HSA vs HRA vs FSA Comparison Chart
| Health Savings Account (HSA) | Flexible Spending Account (FSA) | Health Reimbursement Arrangement (HRA) | |
| Account Owned By | Employee/ Individual | Employer (held in employee’s name) | Employer (held in employee’s name) |
| Contributions Made By | Employer, employee or both | Employer, employee or both | Employer |
| Separate Bank Account for Each Employee | Yes; IRA-type account | No | No |
| Expenses Covered | Medical, dental, vision, prescription and some over-the-counter expenses. COBRA, retiree medical insurance premiums, LTC premiums or expense – Reference: IRS Publication 502 | Medical, dental, vision, prescription and some over-the-counter expenses – Reference: IRS Publication 502 | Medical, dental, vision, prescription and some over-the-counter expenses. Post-tax insurance premiums. – Reference: IRS Publication 502 |
| Eligibility Requirements | Must be covered by a qualified HDHP (high deductible health plan) | None | Must have minimum essential coverage to receive reimbursements tax-free |
| Maximum Annual Contribution | 2022: $3,650 (single), $7,300 (family), Catch-up $1,000 | Determined by Employer; Capped at $2,850, including employee contributions, in 2022 | 2022: $5,450 (single), $11,050 (family) |
| Average Cost to Cover $2,000/year Deductible | $2,000 | $2,000 | $500-1,000 |
| Money Can Be Invested | Yes | No | No |
| Portable after Termination | Full portability required | None | Portability allowed at employer’s discretion |
| Rollover | Full rollover required | $500 rollover allowed at employer’s discretion | Rollover allowed at employer’s discretion |
| Funds Availability | As deposits are credited | Full annual election available on first day of coverage (uniform coverage) | As deposits are credited; may be credited in a lump sum |
| Claim Adjudication | Not allowed; though participants must retain receipts | Required | Required |
| Compatibility with Other Savings Accounts | May be paired with HRA/ FSA if limited to amounts over deductible, or to dental/ vision only; may be paired with DCAP, PRA | May be paired with HRA, DCAP, PRA. If paired with an HSA, must be limited to amounts over the deductible or to dental/vision only | May 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 Contributions | Can 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 Plan | Generally no | Yes | Yes |
| COBRA | Does not apply | Applies | Applies |
| Retirees | Can be covered | Cannot be covered | Can be covered |
| Debit Card Available | Yes | Yes | Yes |
| Contributions for Medicare Participants | Contributions cannot be made once an individual has Medicare coverage | No limits on contributions | No limits on contributions |
| Usage for Ineligible Expenses | Allowed. Amounts included in income; subject to 20% penalty unless after account beneficiary’s death, disability or attaining age 65 | Not allowed | Not allowed |
| Coverage for Sole Proprietors, Partners and 2% or More S-corp Owners | You can’t make a pre-tax contribution to an HSA. However, you can make contributions with your after-tax dollars. | Cannot be covered | Cannot be covered |