Key takeaways
- HSAs offer significant tax advantages and can be used for both immediate medical expenses and long-term investments.
- When shopping for an HSA, it’s important to consider how you plan to use the account and to watch out for fees, minimum balances, interest rates and customer service.
A Health Savings Account (HSA) is a tax-advantaged savings account that you’re eligible to contribute to if you’re enrolled in a high-deductible health plan. HSAs are considered triple-tax advantaged because contributions are tax deductible if you contribute by paycheck deduction, while earnings are tax-free if money is used for qualified healthcare expenses, and withdrawals are also tax-free if used for qualified healthcare expenses.
An HSA can be used like a checking account to pay for medical bills as they arise, as an investment account to prepare for health care costs down the road or as a combination of the two.
An HSA is a savings account that lets you set aside pre-tax dollars to pay for health care expenses. Unlike flexible spending accounts (FSAs), money in an HSA carries over from year to year. To qualify for an HSA, you must have a high-deductible health plan (HDHP). In 2024, the minimum deductible is $1,600 for individuals and $3,200 for families. In 2025, the minimum deductible is $1,650 for individuals and $3,300 for family coverage.
While HSA account holders can typically choose to invest the funds, they usually have the option of keeping them in what providers call a “cash account.” This account often has many similarities to a standard savings or checking account, with funds earning nominal interest and receiving federal deposit insurance coverage up to the standard limits.
When shopping for an HSA, it’s important to consider:
- Account fees
- Investment options
- Minimum balance requirements
- Account accessibility
- Interest rates
- Customer service
Depending on how you plan to use the HSA, certain account features will matter more to you than others.
To help you in your search, Bankrate has compiled a list of the best HSA accounts of 2024. To narrow our choices, we compared fees, balance requirements, investment choices, interest rates and account accessibility of more than a dozen top HSA providers.
The best HSA accounts in 2024
- Best for accessibility: Lively
- Best for investment options: Fidelity Investments
- Best for short-term spending: HealthEquity
- Best for reimbursement of out-of-pocket expenses: HSA Bank
- Best HSA offered by a traditional bank: Bank of America
Best for accessibility: Lively
Overview: A Lively features no hidden fees that cut into your savings. While some HSA providers make it hard to find interest rates and other account details on their websites, Lively’s website is simple, easy to follow and provides relevant details in plain view.
Investment options: Customers have access to lots of commission-free investments online through two options:
- A self-directed brokerage account with Charles Schwab, which charges no fee for balances of $3,000 or more and $24 annually for balances below that.
- A guided portfolio by Devenir, which comes with an annual fee of 0.5 percent, but there is no cash minimum to invest in it.
Cash account features: Cash balances in a Lively HSA are federally insured and earn interest. The annual percentage yield (APY) starts at 0.01 percent and increases by balance tiers, with the highest tier of over $10,000 earning 0.12 percent.
Other perks: A Lively HSA comes with a debit card to pay health care expenses. It also offers online banking and a mobile app that lets you track and manage the account from anywhere. Lively also offers streamlined HSA administration to employers.
Pros
- No hidden fees
- No minimum opening deposit
- Website is clear and easy to navigate
Cons
- Interest rates are low
- The guided portfolio option comes with a high fee
Best for investment options: Fidelity Investments
Overview: With a Fidelity HSA, you can invest in stocks, bonds, ETFs, mutual funds and other options. Online U.S. stock and ETF trades are commission-free, but there may be underlying fees for certain investments.
Investment options: Two options exist, neither of which requires any set minimum opening deposit:
- Fidelity HSA, the self-directed account, has no maintenance fees or minimum opening deposit requirements.
- Fidelity Go HSA, the managed account, has no maintenance fees. It has an annual fee of 0.35 percent if your account balance is $25,000 or more.
Cash account features: Cash balances in a Fidelity HSA are swept into an interest-bearing account that earns a much higher interest rate than other HSAs. The same interest rate applies to all balances.
Other perks: You can download the Fidelity Health App to access and manage your account activity. It’s relatively easy to transfer another HSA account balance to Fidelity: You supply the details of that account, and Fidelity contacts the provider to handle the transfer.
Pros
- No maintenance fees for the self-directed account
- No minimum opening deposit
- High interest rate earned on all cash balances
Cons
- There’s a 0.35 percent fee for balances of $25,000 or more in the Fidelity Go HSA
Best for short-term spending: HealthEquity
Overview: HealthEquity is a nonbank HSA custodian and one of the largest HSA providers. It’s a good choice for customers who need to use their HSA regularly for medical expenses because of the multiple ways available to spend and track the account. Account holders can access their funds with a debit card, through online banking or with the mobile app.
Investment options: HealthEquity provides options with different levels of risk, including:
- Low-Risk Yield Plus: In addition to being a low-risk option, it offers varying interest rates based on balance.
- Varying Risk Mutual Funds: This option incorporates low-cost mutual funds with no hidden fees for trading and investing. Members can manage their investment portfolio personally or enroll in HealthEquity’s Advisor for personalized web-based investment advice.
Investment-related fees: There is a monthly HealthEquity investment administration fee of 0.03 percent, capped at $10. Additionally, the Advisor option costs an additional monthly fee of 0.05%, which is charged on the average daily invested balance of the mutual fund portfolio and capped monthly at $15.
Cash account features: HealthEquity savers do earn some interest, and funds are insured up to federal limits through Federal Deposit Insurance Corp. (FDIC)– or National Credit Union Administration (NCUA)-insured institutions.
Other perks: HealthEquity offers 24/7 customer support by phone or live chat. The HealthEquity mobile app lets you send payments and reimbursements, view claim status, take pictures with your device to initiate claims and payments and link debit card transactions to claims.
Pros
- No minimum opening deposit
- Many ways to access funds
- All balances earn interest
Cons
- There’s a 0.36 percent annual administration fee
Best for reimbursement of out-of-pocket expenses: HSA Bank
Overview: HSA Bank is a division of Webster Bank, dedicated to health accounts. The bank makes it easy for customers to pay themselves back for IRS-qualified medical expenses that were paid out of pocket. Ways to do so include withdrawing cash from the account at an ATM, as well as transferring funds from the account to an external bank account.
Investment options:
- Choice: This brokerage experience offers a large range of stocks, mutual funds and ETFs.
- Select: Customers can choose from a recommended list of mutual funds selected by an SEC-registered investment advisor.
Cash account features: The HSA account comes with no account fees unless you opt for printed account statements, in which case it’s $1.50 a month. It also comes with a debit card, which you can use to pay for IRS-qualified medical expenses. You can also use the card to obtain funds from an ATM for reimbursement of qualifying medical expenses you paid for out of pocket. The account earns meager interest, with the highest APY of 0.5 percent only offered on balances of $50,000 or more.
Other perks: HSA Bank offers a 24/7 customer support line as well as a mobile app.
Pros
- No monthly account fees when you opt for e-statements
- No minimum opening deposit
Cons
- There’s a $1.50 monthly fee for paper statements
- To earn the highest APY, you need at least $50,000
- There’s a $25 fee for closing your account.
Best HSA offered by a traditional bank: Bank of America
Overview: Bank of America, the second largest bank in the U.S., offers an HSA that’s easy to manage through the bank’s website or mobile app. Included is a Visa debit card with no transaction fees, which can be used for qualifying doctor visits, pharmacy purchases and online health care purchases.
Investment options: Investors have dozens of Merrill (a subsidiary of BofA) mutual funds to choose from. Before you begin investing, your cash account must reach a set minimum balance, which you can determine by logging on to your account.
BofA does not charge transaction fees to buy or sell investments, but there are internal expenses with mutual funds. BofA is also an HSA custodian for small and large businesses.
Cash account features: Savers earn interest at tiered rates, with the highest rate, 0.7 percent APY, offered on balances of over $10,000.
Other perks: Members can submit claims and monitor the HSA through BofA’s member website or the MyHealth BofA mobile app. Included in the digital and online tools are a savings calculator, as well as guidance and education in matching financial strategies with health and wellness goals. Customers have 24/7 support by phone or online chat.
Fees: There’s a standard monthly account fee of $2.50 and an account transfer fee of $25, both of which might be waived if the HSA is through your employer.
Pros
- No minimum opening deposit
- Widespread branch access
- Broad selection of mutual funds to choose from
Cons
- There’s a $2.50 monthly account fee
- Other HSAs offer higher earning potential
How to choose the best HSA
There are advantages to opening an HSA through your employer, if it’s available. With an employer-provided HSA, you can reduce taxes, and your company might contribute to your account.
“In some cases, employer plans can get a better price point, but maybe you can’t get it for free on your own,” says Eric Remjeske, founder and president of Devenir, a Minneapolis-based HSA investment advisor and research firm. HSA shoppers might find Devenir’s HSASearch tool helpful.
If you decide to shop for an HSA, here’s what to consider.
- Decide how you will use the account. Knowing how you intend to use an HSA — whether for immediate and near-term medical expenses or as an investment account for future health care costs — will help you narrow your options.
- Watch out for fees. Always ask for a complete schedule of fees before you make a decision, as HSA fees vary greatly among providers. There may be maintenance fees, investment fees, paper statement fees and per-transaction charges. Some HSAs charge a fee to open the account, obtain, replace or renew a debit card or transfer money from a savings account to an investment account. HSAs may also have overdraft fees or nonsufficient funds fees.
- Inquire about minimum balances to open or invest in a HSA. Some HSA administrators waive fees if an account meets a balance threshold. Ask whether the fee waiver is based on a minimum savings balance or a combined savings and investment balance. Minimum balance requirements to invest usually range between $500 and $3,000.
- Compare interest rates. Much like a traditional savings account, HSAs offer an opportunity to earn interest on the cash balance. For savers who plan to maintain an HSA as a spending account, savings rates are something to look at.
- Make sure HSA funds are easily accessible. When health care bills arise, you need to be able to get to your HSA funds to pay them. Find out whether the HSA comes with a debit card, online bill pay or checks. Find out how easy or difficult it is to transfer funds out of the account to your personal checking, for example.
- Make sure investment options are diverse and strong. Some HSAs offer the chance to invest and grow the funds. HSA custodians offer a mix of mutual funds, stocks, bonds and other investment products. Look for investment options that charge low fees and don’t have balance thresholds to meet before you can invest. Look for varied investment options with a good performance. Keep in mind that stocks, bonds and other investments are not federally insured.
- Savers, choose a federally insured institution. If you plan to keep your HSA in a spending account, as opposed to invested, make sure the bank or credit union you select is insured by the FDIC or the NCUA’s National Credit Union Share Insurance Fund. If your financial institution were to fail, you would be covered for up to $250,000.
- Evaluate the customer service. Make sure the bank, credit union or HSA custodian answers all your questions and tells you everything you need to know to make informed choices. Find out about customer service hours and tools that can help you track and manage your account, such as mobile apps. Some financial institutions are better at offering educational videos and articles online. If you prefer an in-person experience, inquire about branch locations and hours.
— Bankrate writer Karen Bennett and former Bankrate writers René Bennett and Libby Wells contributed to updates of this story.
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