Story from TaxAct: Health savings vs. flexible spending accounts: How do they affect taxes? (2024)

Story from TaxAct: Health savings vs. flexible spending accounts: How do they affect taxes? (1)

“Our new Constitution is now established, everything seems to promise it will be durable; but, in this world, nothing is certain except death and taxes.” — Benjamin Franklin, 1789

But was this illustrious founding father the first to introduce this now commonly known concept?

“The Yale Book of Quotations” shows that Christopher Bullock said in 1716, “’Tis impossible to be sure of any thing but Death and Taxes.” And only eight years later, Edward Ward stated that “Death and Taxes, they are certain.”

Regardless of the origin, the fact that this sentiment still rings true hundreds of years later proves the perpetuation of the inevitable: The majority of taxes are unavoidable, even when it comes to the financial burden associated with our health itself.

Fortunately, there are multiple options available for those seeking a tax-advantageous safety net of sorts. Two of the most common ones are health savings accounts, or HSAs, and flexible spending accounts, or FSAs.

Need help filing your taxes? Visit taxact.com.

What’s the difference between an FSA and an HSA?

Story from TaxAct: Health savings vs. flexible spending accounts: How do they affect taxes? (2)

First, it’s important to note that both types of accounts serve to allocate pretax dollars to be set aside for specified purposes, including — but not limited to — medical, vision and dental expenses you may incur throughout the term of your given plan.

HSAs are accounts you set up yourself. You can set up an account at your bank or credit union, for example. With this account, you can keep it no matter where you go or where you work, or if you work at all. You — and possibly your employer — contribute to the account throughout the year. The only stipulation is you must have a high-deductible health plan to have an HSA. Further, funds in an HSA can be rolled over each year, making it a smart choice if you plan on long-term savings.

Once your HSA is set up, you can allocate additional money to the account with automatic deductions from your paycheck, and all funds contributed are tax deductible.

An HSA is also a good consideration for those who wish to carry their plan and funds with them, even if they choose to pursue a career with a different employer.

Your employer owns your health FSA, and both you and your employer can fund it. One of the key benefits of an FSA is that funds can be utilized for child care expenses in addition to products and services related to your health. This type of plan is, however, a use-it-or-lose-it arrangement. There is a rollover provision, though. Up to $500 of your unused FSA funds can be rolled over to the next year. If you contribute more throughout the year than you’re able to spend, you may find yourself scrambling to make doctor’s appointments in December to use up what you’ve put into your FSA.

As is the case with an HSA, you can apply funds to your FSA from your gross pay, which means that every dollar you put in is considered a tax-free contribution. In addition, you’re not likely to owe taxes on any withdrawals as long as you use the funds strictly for qualified expenses.

Note: Self-employed filers are able to open an HSA, but not an FSA.

How do health accounts help you save on your taxes?

Story from TaxAct: Health savings vs. flexible spending accounts: How do they affect taxes? (3)

When you make qualified contributions to an HSA or a health FSA, you can take a deduction for the amount of your contribution — or your contributions can reduce your taxable income on the federal W-2 form. Either way, your income tax bill goes down.

If your employer makes qualified contributions for you, the amount of its contributions is not taxable.

Note: Health account contributions do not reduce your income tax subject to Social Security and Medicare tax.

Why not take a tax deduction for medical expenses instead?

Instead of setting up a health account, you could pay for your medical expenses with after-tax dollars and take a deduction. However, there’s one major problem with that.

You can deduct medical expenses only to the extent that they exceed 7.5% of your adjusted gross income.

There goes most or all of your deduction. If you qualify for a health account or other plan, it’s usually well worth the trouble to set it up and use it for any qualified medical needs that arise throughout the tax year.

Contributing to an FSA or an HSA can be a game changer

Even those with the most robust medical, vision or dental insurance policies may still find themselves wondering what might happen if their health plan fails to cover an unexpected expense. Depending on your individual circ*mstances, an HSA or an FSA may offer the peace of mind you seek for yourself and your family — as both a safety net in times of need and a welcome break for at least some of those unavoidable taxes.

For more information about TaxAct, visit taxact.com.

Story from TaxAct: Health savings vs. flexible spending accounts: How do they affect taxes? (2024)

FAQs

What is the difference between FSA and HSA for tax purposes? ›

You won't pay tax on IRS-eligible healthcare expenses, but any other expenses will be taxed as income. A few more differences: FSAs are employer-sponsored plans, and HSAs are owned by you. Therefore, when you change employers, you can take the HSA with you, but any funds contributed to your FSA generally must be spent.

How does a Flexible Spending Account affect taxes? ›

A Flexible Spending Account (FSA) allows you to put aside a set amount of money from your paychecks before taxes to pay for certain specific health care or dependent care expenses, which lowers your taxable income.

How does a health savings account affect my taxes? ›

Health Savings Accounts offer a triple-tax advantage* – deposits are tax-deductible, growth is tax-deferred, and spending is tax-free. All contributions to your HSA are tax-deducible, or if made through payroll deductions, are pre-tax which lowers your overall taxable income.

What is the tax penalty for HSA and FSA? ›

Penalty for making excess contributions

If you exceed contribution limits for an HSA or FSA, the excess amount will be subject to regular income tax. But that's not all. An excise tax of 6% will also apply to any amount that is over the contribution limit.

Why would someone choose FSA over HSA? ›

You don't have to be enrolled in an HDHP to open an FSA. So, if you have regular medical expenses, it may make more sense. And, while HSA contributions accumulate through the year, funds from your FSA are available in full at the beginning of your plan year.

What are the disadvantages of HSA? ›

Meeting the Mark: One major hurdle with an HSA is the high-deductible health insurance plan (HDHP) requirement. Before your insurance kicks in, you need to pay a significant amount out-of-pocket. This can be a challenge, especially if unexpected medical costs arise early in the year.

Do I need to report HSA on taxes? ›

You must report distributions from your HSA on IRS Form 8889. You will receive a separate 1099-SA for each type of distribution made during the tax year. The five distribution types are 1) normal; 2) excess contribution removal; 3) death; 4) disability; and 5) prohibited transaction.

Do I need to report FSA on tax return? ›

Since these salary reductions are contributions to the account and aren't included in your taxable wages on your W-2, you don't enter them as a deduction on your tax return. They may appear in Box 14 of the W-2 for informational purposes only (which you can verify with your employer).

How much tax do you save with FSA? ›

Combined, the employee share of FICA taxes of 7.65% and the average income tax rate of 13.6% come to 21.25%. This means that you save approximately 21.35% of every dollar you contribute to an FSA. If you contribute the 2023 maximum of $3,050, you would save 21.25% of that, or approximately $648.12.

Why does my HSA lower my tax refund? ›

Contributions you make to your HSA through payroll deductions may be excluded from your gross income. You are eligible for a tax deduction for additional contributions you made to your HSA even if you do not itemize your deductions. Contributions made to your HSA by your employer may be excluded from your gross income.

How much will HSA reduce my taxes? ›

How does an HSA help me save on taxes? Every dollar you add to your HSA reduces your taxable income by one dollar. So, if your effective tax rate is 25 percent, you'll save a quarter for every dollar you set aside.

Why is my HSA contribution being taxed? ›

An HSA distribution—money spent from your HSA account—is nontaxable as long as it's used to pay for qualified medical expenses. HSA distributions used for anything other than qualified medical expenses are not only taxable, they're subject to an additional 20% penalty if you're not disabled or are under the age of 65.

What is the tax loophole for HSA? ›

Tax deductions for HSA contributions

For those under the Social Security wage base ($168,600 for 2024), this means you dodge 7.65% FICA tax (6.2% SS and 1.45% Medicare) but also means those wages don't count towards your Social Security benefit either (since you didn't pay into the system).

Does IRS check HSA accounts? ›

Verification of expenses is not required for HSAs. However, total withdrawals from your HSA are reported to the IRS on Form 1099-SA. You are responsible for reporting qualified and non-qualified withdrawals when completing your taxes.

Does HSA and FSA reduce taxable income? ›

Key Takeaways. An FSA helps employees cover health-related costs not included in their insurance plans. Contributing to an FSA reduces taxable wages since the account is funded with pretax dollars.

Should I include HSA in tax return? ›

You can claim a tax deduction for contributions you, or someone other than your employer, make to your HSA even if you don't itemize your deductions on Schedule A (Form 1040). Contributions to your HSA made by your employer (including contributions made through a cafeteria plan) may be excluded from your gross income.

What happens to unused FSA funds? ›

Unused FSA money returns to your employer. The funds can be used towards offsetting administrative costs incurred during the plan year, employers can also reduce salary reductions in the next FSA year, or funds must be equally distributed to employees who enroll in an FSA for the next year.

Should I have a tax form for my FSA? ›

The funds in your Medical and Dependent Care FSA are deposited pre-tax and the amount is deducted from your Annual Gross Income. This will be represented on the W-2 you receive from your Employer for tax reporting. There are no additional tax forms issued for the FSA plans.

Do you report dependent care FSA on taxes? ›

Box 10 on your W-2 form should indicate the total annual amount of your Dependent Care FSA deductions. When completing your tax return, you will need to attach a Child and Dependent Care Expenses form (Form 2441 for a 1040 return; Schedule A for a 1040A return). You should contact a tax preparer for more details.

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