HSA vs HRA vs FSA Comparison Chart

 Health Savings
Account (HSA)
Flexible Spending
Account (FSA)
Health Reimbursement
Arrangement (HRA)
Account Owned ByEmployee/ IndividualEmployer (held in employee’s name)Employer (held in employee’s name)
Contributions Made ByEmployer, employee or bothEmployer, employee or bothEmployer
Separate Bank Account for Each EmployeeYes; IRA-type accountNoNo
Expenses CoveredMedical, dental, vision, prescription and some over-the-counter expenses. COBRA, retiree medical insurance premiums, LTC premiums or expense – Reference: IRS Publication 502Medical, dental, vision, prescription and some over-the-counter expenses – Reference: IRS Publication 502Medical, dental, vision, prescription and some over-the-counter expenses. Post-tax insurance premiums. – Reference: IRS Publication 502
Eligibility RequirementsMust be covered by a qualified HDHP (high deductible health plan)NoneMust have minimum essential coverage to receive reimbursements tax-free
Maximum Annual Contribution2021: $3,600 (single), $7,200 (family), Catch-up $1,000Determined by Employer; Capped at $2,750, including employee contributions, in 20212021: $5,300 (single), $10,700 (family)
Average Cost to Cover $2,000/year Deductible$2,000$2,000$500-1,000
Money Can Be InvestedYesNoNo
Portable after TerminationFull portability requiredNonePortability allowed at employer’s discretion
RolloverFull rollover required$500 rollover allowed at employer’s discretionRollover allowed at employer’s discretion
Funds AvailabilityAs deposits are creditedFull annual election available on first day of coverage (uniform coverage)As deposits are credited; may be credited in a lump sum
Claim AdjudicationNot allowed; though participants must retain receiptsRequiredRequired
Compatibility with Other Savings AccountsMay be paired with HRA/ FSA if limited to amounts over deductible, or to dental/ vision only; may be paired with DCAP, PRAMay be paired with HRA, DCAP, PRA. If paired with an HSA, must be limited to amounts over the deductible or to dental/vision onlyMay be paired with FSA, DCAP, PRA. If paired with an HSA, must be limited to amounts over the deductible or to dental/vision only
Employer ContributionsCan be made on behalf of current employees (account extends to spouse and dependents)Can be made on behalf of current employees (account extends to spouse and dependents)Can be made on behalf of current, former employees, their spouses and dependents, and spouses and dependents of deceased employees
ERISA PlanGenerally noYesYes
COBRADoes not applyAppliesApplies
RetireesCan be coveredCannot be coveredCan be covered
Debit Card AvailableYesYesYes
Contributions for Medicare ParticipantsContributions cannot be made once an individual has Medicare coverageNo limits on contributionsNo limits on contributions
Usage for Ineligible ExpensesAllowed. Amounts included in income; subject to 20% penalty unless after account beneficiary’s death, disability or attaining age 65Not allowedNot allowed
Coverage for Sole Proprietors, Partners and 2% or More S-corp OwnersYou can’t make a pre-tax contribution to an HSA. However, you can make contributions with your after-tax dollars.Cannot be coveredCannot be covered