% who contributes through payroll. In the taxable account, dividends taxed each year would leave a little less. State tax isn’t included.
HSA vs FSA
| HSA | Health FSA | |
|---|---|---|
| Needs a high-deductible plan | Yes | No |
| Unused money | Rolls over every year | Mostly lost at the end of the year |
| If you change jobs | It’s yours | Stays with the employer |
| Can be invested | Yes | No |
See your own numbers
The HSA calculator shows the tax you’d save in your state and what your HSA could grow to. The paycheck calculator shows how an HSA contribution changes your take-home pay, including the Social Security and Medicare saving. Buying your own cover? The ACA subsidy calculator shows what a Marketplace plan would cost after the premium tax credit.