The Quick Answer
Both HSAs and FSAs let you pay for medical expenses with pre-tax dollars โ but they have very different rules about who qualifies, how much you can contribute, and critically, what happens to unused funds at year end.
๐ก Key difference: HSA funds roll over forever. FSA funds typically expire at year end. HSA requires an HDHP. FSA does not.
Side-by-Side Comparison
- HSA โ requires HDHP: Yes ยท FSA โ requires HDHP: No
- HSA 2025 limit (individual): $4,300 ยท FSA 2025 limit: $3,300
- HSA rollover: Full rollover every year ยท FSA rollover: Up to $660 only
- HSA owned by: You ยท FSA owned by: Your employer
- HSA invests: Yes, can invest for growth ยท FSA invests: No
- HSA after 65: Can use for anything ยท FSA after 65: Expires with employment
When to Choose an HSA
- You are enrolled in an HDHP
- You are generally healthy and don't expect high medical costs
- You want to build long-term tax-free savings for future medical costs
- You want the flexibility of investing the balance
When to Choose an FSA
- You are NOT enrolled in an HDHP
- You have predictable, recurring medical expenses each year
- You want immediate access to the full year's contribution from day one
- You won't be changing jobs and losing the account
Can You Have Both?
Generally no โ if you have an HSA you cannot have a standard FSA. However, you can have a Limited Purpose FSA alongside an HSA, which covers only dental and vision expenses.
Calculate Your HSA Tax Savings
See exactly how much you save in taxes by contributing to your HSA.
Calculate Your HSA Tax Savings โFrequently Asked Questions
What can I spend HSA and FSA money on?
Both cover qualified medical expenses: doctor visits, prescriptions, dental care, vision care, medical equipment, lab work, and much more. HSA funds can also be used for long-term care premiums and COBRA premiums. After age 65, HSA funds can be used for any expense.
What happens to my FSA if I change jobs?
If you leave your job, you lose any unspent FSA balance. This is one of the key advantages of an HSA โ you own it and take it with you regardless of employment.
Which saves more in taxes?
Both save the same percentage in taxes on contributions. The HSA advantage is long-term: funds grow tax-free over decades if invested, creating a much larger tax benefit for people who can afford to pay current medical costs out of pocket.