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HSA and FSA Explained

Tax-advantaged ways to pay for medical expenses through your paycheck. HSA and FSA both use pre-tax dollars but with different rules.

PayslipIQ provides educational information and estimated calculations only. It does not provide tax, legal, financial, accounting, employment, benefits, or payroll advice. PayslipIQ is not a CPA firm, law firm, financial advisor, payroll provider, or tax authority. Always verify your paycheck, deductions, withholdings, and tax position with your employer's payroll department, a qualified CPA, the IRS, your state tax authority, or another appropriately qualified professional. Calculations are estimates; your actual paycheck may differ based on factors specific to your employer, location, benefits elections, and personal tax situation.

HSA basics

Health Savings Account. Available only with a High Deductible Health Plan (HDHP). Annual limits set by the IRS. Funds roll over year to year, and the account is yours for life. Can be invested once balance hits a plan threshold.

FSA basics

Flexible Spending Account. Available with most employer health plans. Annual limit set by the IRS, lower than HSA. Use-it-or-lose-it: any unspent funds at year-end are forfeited (with a small carryover or grace period in some plans).

Tax treatment

Both reduce federal income tax wages, FICA wages, and most state income tax wages when contributed through a Section 125 cafeteria plan via payroll deduction.

Triple tax advantage of HSA

HSA is the only account in the US tax code that is tax-free at all three stages: contribution, growth, and qualified withdrawal. No other vehicle matches this.

Limited Purpose FSA

A special FSA limited to dental and vision expenses. Can co-exist with HSA. Useful if you want HSA contributions plus dental/vision FSA.

Dependent Care FSA

Different account for dependent care expenses (childcare, after-school care). Separate annual limit. Use-it-or-lose-it.

Frequently asked questions

What is the HSA contribution limit?
The IRS sets it annually. Verify the current year at irs.gov. There is a catch-up contribution for age 55+.
Can I have HSA and FSA at the same time?
Limited Purpose FSA (dental and vision only) yes. General-purpose FSA disqualifies HSA contributions.
What happens to my FSA when I leave a job?
Unspent funds typically forfeit unless your plan offers run-out or COBRA-style continuation.
Can I invest my HSA?
Yes, once you hit the plan's investment threshold. Most custodians allow mutual fund investments inside HSA.

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