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A Health Savings Account May Be Your Best Retirement Plan

By James M. Dahle, MD, FACEP | on January 8, 2014 | 3 Comments
From the College
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HSA May Be Your Best Retirement Plan

How an HSA can help cover health care costs and serve as a triple-tax-free, stealth IRA investment plan

Question: My employer has recently gone to a high-deductible health plan (HDHP), so I became eligible this year to use a health savings account (HSA). What is the best way to use my HSA?

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ACEP Now: Vol 33 – No 01 – January 2014

Answer: In 2014, HDHPs must have a minimum deductible of $1,250 if you’re single ($2,500 family) and a maximum out-of-pocket amount of $6,350 ($12,700 family). The plan may offer preventive care for a lower deductible (or none at all) and still qualify. If your only health coverage is a HDHP, then you qualify for an HSA and may contribute up to $3,300 ($6,550 family), with a $1,000 “catch-up” contribution if you’re older than 55. Even if your spouse is covered by a non-HDHP, as long as you are not, you may still use an HSA, and if at least one of your children is also not covered by a non-HDHP, you may contribute the higher family amount.

There are two ways that people use their HSAs. The first is to pay for health care in the year you make the contribution. If you get a CT scan for $1,000, you use the HSA money to pay for it. Not only do you get to use untaxed dollars to pay your health-insurance premiums (at least if you’re self-employed), you also get to pay for unreimbursed health care using untaxed dollars. If you plan to use your HSA to pay your deductible and other health-related expenses in the near future, you want to invest the money very conservatively, probably in the savings-account option of your HSA.

HSAs for Long-Term Savings

The second way to use an HSA is as a “Stealth IRA.” Many physicians need to save more money for retirement each year than they are allowed to contribute to their available retirement plans. While a taxable investing account is always an option to save more, an HSA offers three significant advantages over a taxable account as a retirement savings plan. First, just like any other retirement plan, it offers an estate-planning advantage in that you can simply name a beneficiary on the account instead of having those assets go through probate. Second, although asset protection is always state-specific, your state may protect assets in an HSA from your creditors in a lawsuit or bankruptcy proceedings. Last, and most important, an HSA is the only “triple-tax-free” account.

Pages: 1 2 3 | Single Page

Topics: Cost of Health CarePersonal FinancePublic PolicyThe End of the Rainbow

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About the Author

James M. Dahle, MD, FACEP

James M. Dahle, MD, FACEP, is the author of The White Coat Investor: A Doctor’s Guide to Personal Finance and Investing and blogs at http://whitecoatinvestor.com. He is not a licensed financial adviser, accountant, or attorney and recommends you consult with your own advisers prior to acting on any information you read here.

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3 Responses to “A Health Savings Account May Be Your Best Retirement Plan”

  1. February 3, 2014

    Illumination Wealth Management | Illumination Wealth February 2014: The Biggest Expense Standing In Your Way To Wealth… Reply

    […] Acep Now: A Health Savings Account May Be Your Best Retirement Plan […]

  2. June 18, 2016

    Ike Dalley Reply

    Useful article , I learned a lot from the analysis . Does someone know if I might be able to obtain a blank IRS 1125-A document to work with ?

  3. April 28, 2018

    James Reply

    One problem with HSA’s is that the rules are very vague, poorly written, and incomplete. I have a $10,000 policy for myself and my 2 teenaged kids. My wife has a very generous employee benefit from her work, but no employer subsidy for dependent coverage. She could cover us, but if she did, it would take over half her paycheck and sometime more than her paycheck.

    However, my health plan is apparently considered “Individual,” not “Family,” because my wife is not on the plan, and because we do have the option of being on the employer-provided plan, even though it doesn’t make sense for us. So my HSA is considered “Individual,” and I’m held to the lower contribution limits. In fact, I’ve been advised by several accountants and tax attorneys not to contribute to the HSA at all, nor withdraw funds from it, as my wife’s status may make us ineligible to use the HSA.

    Of course, there appear to be no rules describing this relatively common situation. HSA’s were designed to help the self-employed middle class, like me, so perhaps the politicians and civil service had so little interest they couldn’t stay awake to finish writing the rules.

    So I’ve got $10,000 stranded in an HSA I’ve been advised not to use. I can’t transfer it to my wife because it’s an individual asset, and an individual account.

    Hopefully, if the Trump Administration is the least bit serious about healthcare finance (or anything else, for that matter; tough to say at this point) they’ll finish writing the rules for HSA’s. Until such time, I can’t recommend them.

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