HSA: The Triple Tax Advantage Account

Most people think of a Health Savings Account (HSA) as a way to pay for medical expenses. But savvy investors know it is actually one of the best investment accounts in existence—better than a 401(k) or Roth IRA in many ways.

The Triple Tax Advantage

An HSA offers three tax benefits that no other account can match:

1. Tax-deductible contributions — Reduces your taxable income (like a 401(k))
2. Tax-free growth — No taxes on investment gains (like a Roth IRA)
3. Tax-free withdrawals — No taxes when used for medical expenses

How HSAs Work

Eligibility

You can contribute to an HSA if you:

• Have a High Deductible Health Plan (HDHP)
• Are not enrolled in Medicare
• Are not claimed as a dependent
• Have no other non-HDHP health coverage

2024 Contribution Limits

What Counts as an HDHP (2024)

• Minimum deductible: $1,600 (individual) / $3,200 (family)
• Maximum out-of-pocket: $8,050 (individual) / $16,100 (family)

The Secret: Invest Your HSA

Most people use their HSA like a checking account—money goes in, money comes out for medical bills. But here is the strategy that builds serious wealth:

Pay medical expenses out of pocket now. Invest your HSA for decades. Reimburse yourself later.

The Stealth Retirement Account

After age 65, an HSA becomes even more flexible:

• Withdrawals for ANY purpose are allowed
• Medical withdrawals remain tax-free
• Non-medical withdrawals are taxed as ordinary income (like a 401(k))

This makes the HSA a backup retirement account. Use it for medical expenses tax-free, or treat it like a Traditional IRA if you do not need it for healthcare.

HSA Investment Strategy

Step 1: Find an HSA with Good Investments

Not all HSAs are created equal. Look for:

• Low-cost index funds as investment options
• Low or no account fees
• No minimum balance to invest

Good HSA providers for investing:

• Fidelity (no fees, great funds)
• Lively (partners with Schwab)
• HSA Bank (TD Ameritrade integration)

Step 2: Keep a Cash Buffer

Maintain enough cash in your HSA to cover your deductible. Invest the rest.

Step 3: Max It Out

Contribute the maximum every year if possible. This is often more valuable than contributing beyond your 401(k) match.

Prioritizing Your HSA

Where does the HSA fit in your savings priority?

1. 401(k) up to employer match (free money)
2. Max out HSA (triple tax advantage)
3. Max out Roth IRA
4. More 401(k) or taxable brokerage

Tracking Medical Expenses

To reimburse yourself years later, you need proof:

1. Save all medical receipts — Digital copies work fine
2. Keep a simple spreadsheet — Date, amount, what it was for
3. Do not lose this documentation — You may need it decades later

The IRS has no time limit on reimbursement. A medical expense from 2024 can be reimbursed in 2054 if you kept the receipt.

Common HSA Mistakes

Other mistakes:

• Not investing the balance
• Using high-fee HSA providers
• Not maximizing contributions
• Losing track of receipts for future reimbursement
• Forgetting the catch-up contribution at 55

HSA vs. FSA

Do not confuse HSAs with Flexible Spending Accounts (FSAs):

HSAs are far superior for long-term wealth building.

The Bottom Line

The HSA is a hidden gem that most first-generation wealth builders overlook. Do not make that mistake.