What is the difference between HSAs, HRAs and FSAs and what can each type of savings account be used for?

Breaking down the key differences and uses of HSAs, HRAs, and FSAs

Modified on:
May 25, 2025 4:00 pm

Understanding these types of accounts saves you money on medical expenses, right from an HSA, HRA, or FSA. However, each one works a little differently and may come with its own rules. If you’ve ever wondered how they compare and what each can be used for, you are about to find out in easy-to-understand terms.

What is an HSA, HRA, and FSA?

When it comes to managing healthcare costs, you might come across terms like HSA, HRA, and FSA. These are all types of accounts designed to help you save money for medical expenses, but they work in different ways. Knowing how they differ can help you choose the right one for your needs.

How does an HSA work?

A Health Savings Account (HSA) is a savings account you can use to pay for qualified medical expenses. To open an HSA, you need to be enrolled in a High-Deductible Health Plan (HDHP).

Here are some key details about HSAs:

  • Contributions: You, your employer, or even a family member can contribute money to your HSA. The IRS sets annual limits on contributions.
  • Tax advantages: Contributions are tax-deductible, the money grows tax-free, and withdrawals for qualified expenses are tax-free.
  • Portability: The account belongs to you, so you keep it even if you change jobs.
  • Rollover: Unused funds roll over each year. You do not lose the money at the end of the year.
  • Use for non-medical expenses: After age 65, you can use the money for non-medical expenses without penalties, although you will pay income tax on those withdrawals.

What can you use an HSA for?

You can use an HSA to cover a wide range of qualified medical expenses, including:

  • Doctor visits and prescription medications
  • Dental and vision care
  • Medical equipment like hearing aids
  • Certain over-the-counter medications and supplies

What is an HRA and how does it work?

A Health Reimbursement Account (HRA) is funded entirely by your employer to help cover your medical expenses. Unlike an HSA, you cannot contribute to an HRA.

Here is what you need to know about HRAs:

  • Employer-owned: The employer owns the account and sets the rules, including how much is contributed.
  • Limits: There are no IRS-set limits on contributions, but the employer decides how much money to provide.
  • Rollover rules: Employers may allow unused funds to roll over to the next year, but it is not guaranteed.
  • Portability: You cannot take the account with you if you leave your job.
  • Usage: You can only use HRA funds for eligible healthcare expenses approved by your employer.

How does an FSA work?

FSA, which is a Flexible Spending account is another account that allows you to save money for medical expenses that are eligible under the IRS. Usually, this is offered through an employer and enables you to determine how much to deduct from your annual salary. 

Here are some basic facts about FSAs: 

  • Contribution limits: Depending on the Irs, they have determined Annual Limits on how much you can contribute.
  • “Use-it-or-lose-it” rule: If the money is not used at the end of the year, it is forfeited unless the employer offers a grace period or a carryover option. 
  • Tax benefits: Contributions are made pre-tax lowering your taxable income.
  • Dependent care FSAs: Some employers offer FSAs strictly for dependent care expenses like daycare or elder care expenses.

What can you use an FSA for?

FSAs can be used for a variety of medical expenses, including:

  • Copays, deductibles, and prescriptions
  • Dental and vision care
  • Certain over-the-counter items, if approved under IRS guidelines

What are the key differences between HSAs, HRAs, and FSAs?

While all three accounts are designed to help with healthcare expenses, they differ in a few significant ways:

  • Ownership: HSAs are owned by you, HRAs are owned by your employer, and FSAs are employer-sponsored but controlled by you for the plan year.
  • Contribution sources: HSAs allow contributions from multiple sources, HRAs are funded only by employers, and FSAs are funded by employee payroll deductions.
  • Portability: Only HSAs are portable.
  • Rollover: HSAs always roll over, HRAs may roll over depending on employer rules, and FSAs often have a “use it or lose it” policy.

By understanding these differences, you can choose the best option for your healthcare savings and spending needs. Each account has its strengths, so think about your healthcare expenses, tax situation, and job stability when deciding.

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Enobong Demas
Enobong Demashttps://polifinus.com/author/e-demas/
I write on social welfare programs and initiatives for the United States, focusing on how these programs impact the lives of everyday Americans. My background in environmental sciences allows me to approach these topics with a unique analytical lens to provide my readers with a clear and well-rounded insight, eliminating the complexities often common with these topics.

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