HSA vs HRA vs FSA Comparison Chart
Navigating the alphabet soup of healthcare accounts is much easier when you can see the key differences in ownership, portability, and contribution limits side-by-side. This table breaks down the unique features of HSAs, FSAs, and HRAs to help you identify the best strategy for managing your expenses and savings.
Health Savings | Flexible Spending | Health Reimbursement | |
| 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 |