FSA vs. HSA
Following are the key differences and similarities between these two great financial tools that help to control healthcare costs.
A Flexible Spending Account (FSA) and a Health Savings Account (HSA) both are a type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses. The contribution limits for an FSA and HSA vary slightly.
Available through employer sponsor only
Employees choose the contribution amounts to an FSA, which are deducted from their gross pay and reduce taxable income. You can sign up for an FSA during your employer’s open enrollment, and any health plan, or even no health plan qualifies for an FSA.
Available regardless of employment status
Anyone can have an HSA as long as they have a High Deductible Health Plan. If you don’t have an HSA through work, then you can sign up on your own with an HSA provider and make contributions directly, which you can declare on your annual taxes, therefore reducing your taxable income. You can not have both an FSA and HSA in the same year
Use it or lose it feature, no investment options
The annual contribution limit for an FSA is 3,050. FSAs do not offer investment options. If you do not use your funds by the of the end of the year, they do not carry over, they are forfeited. However, the entire amount is available on day one of the new year.
Unused funds carry over; investing allowed
The 2023 HSA annual contribution limit is 3,850 ($7,750 for a family). Funds in an HSA roll over year to year. Many HSAs offer investment options – you can put part or all of your contribution in the market. You cannot spend more than the funds deposited in the HSA, but you can be reimbursed later after you have grown the savings.
Budgeting for healthcare expenses
Because the entire annual FSA contribution is available on day one, those with specific conditions or illnesses, or a growing family could benefit greatly from being able to cover the expenses of various doctor appointments and other illnesses that are quite common throughout the year, such as flu’s, earaches, sore throats, allergies, and even the occasional broken bone.
Saving for the future or a rainy day
An HSA offers a lot of savings benefits for those who are relatively healthy and do not expect to have that many healthcare expenses. Contributions are tax free and grow interest, and they roll over. And if they have to use the funds, they can also withdrawal tax free. A person can always start with smaller contributions and adjust as their family grows and needs change.
Part of the MR HEALTH INSURANCE – Health Insurance 101 Series
Available through employer sponsor only


Available regardless of employment status
Use it or lose it feature, no investment options


Unused funds carry over; investing allowed
Budgeting for healthcare expenses


Saving for the future or a rainy day
Part of the MR HEALTH INSURANCE – Health Insurance 101 Series
Test Your Knowledge on Health Insurance
Take our Health Insurance Quiz with the latest 2023 Questions and Answers!
Buy Health Insurance
Purchase these affordable supplemental health plans that you can use in tandem with your major medical to save on healthcare expenses.
State Mandates for Health insurance
Following is a list of the states, as of 2019, that have mandated residents purchase qualifying health insurance (which is like the federal essential health benefits) or face a tax penalty when they file their income taxes.
California – the penalty for Californians who go without health insurance may be 2.5% of household income or $696 per adult (this number will rise yearly with inflation), whichever is larger.
Massachusetts – the tax penalty amount varies depending on your income, age and family size, but note the maximum penalty can be no more than half the price of the lowest premium plan available on the Massachusetts healthcare marketplace. For more information on Massachusetts health insurance mandates, click here.
New Jersey – the tax penalty is $695 for adults and $347.50 for each child, with a maximum family penalty of 2.5% of annual income,. The penalty is capped at three times the adult penalty ($2,085), or the state average cost for a bronze-level plan, whichever is greater. For more information on New Jersey health insurance mandates, click here.
Vermont – Vermont has passed legislation that requires residents to have qualifying health insurance in 2020, but the penalty for non compliance has not yet been established.
Washington, D.C. – the tax penalty is $695 for adults and $347.50 for each child, with a maximum family penalty of 2.5% of income, or three times the adult penalty ($2,085), whichever is greater. For more information on Washington, D.C. health insurance mandates, click here.
What is the Federal Marketplace
What is the Marketplace?
The public health insurance Marketplace (also referred to as an “Exchange”) is where you can purchase health insurance (also known as Obama Care) for you and your family. A plan from the marketplace is considered a comprehensive major medical plan and also contains the essential health benefits (see below) as established under the Affordable Care Act (ACA) law. When you purchase your health insurance through the marketplace, you are guaranteed issue regardless of any pre-existing condition and you may be eligible for a subsidy (premium tax credit) to help off-set high premiums.
The essential health benefits are as follows:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Prescription Drugs
- Mental health and Substance Abuse disorder services
- Rehabilitative and habilitative services and devices
- Pediatric services, including oral and vision care
- Preventive and wellness services, and chronic disease management