Who can have one?
To open an HSA, you need a high-deductible health plan (HDHP). Anyone whose employer offers an FSA can get one. Employers can also offer HRAs to their employees to reimburse approved medical and dental expenses.
Who owns & controls them?
- An HSA is yours. You own it and control the funds, even if you change jobs.
- On the other hand, your employer owns the FSA. If you leave your job, you generally can't take the FSA with you. If you leave your job or lose your job, you may lose access to any funds left in your FSA, except in cases where you opt for COBRA to extend the benefits.
- With an HRA, if you leave your job, unused funds stay with the employer.
Who can contribute?
- HSA: You, your employer or anyone else can add money if you have a high deductible health plan.
- FSA: You mainly fund it, but your employer can chip in too.
- HRA: Only your employer puts money in.
What are the tax benefits?
- HSA: Triple tax benefits! No taxes on the money you put in, it grows tax-free and no taxes when used for medical bills.
- FSA: You save on taxes when you put money in. However, FSAs don’t allow funds to grow over time.
- HRA: You don't pay taxes on what your employer contributes.
How can I use the money?
- HSA: Pay for many medical costs like copays, medical bills, prescriptions and other qualifying health care costs. You can also invest some of the money.
- FSA: Covers medical bills. You get the full year's amount up front.
- HRA: Pays for certain medical expenses set by your employer.
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