Email FacebookTwitterMenu burgerClose thin

HSA Withdrawal Rules


A health savings account (HSA) is a specialized savings account for individuals with a high deductible health plan (HDHP). Although building savings in this account is a good idea, it’s important to understand HSA withdrawal rules. Let’s take a closer look at the HSA withdrawal rules to keep in mind. If you need help applying these rules to your unique situation, then a financial advisor can help. A qualified financial advisor can help you create a streamlined plan for your HSA funds.

HSA Definition

Before we jump into the HDA withdrawal rules, let’s talk about what an HSA is. An HSA is a health savings account. The purpose of the account is to help you save on medical costs. Although the funds generally aren’t available to cover a health insurance premium, most other medical-related expenses are allowed.

The catch with an HSA is that you can’t open this account unless you have a high-deductible health plan (HDHP). Most HDHP only provide a small amount of coverage until you meet your deductible. When you have an HDHP, an HSA is a tax-savvy way to save for potential medical expenses.

HSA Withdrawal Rules

As a practical matter, you are allowed to withdraw funds from your HSA at any time for any reason. But if you aren’t using the funds to cover a qualified medical expense, then you’ll be stuck paying a penalty tax. Here’s a closer look at the HSA withdrawal rules.

Qualified Medical Expenses

You can withdraw funds from your HSA at any time to cover qualified medical expenses, which are listed below. The amount you can withdraw in a given year varies based on your medical costs.

An HSA withdrawal is the last tax perk in the string of three tax advantages offered through this account. When you pull out funds from your HSA for any qualified medical expense, you won’t have to pay any taxes on the withdrawal.

Other Distributions

Unfortunately, life doesn’t always go as planned. If you need to make a withdrawal from your HSA for something other than a qualified medical expense, there’s a penalty to consider. Any HSA withdrawal you make without a qualified medical expense will be subject to income taxes. In addition to the income tax, you’ll have to pay an additional 20% tax on the withdrawal.

The taxes you pay on an unqualified HSA withdrawal will add up quickly. With that, it’s best to hold off on pulling funds out of your HSA for any other reason than a qualified medical expense. Luckily, there are a few exceptions to this rule, which we cover below.

What If I’m Retired?

The HSA withdrawal rules change a bit when you turn 65. At that point, you can withdraw funds from your HSA without an extra penalty. That’s true even if you use the funds for something other than a qualified medical expense. You will still have to pay taxes on withdrawals made for something other than a qualified medical expense. When you make a withdrawal from an HSA, the funds will count towards your income for the year. With that, you’ll just pay regular taxes on the withdrawals.

The same rules apply if you become disabled. The funds can be withdrawn without an extra penalty. But you’ll still have to pay regular income tax on withdrawals made for anything other than a qualified medical expense.

Also, once Medicare kicks in, you can use it for certain expenses, such as Part B premiums and Part D prescription drug coverage. That also includes supplemental policy premiums (Medigap) but only for retirees over age 65 with an employer-sponsored health plan. Alternatively, HSA funds may partially cover the cost of a long-term, tax-qualified car insurance policy. Or, if you are 65 or older, your funds may go towards nonqualified medical costs. However, this last option forfeits some of your tax advantages.

What If I’m Laid Off?

Usually, you can’t use HSAs for private health insurance premiums. However, you can use them if you are using them to pay for health insurance coverage that is part of an employer-sponsored plan through COBRA. Your funds may also cover premium costs if you receive unemployment compensation. This works at any age.

What Counts as a Qualified Medical Expense?

hsa withdrawal rules

You don’t have to pay taxes on withdrawals made for qualifying medical expenses. So, it’s pretty important to be clear on what counts as a qualified medical expense.

Here’s a look at what counts:

  • Payments made to a doctor, dentist, surgeon, chiropractor, psychiatrist or psychologist
  • Physical examinations
  • Artificial teeth
  • Bandages
  • Birth control pills
  • Breast pump
  • Cost of improvements to your home designed to accommodate a condition
  • Contact lenses
  • Fertility treatments
  • Drug addiction treatments
  • Guide dog
  • Lead-based paint removal
  • Long-term care
  • Wheelchair
  • Weight-loss programs diagnosed by a physician

Although this is not a comprehensive list, it should give you an idea of what you can consider a qualified medical expense. If you have questions about a particular medical expense, then consider talking to a financial advisor for more clarification.

What Doesn’t Count as a Qualified Medical Expense?

Of course, not everything counts as a qualified medical expense. Here are some things that you can’t include as a qualified medical expense:

  • Childcare
  • Controlled substances
  • Cosmetic surgery
  • Hair removal
  • Funeral expenses
  • Dancing lessons
  • Nutritional supplements
  • Household help
  • Insurance premiums
  • Gym membership dues

Some of the items on this list might seem healthcare-related. However, according to the IRS, these are not qualified medical expenses. If you make a withdrawal from your HSA for any of these expenses, the withdrawal would be subject to income tax and an additional 20% tax.

Bottom Line

hsa withdrawal rules

An HSA is a useful tool for savers who want to set aside funds for their healthcare costs. There is plenty of room to build savings with a triple tax advantage. But it’s important to avoid withdrawals for anything other than a qualified medical expense. Otherwise, you will be on the hook for an expensive tax bill.

HSA Tips

  • An HSA can be a nice addition to your savings plan. But navigating the withdrawal rules is easier with the help of a qualified financial advisor. Finding a financial advisor doesn’t have to be hard. SmartAsset’s free tool matches you with up to three vetted financial advisors who serve your area, and you can have a free introductory call with your advisor matches to decide which one you feel is right for you. If you’re ready to find an advisor who can help you achieve your financial goals, get started now.
  • If you invest through your HSA, look out for the fees. Don’t let fees limit your HSA’s full potential.

Photo credit: ©, ©, ©