Best Health Savings Accounts (HSA) for 2021
While many people are well aware of runaway health insurance premiums, less discussed are the equally disturbing increases in copayments, deductibles, and coinsurance provisions.
They can amount to thousands of dollars each year, on just a single major medical expense. Meanwhile, the tax-deductibility of medical expenses is complicated and unavailable to most taxpayers.
That’s why Health Savings Accounts, or HSAs, are becoming more popular every year. They offer more people an opportunity to get a tax break on their medical expenses, even if they don’t itemize on their tax returns.
Moreover, choosing the right HSA gives you another long-term, tax-advantaged investment vehicle that lets you grow your savings toward financial independence and/or early retirement.
What Is a Health Savings Account?
An HSA is something like a medical IRA.
You contribute funds to the HSA plan, which is tax-deductible. Any withdrawals for a qualified medical expense can be taken tax-free. And whatever you don’t spend can simply be left in the account to either gain interest or to be invested, much the same way as with an IRA.
HSAs have a lot of advantages, even apart from making medical expenses tax-deductible. A few of these benefits include:
- HSAs are triple tax-free. Contributions are made with pre-tax dollars, these savings can be invested and grow tax-free, and the withdrawals aren’t taxed as long as the money is used for healthcare expenses.
- Flexibility in withdrawals. You can withdraw from your account for qualified medical expenses even decades after the expense is incurred. In fact, after age 65, you can pull from an HSA for any purpose—penalty-free—simply by paying ordinary income tax. There are also no required minimum distributions, so you can leave your money to grow as long as you’d like.
- No income limits. High earners are sometimes phased out of other tax-advantaged accounts, but HSAs don’t have any of these types of limitations.
- You get to choose your own HSA provider. The ability to shop around with any bank or brokerage means you can opt for a provider that caters to your situation or goals.
- Catch-up contributions. Those age 55 and over can contribute an additional $1,000 a year, called a catch-up contribution.
That said, health savings accounts don’t come without disadvantages:
- Strict limitations on who can contribute. HSAs are only available to individuals with a high deductible health plan (HDHP). Without this, you’re barred from an otherwise awesome investment vehicle.
- Substantial penalties for pulling from an HSA for non-healthcare-related expenses. Like other tax-advantaged accounts, you have to use the money for its intended purpose—health care expenses (unless you’re over the age of 65). Otherwise, you’re hit with a steep 20% penalty. Fortunately, the IRS definition of qualified expenses is pretty generous. And to provide relief for COVID-19, the recent CARES Act actually even expanded the list.
So now that you have a basic understanding of health savings accounts, let’s look at the best HSA accounts and which HSA provider might suit your situation best.
What Are the Best Places to Open an HSA?
Health savings accounts are offered by a variety of institutions. That can make the decision difficult. But narrowing your options down based on whether you’re looking for an interest-bearing or investment account can help.
HSA Providers can also be referred to as an “HSA Administrator,” or “HSA Custodian.” These all mean the same thing—they are all IRS approved institutions that offer HSA accounts.Or, skip straight to our list of the best HSAs
Banks and Credit Unions
Most banks and credit unions offer health savings accounts. Naturally, these are the preferred choices for interest-bearing accounts.
Between the two, credit unions are more likely to offer a combination of high interest and no monthly fees. You can shop between online banking and credit unions, or check out those with branches available in your area.
While credit unions offer interest-bearing accounts and banks offer both interest-bearing and investment accounts (mostly as a mutual fund), investment brokers provide the widest range of options on the investing front.
With a brokerage, you can engage in self-directed investing in just about any asset classes you want, giving you full control of your HSA investment.
If you go this route, make sure the broker offers access to options similar to banks and credit unions, particularly debit cards and check-writing capability. You’ll want an easy process to withdraw the money to cover healthcare expenses.
Other HSA Providers
There are also HSA providers dedicated to providing hybrid HSA accounts. With these, you’ll get a checking/cash account along with an investment account.
Funds must be transferred back to the checking account for payment of medical expenses.
Best HSA Accounts for 2021
Here are the 11 best places to open a health savings account today:
- 🏆 Lively: Best Overall
- Bank of America
- The HSA Authority
- DCU Credit Union
- HealthSavings Administrators
- Affinity Federal Credit Union
- Northern Bank & Trust Company
- First American Bank
Lively is an HSA provider that allows you to either invest your funds or earn interest on cash balances.
The account has no minimum balance requirements, no monthly fee, and it comes with a debit card. They also allow you to link your bank account for easy online reimbursements, but they’re mostly paperless, so there’s no option for checks.
Funds held in a cash account earn interest at a current rate of 0.01%. This rate was updated in March 2020 as part of the economic fallout due to COVID-19.
If you’re saving for retirement or otherwise don’t anticipate needing most or part of your HSA balance, then you can invest your account instead to earn a higher long-term rate.
They offer two options for investing: self-directed in a TD Ameritrade (soon to be merged with Charles Schwab) brokerage account, or in a guided portfolio from Devenir.
The self-directed investing account charges no trading or commission fees on stocks, ETFs, or options. The guided portfolio, on the other hand, comes with a 0.5% annual fee.
I especially like Lively’s app, which is user-friendly and lets you store receipts, categorize expenses, track deductible healthcare cost spending, and set up an automated HSA contribution. It’s a big step up from the big banks, which often have outdated tech.
2. Fidelity HSA
Fidelity allows you to open an account with no minimum initial deposit and no HSA fees. The account can be accessed with a debit card. And as one of the largest investment brokers in the world, Fidelity HSA offers you a choice between professionally selected funds, target-date funds, or self-directed investing in mutual funds, ETFs, stocks, bonds, U.S. treasuries, CDs, and options.
It’s also worth noting that Fidelity does not charge commissions on stocks, ETFs, and options.
A Fidelity HSA is also great for people who have other investment accounts with Fidelity. This allows you to manage all your investment accounts under a single dashboard.
3. Bank of America
With Bank of America, you can open a Health Savings Account with no minimum initial deposit, but they do charge a monthly fee of $2.50.
The account pays interest of 0.03% APY on balances up to $2,500, rising to 0.07% for accounts over $7,500. If you have at least $1,000 in the account, you can also choose to invest in mutual funds. But I like Lively or Fidelity better if you’re planning to go the investment route due to the wider choice of investment assets and no HSA fees.
With Bank of America, you can access your HSA funds through a debit card, check, or online transfer to your bank account.
Based in Salt Lake City, Utah, HealthEquity was specifically built as an HSA administrator. They offer three different investment options, including a low-interest cash account, their Yield Plus account paying higher interest, or a lineup of Vanguard funds.
There are no account minimums and $0 monthly account fees for individuals.
You do need $500 to start investing, however, and there is a monthly investment administration fee of 0.03%, capped at a maximum of $10.
If you take advantage of their Advisor plans for investment guidance, there is also an additional monthly advisory fee of 0.05% per month, capped at a maximum of $15.00
5. The HSA Authority
Part of Old National Bank, The HSA Authority is designed specifically as an HSA provider. They offer no-load mutual funds for investing purposes, and $1,000 is the minimum balance required to begin to invest your HSA money.
The checking account comes with a debit card, check-writing privileges, and no monthly fees. But there is a $36 annual fee for the investment account.
Further offers three different HSA plan types, all with competitive interest rates on your cash balances:
- Further Premium, which offers their highest rates. This account has a $4/month administrative fee but offers interest rates ranging from 0.35% up to 0.70%.
- Further Value, which is a low-fee account with an investment option. This account has a $1/month administrative fee and offers interest rates ranging from 0.05% up to 0.20%.
- Further Select, which is an FDIC insured account with an investment option. This account has a $3/month administrative fee and offers interest rates ranging from 0.05% to 0.10%.
If you want to invest your cash, Further offers two-tiered investing options.
The first allows you to invest any excess over $1,000 into a variety of pre-selected mutual funds. The second tier allows you to invest any excess over $11,000 into a wider range of mutual funds, stocks, bonds, and other investment classes. This is offered through a self-directed Charles Schwab brokerage account.
Whether you opt for one or both types of investment accounts, Further charges an additional $18 annual fee for investing.
Despite the somewhat confusing tiers and account options, Further makes the list because their rates on the cash accounts are super competitive in today’s economic climate. If you’re opting for investing, however, the fees and balance limitations push me to recommend a different HSA provider.
7. DCU Credit Union
Digital Federal Credit Union‘s HSA Checking account requires no minimum initial deposit and has no monthly fees. The account comes with a debit card and unlimited check-writing. It currently pays 0.20% APY on account balances up to $1,000, with progressively higher rates moving up to 0.5% for balances of $100,000 or more.
Based in Massachusetts, DCU is available to consumers across the United States.
8. HealthSavings Administrators
HealthSavings Administrators is another investment-focused account. You can open either a cash account (with a debit card), an investment account, or both. The cash account pays interest ranging from 0% on balances under $5,000 to 0.25% for balances greater than $25,000.
There is no minimum balance requirement for cash accounts nor to “unlock” the ability to invest your money.
On the investing side, you have your choice of 43 Vanguard funds and Dimensional mutual funds, which are highly rated and have industry-low average expense ratios. In other words, they’re a great choice for investors who want consistent returns without having to micro-manage your HSA investment or pay the high fees for guided portfolios.
A huge downside to HealthSavings Administrators, however, is the lack of transparency in fees. While there are no annual fees for the cash account, the investment account does charge fees. They are referenced on the website, but not specifically disclosed.
9. Affinity Federal Credit Union
The Affinity Federal Credit Union HSA account has no minimum deposit requirement and charges no HSA fees. It offers a debit card with the account, but no checking privileges are indicated. The account currently pays 0.25% APY and you can fund it with direct deposits. It’s available primarily to residents of New Jersey and Connecticut, but there’s a long list of exceptions.
Since most credit unions serve consumers who either live in a specific geographic location or work in a certain industry, it’s best to check with institutions in your local area.
10. Northern Bank & Trust Company
The Northern Bank & Trust Company HSA requires $25 to open the account, then no minimum balance after that. There’s no monthly service charge, but there is a $25 account closing fee. As of September 1st, NBTC pays 0.02% on balances less than $5,000, up to 0.20% on balances above $25,000.
You’ll be issued a debit Mastercard as well as checks to pay for medical expenses.
11. First American Bank
You can open a basic HSA account at First American Bank with no minimum initial deposit, and no monthly fees. The account comes with a debit card as well as unlimited check-writing and mobile wallet.
The basic account is interest-bearing, but you can invest if you have at least $2,000 in the checking portion of your account. HSA money can be invested in mutual funds, and the monthly fee is $2.95 for the service.
What to Look for in an HSA Provider
There are a few key aspects to consider when shopping for a health savings account:
1. Access to Your HSA
The best companies offer easy access to your funds.
At a minimum, the account should include a few checks along with a debit card that can be used to pay a qualified medical expense directly.
But the best HSAs also offer the convenience of online transfers so that you can reimburse yourself for out-of-pocket expenses by making a one-time or reoccurring transfer from your HSA to your personal checking or savings account.
2. Minimal HSA Fees
In fact, the very best HSA providers don’t have any fees for individual HSA accounts.
But plenty of companies offer HSAs while imposing various fees, including an activity or a monthly fixed fee. Be wary of these, or at least have a good reason for choosing that company if you do.
3. Opening Deposit and HSA Balance Requirements
Opening an HSA account is generally no more complicated than opening any other type of account. You provide basic information, complete forms specific to the HSA provider, and make your opening deposit.
This opening deposit is often minimal, like $50 or $100—sometimes even $0. But it varies from one HSA administrator to another, so you’ll need to check.
You’ll also want to understand any ongoing minimum balance requirements. Some administrators waive fees if your account balance is high enough, while others require a certain amount before allowing you to invest your funds versus keeping it as interest-bearing cash.
Understanding these nuances can help you select the best HSA account for your situation.
4. HSA Investment Opportunities
This gets back to the IRA nature of an HSA.
Again, any unused HSA money in the account can be left to grow. Since ultimately an HSA is a tax-advantaged investment vehicle, you’ll want to be able to put that money to work.
At a minimum, an HSA account should be interest-bearing.
For these types of cash accounts (typically through banks and credit unions), you’ll want to compare the interest rates being offered.
But depending on your age and health status, you may also be interested in more aggressive investments. For investment accounts, you’ll want to compare what asset classes are available to you and how easily you can re-balance.
You can open an investment account with a bank (typically to invest in mutual funds), but an actual investment broker will give you the most asset flexibility if you’re interested in self-directed investing.
Interest-Bearing Account vs. Investment Account
Which should you choose? It really comes down to two questions:
- How much do you intend to contribute to the plan each year?
- How much money do you expect to withdraw for medical expenses in a typical year? (I recommend you review your out-of-pocket medical expenses over the past several years to get an idea.)
The answer to either of these questions can determine whether you’re better off keeping your money in an interest-bearing account or an investment account.
Investment HSA Accounts:
If you plan to make the maximum allowable HSA contribution each year and you don’t anticipate regular withdrawals (for example, if both you and your family are in good or excellent health), then you can expect the account to grow to a substantial balance over time.
And if that’s the case, then you might prefer an investment account.
You can use this type of HSA to invest in stocks, bonds, mutual funds, exchange-traded funds (ETFs), or any other investment allowable under the plan.
This will be even more important if you’re years away from retirement (lots of time to put compound interest to work!).
Generally speaking, you won’t be able to make contributions to an HSA once you reach 65. However, between now and then, you can build up the account and have it available to cover medical expenses in retirement.
Interest-Bearing HSA Accounts:
Conversely, if you plan to make minimal contributions (perhaps only enough to cover any anticipated medical expenses), or you routinely have high out-of-pocket medical expenses (enough that will challenge the annual contribution limit), you’d likely be better served with an interest-bearing account.
It may not earn as much growth as an investment account, but it will offer the complete safety of the principal. That will guarantee your HSA money will be available when needed.
Do Banks and Credit Unions Offer HSAs?
Both banks and credit unions routinely offer Health Savings Accounts. In most cases, a bank or credit union will set up your HSA using either a savings account or a money market account. Either will be interest-bearing and highly liquid.
Banks and credit unions are the best choices if you expect to be an active user of your HSA account. The funds you deposit into your account will have zero risk, and be available as needed. And if you’re opening an account through your local bank, it may be more convenient than a remote investment broker will be when dealing with local healthcare providers.
Interest that a bank or credit union will pay on the HSA account is not likely to be competitive, with the highest rates being paid on deposit accounts you see advertised.
But it’s important to remember that an HSA is a special-purpose account, and the interest rate of return is, at best, a secondary consideration. That will be especially true if you’ll be actively using the account to pay medical expenses.
Opening a Health Savings Account with an Investment Broker
Brokerage firms are more likely to impose a minimum initial deposit into the account, and to charge fees. You’ll need to weigh the fees against the potential investment performance of your account.
Be sure to review any restrictions on investment options within an HSA account. A brokerage firm may make certain investments available in the account while excluding others.
But even if they have no restrictions, you may want to lean on the conservative side of the risk spectrum with this type of account. After all, a sudden need for funds to cover a major health event can arise at any time.
Just be sure that if you do choose an investment account, at least some of the money should be held in a cash type account for potential immediate use. The reality of healthcare is that the need often occurs suddenly.
You won’t want to be caught in a situation where you’ll need to sell investments to cover medical expenses. If those expenses coincide with a decline in the value of your investments, the sale will lock in your losses.
This is when it’s important to remember that the first purpose of an HSA is to cover your medical costs. The investment angle and additional tax benefit is nice to have, but it’s only a secondary consideration.
Find the Best Health Savings Account for You
Not only do HSAs have a lot of benefits, but as you can see from the list above, you’ll have plenty of options as to the best Health Savings Accounts.
It’s becoming more important every year, as health insurance and out-of-pocket medical bills rise. But another under-appreciated factor is the changes that took place with the 2017 Tax Cuts and Jobs Act, that ushered in major shifts in the tax code.
Chief among them is the fact that the standard deduction has nearly doubled. For 2021, the standard deduction is $12,550 for single people and $25,100 for those who are married filing jointly. With the increase in those thresholds, far fewer people will be able to itemize expenses on their tax returns. That includes medical costs. And that’s where HSAs can help.
Not only will you get a tax deduction for your annual contribution to an HSA account, but that will automatically make any expenses paid out of the account tax-free. That will be even better than itemizing the expenses on your tax return—if you even can anymore.
Can I Use my HSA Funds for Non-Health Expenses?
A word of warning: any payments made from your HSA must be limited to qualified medical expenses.
If funds are disbursed for any other purpose, that payment will be fully taxable and subject to an early withdrawal penalty. For example, if you use your HSA debit card to pay for a prescription, then include other non-medical purchases or take cash back, the payment over and above the cost of the prescription itself will be taxable.
Are HSA Accounts Worth It?
For millennials who are generally healthy and want to save for a future qualified medical expense, an HSA is totally worth it.
Given the tax savings and other advantages, it could be a great way to plan for a healthy and wealthy future. Especially after retirement, the money in your HSA can be used to offset the cost of medical treatments so you can hold onto your hard-earned savings.
Health Savings Accounts Offer Tax-Sheltered Investing
Whatever you don’t spend in your HSA account can simply be carried forward and invested in much the same way as an IRA. You can hold the funds in safe, interest-bearing bank accounts, or with investment platforms that allow you to either invest in mutual funds or engage in self-directed investing in just about any asset classes you want.
Since the investment income is tax-sheltered, it can build up just like a retirement account. And whatever you don’t spend out of the account between now and retirement can help provide for you in your old age.
If you don’t have an HSA account right now, there’s no time like the present to take advantage of this major benefit that’s available to anyone with an HDHP insurance plan. It’s just a matter of selecting the best places to open an HSA. Use this guide as a starting point and make it happen.
Quick Summary: Compare the top HSA accounts
|Fee For Cash Accounts||APY On Cash Balances||Fee for Investments||Min to Invest||Investment Platform|
|1. Lively||$0||0.01%||$0 self-directed; 0.50% guided portfolio||$0||TD Ameritrade|
|3. Bank of America||$2.50/mo||0.03% – 0.07%||$0||$1,000||Mutual Funds|
|4. HealthEquity||$0||Varies||0.03% admin + 0.05% advisory||$500||Mutual Funds|
|5. The HSA Authority||$0||Varies||$36/yr||$1,000||Mutual Funds|
|6. Further||$1 – $4/mo||0.05% – 0.70%||$18/year||$1,001||Charles Schwab|
|7. DCU||$0||0.20% – 0.50%||N/A||N/A||N/A|
|8. HealthSavings||$0||0% – 0.25%||Undisclosed||$0||Mutual Funds|
|9. Affinity Federal||$0||0.25%||N/A||N/A||N/A|
|10. NBTC||$0||0.02% – 0.20%||N/A||N/A||N/A|
|11. First American Bank||$0||0.01% – 0.15%||$2.95/mo||$2,000||Mutual Funds|