1.44- What is a "Health Saving Account" HSA and how is it deducted?

Various programs are designed to give individuals tax advantages to offset health care costs. This publication explains the following programs.


  • Health Savings Accounts (HSAs).


  • Medical Savings Accounts (Archer MSAs and Medicare Advantage MSAs).


  • Health Flexible Spending Arrangements (FSAs).


  • Health Reimbursement Arrangements (HRAs).

An HSA may receive contributions from an eligible individual or any other person, including an employer or a family member, on behalf of an eligible individual. Contributions, other than employer contributions, are deductible on the eligible individual’s return whether or not the individual itemizes deductions. Employer contributions aren’t included in income. Distributions from an HSA that are used to pay qualified medical expenses aren’t taxed.

An Archer MSA may receive contributions from an eligible individual and his or her employer, but not both in the same year. Contributions by the individual are deductible whether or not the individual itemizes deductions. Employer contributions aren’t included in income. Distributions from an Archer MSA that are used to pay qualified medical expenses aren’t taxed.

A Medicare Advantage MSA is an Archer MSA designated by Medicare to be used solely to pay the qualified medical expenses of the account holder who is enrolled in Medicare. Contributions can be made only by Medicare. The contributions aren’t included in your income. Distributions from a Medicare Advantage MSA that are used to pay qualified medical expenses aren’t taxed.

A health FSA may receive contributions from an eligible individual. Employers may also contribute. Contributions aren’t includible in income. Reimbursements from an FSA that are used to pay qualified medical expenses aren’t taxed.

An HRA must receive contributions from the employer only. Employees may not contribute. Contributions aren’t includible in income. Reimbursements from an HRA that are used to pay qualified medical expenses aren’t taxed.

A Health Savings Account (HSA) is a tax-exempt trust or custodial account you set up with a qualified HSA trustee to pay or reimburse certain medical expenses you incur. You must be an eligible individual to qualify for an HSA.

No permission or authorization from the IRS is necessary to establish an HSA. You set up an HSA with a trustee. A qualified HSA trustee can be a bank, an insurance company, or anyone already approved by the IRS to be a trustee of individual retirement arrangements (IRAs) or Archer MSAs. The HSA can be established through a trustee that is different from your health plan provider.

Your employer may already have some information on HSA trustees in your area.