Healthcare Account comparison
HSA vs. FSA vs. HRA

Health Savings Accounts (HSAs), Healthcare Flexible Spending Accounts (FSAs), and Health Reimbursement Arrangements (HRAs) each let members use tax-advantaged dollars to pay for qualified medical expenses. But there are some important differences to keep in mind.

Which one will benefit me the most?

Consider an HSA if you want to…

  • Save a bunch of money on healthcare premiums

  • Rollover your money and keep it year after year

  • Maximize your tax savings

  • Invest for future healthcare expenses

Consider an FSA if you want to…

  • Get a smaller deductible

  • Prioritize near-term healthcare expenses

  • Manage significant prescription costs

Consider an HRA if you want to…

  • Get free money from your organization

  • No, really. Free money. Take it!

Consider an HSA if you want to…

  • Save a bunch of money on healthcare premiums

  • Rollover your money and keep it year after year

  • Maximize your tax savings

  • Invest for future healthcare expenses

Consider an FSA if you want to…

  • Get a smaller deductible

  • Prioritize near-term healthcare expenses

  • Manage significant prescription costs

Consider an HRA if you want to…

  • Get free money from your organization

  • No, really. Free money. Take it!

Side-by-side comparison

Health Savings Accounts (HSAs), Healthcare Flexible Spending Accounts (FSAs), and Health Reimbursement Arrangements (HRAs) each let members use tax-free dollars to pay for qualified medical expenses. But there are some important differences to keep in mind.

Health Savings Account

HSA

Flexible Spending Account

FSA

Health Reimbursement Arrangement

HRA

Account overview

An HSA lets you use pre-tax money to pay for qualified medical expenses.1 HSAs require an HSA-qualified health plan in order to contribute. You can invest2 HSA dollars and grow tax-free earnings. Funds never expire—even if you change health plans, employers, or retire.

A Healthcare FSA similarly empowers members to set-aside pre-tax money to pay for eligible medical expenses.3 The difference is that members do not keep their unused FSA money and funds may be forfeited back your employer. FSAs are generally paired with traditional health plans.

An HRA is an employer-owned and -employer-funded account designed to help members bridge the gap on eligible healthcare expenses. HRAs are highly customizable and a great way for organizations to offset rising costs. Common eligible expenses include deductibles, coinsurance and copays.4

Health plan type

HSA-qualified/High-deductible health plan

Traditional health plan

Either HSA-qualified or traditional health plan (integrated with an ACA-compliant health plan)

Account ownership

Member-owned (take your HSA with you)

Employer-owned (no portability)

Employer-owned (no portability)

Who contributes?

Member, employer or family2

Member, employer

Employer only

Tax-deductible contributions

Yes – State, federal and FICA tax deductible for employers and members1

Yes – State, federal and FICA tax deductible for employers and members3

Yes – State, federal and FICA tax deductible for employers

Adjust contribution amount?

Anytime

Only during annual enrollment (or with qualifying life event)

Employer chooses at beginning of plan year

Tax-free distribution

Yes1

Yes

Yes

Debit card

Yes, availability varies by plan

Yes, availability varies by plan

Yes, availability varies by plan

Can members invest?

Yes2

No

No

Tax-free earnings

Yes

No

No

Long-term savings

Yes

No

No

Do funds expire?

Never

Yes

Yes

Account carryover

Yes—even if you change health plans, employers, or retire

Varies by plan—some FSAs offer grace periods or limited carryover (up to $550 for 2021)

No

2021 contribution limits

$3,600 (Individual coverage) $7,200 (Family coverage)


View all HSA limits and guidelines

$2,750
(Individual or family coverage)

Varies by plan type

Account compatibility

LPFSA, DCFSA, HRA

LPFSA, DCFSA, HRA

FSA, HSA6, LPFSA, DCFSA

How do I enroll?

You can enroll in an HSA-qualified health plan and sign up for an HSA during your organization’s annual enrollment. If you have a high-deductible health plan on your own—not offered through an employer—you can sign up for an HSA right now.

Open an account

You can enroll in a health plan and sign up for an FSA during your organization’s annual enrollment period.

You can enroll in a health plan and sign up for an HRA during your organization’s annual enrollment period. Some plans feature automatic enrollment. Consult your annual enrollment materials to learn how to enroll.

HSA

FSA

HRA

  • An HSA lets you use pre-tax money to pay for qualified medical expenses.1 HSAs require an HSA-qualified health plan in order to contribute. You can invest2 HSA dollars and grow tax-free earnings. Funds never expire—even if you change health plans, employers, or retire.

    A Healthcare FSA similarly empowers members to set-aside pre-tax money to pay for eligible medical expenses.3 The difference is that members do not keep their unused FSA money and funds may be forfeited back your employer. FSAs are generally paired with traditional health plans.

    An HRA is an employer-owned and -employer-funded account designed to help members bridge the gap on eligible healthcare expenses. HRAs are highly customizable and a great way for organizations to offset rising costs. Common eligible expenses include deductibles, coinsurance and copays.4

  • HSA-qualified/High-deductible health plan

    Traditional health plan

    Either HSA-qualified or traditional health plan (integrated with an ACA-compliant health plan)

  • Member-owned
    (take your HSA with you)

    Employer-owned
    (no portability)

    Employer-owned
    (no portability)

  • Member, employer or family2

    Member, employer

    Employer only

  • Yes – State, federal and FICA tax deductible for employers and members1

    Yes – State, federal and FICA tax deductible for employers and members3

    Yes – State, federal and FICA tax deductible for employers

  • Anytime

    Only during annual enrollment (or with qualifying life event)

    Employer chooses at beginning of plan year

  • Yes1

    Yes

    Yes

  • Yes, availability varies by plan

    Yes, availability varies by plan

    Yes, availability varies by plan

  • Yes2

    No

    No

  • Yes

    No

    No

  • Yes

    No

    No

  • Never

    Yes

    Yes

  • Yes—even if you change health plans, employers, or retire

    Varies by plan—some FSAs offer grace periods or limited carryover (up to $550 for 2021)

    No

  • $3,600 (Individual coverage)
    $7,200 (Family coverage)

    View all HSA limits and guidelines

    $2,750
    (Individual or family coverage)

    Varies by plan type

  • LPFSA, DCFSA, HRA

    LPFSA, DCFSA, HRA

    FSA, HSA6, LPFSA, DCFSA

  • You can enroll in an HSA-qualified health plan and sign up for an HSA during your organization’s annual enrollment. If you have a high-deductible health plan on your own—not offered through an employer—you can sign up for an HSA right now.

    You can enroll in a health plan and sign up for an FSA during your organization’s annual enrollment period.

    You can enroll in a health plan and sign up for an HRA during your organization’s annual enrollment period. Some plans feature automatic enrollment. Consult your annual enrollment materials to learn how to enroll.

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