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I know the HSAs are really good retirement accounts, but I prefer the PPO + FSA route with good plan. We have a lot of medical expenses, so really good insurance saves us a lot. I hit my personal deductible on 1/2 this year, and we’re quite close on the family wide deductible.
Our premium is also super low. Spouse works at a FAANG.
I’m not on what I would consider a high premium plan. My SO’s work offers really low premiums, such that our family premium for the low deductible plan is significantly lower than my individual premium would be on the high deductible plan offered through my employer. My SO’s work does offer a high deductible plan too, but the delta in premiums is not substantial.
That being said, I don’t know that it saves me more. I haven’t done the math on this. A lot of it is peace of mind. I didn’t hesitate to go to the ER when telemedicine recommended it earlier this year knowing that it wouldn’t be astronomical. I probably still would have gone in on the high deductible plan, but there would have been a level of hesitation and stress that I avoided.
I maxed out HSA. Keep $5,000 in cash/not invested for deductible and expenses. I invest the rest. After 10 years the HSA account is approaching $85K and growing strong with the current market. I highly recommend HSA over FSA any day.
Mentor
I treat it as a retirement account. Money goes in and does not come out
Don’t touch it and let it build and only use it as a last resort
Max invest and almost never use it - have 120k in it
Im 30 and my HSA has nearly 65k in it. Maxing it for years, never withdrawn, keeping receipts for medical appointments. But I don’t plan to pull it unless a true EMERGENCY were to hit me
100% S&P500. Expense ratio is like .03
Coach
About max contribution and generally letting it grow, but will sometimes use for current year med exp and just take the tax benefit on it. Mostly invest and grow.
Max out, get deduction, invest for tax free growth reimburse expenses periodically. We didn't reimburse for several years and accumulated over $50k but started to worry about maintaining adequate receipts for decades and adverse tax consequences if it goes to a non-spouse beneficiary.
I will qualify that by saying I have access to Mega Backdoor Roth through work 401k and the above approach also allows us to contribute more to that, without the strings attached. I can't think of any benefit to having those funds in HSA instead of Roth IRA (and we still get the deduction for contributions). If we were maxing out MBDR then we wouldn't reimburse HSA and would instead figure out a better approach to maintaining receipts.
Fortunately, our annual contributions generally exceed medical expenses so after the initial large withdrawal from accumulated receipts the HSA balance has continued to grow.
Subject Expert
I agree with all this.
I don’t currently have MBDR access. If it did I’d withdraw for medical.
It is a burden keeping all the receipts for years, but probably worth it.
I have just started to Max out/invest/not touch HSA a year or two ago - DUMB question and please don’t shame me. If we aren’t using the funds why do we still need to track our medical receipts? Or did I read that wrong above? I thought we only needed receipts for spending HSA $?
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My wife and I both max out our HSA's and have been doing so for five years now. Plus lower premiums on HSA medical accounts vs PPO. We are both relatively healthy, so we use some each year but the accounts are growning tax free. We keep $3K in active, then invest the rest. Will turn it into a IRA at age 65. FSA's I hate the use it or lose it situation.
Most people think HSAs are just a savings or retirement account. The problem is, very few consider how they fit into a bigger strategy to create tax-free income later. I’d love to hear how others are approaching this.
Store receipts for all major medical bills in the cloud for future tax free withdrawals + use tax free for medical spend in old age + just pay ordinary income tax after 65 on withdrawals? Not rocket science
I'm going to use my ancestral land to venture into mining of Gold. Since there is a huge deposit of this mineral I think is the best investment of all time.
Make sure to save all receipts
Max it out and pay out anything less than $1k just to keep the list manageable. Anything over $1k I keep for a future date
Max out, invest everything allowed, don't touch it till way later.
First hsa I had to keep 1500 cash, new one I can invest it all.
I have cash other places, I don't need to hold cash here.
Use some asset location strategies to invest here taking advantage that the investments inside won't cause you certain tax or capital gains issues. Look into it.
Max out, invest for retirement, u less i absolutely need it. Used it twice in 18 years for 2 hospital stays (deductible), but that’s all.
I max out HSA and FSA. I will use up FSA and as little as HSA as possible. Whatever is left at the end of the year, I invest it. Then I start all over the next year.
Yes, our FSA is for vision and dental
Invest and chill. None of my retirement accounts have great balances, but my HSA is the highest
This is probably not the best plan (feel free to tell me why I am wrong)….
Put in max and invest.
Expense anything under $200.
Keep a Google Drive folder with receipts and a detailed spreadsheet for anything above $200.
The logic is I just don’t want to deal with maintaining records on lower dollar expenses over time.
Subject Expert
Makes sense. Hopefully that would be enough in the (unlikely?) event you are audited in the year of making a major withdrawal.
I am saving all receipts, but it is a hassle.
You may need all those little expenses over time if the account grows. I keep a file of all the receipts soft copy . I do like your idea of keeping a spreadsheet tho lol
Max out. Invest. Let it sit until retirement. Obviously, if I have a medical expense that I can't pay for without it, then that changes things.