Best Health Savings Accounts in December 2024

A health savings account (HSA) is a powerful and tax-efficient savings and investment account. It features what’s called the “triple tax advantage”: tax-deductible contributions and tax-free growth and withdrawals. It must be paired with a high deductible health insurance plan (HDHP).

An HSA is subject to annual contribution limits, and withdrawals are tax free only if they are used for qualified medical expenses, such as deductibles, copayments, prescription medications, and certain medical procedures. HSA owners can invest the money in the account for long-term growth, building significant funds for use when healthcare expenses rise with age.

All of the HSAs recommended below offer basic services for spending and managing receipts, no account minimums, investing options, and mobile account access. Account variables such as transparency, fees, minimum investment thresholds, quality and number of investment options, and default cash interest rates are the basis of our evaluation.

Best health savings accounts (HSAs)

*APYs as of May 6, 2024

Our recommendations for best HSAs

Best for investors: Fidelity Investments

Fidelity is a clear leader in HSAs because it provides the best of everything in one account, setting the gold standard against which all other accounts should be compared.

HSAs at Fidelity have no account minimums, monthly maintenance fees, or minimum investment thresholds. They can be integrated with the discount broker’s robo-advisor service, Fidelity Go, and thousands of investment options.

Account holders can access all investment types provided by Fidelity, including no-fee mutual funds, exchange-traded funds (ETFs), stocks, bonds, and high-yield money market funds.

The Fidelity Go robo-advisory services fee is 0.35% a year for balances of $25,000 or more. There is no advisory fee for balances under $25,000.

Another distinguishing feature of the account is the cash sweep. Idle cash is automatically invested in the Fidelity Government Cash Reserves Fund (FDRXX), which has an APY of around 5%. This is a much higher default interest rate than its competitors. Most other HSAs have a negligible default cash interest rate but offer high yield money market and bond funds with a similar risk profile as investment options.

Though we recommend other HSA providers on this list, consumers should carefully consider each against the Fidelity HSA, because it leads the pack in many categories.

Why we recommend it: The Fidelity Investments HSA provides a high default interest rate on cash and a broad range of investments and tools to manage accounts. No minimums, maintenance fees, or account fees make the excellent account features accessible to all.

Best bank: Bank of America

Bank of America is a solid HSA choice, especially for existing banking customers and those who appreciate physical branch locations. The account offers convenient mobile access and 40 mutual funds, including several low-cost index funds, Vanguard target retirement date funds, and the Vanguard Federal Money Market Fund (VMFXX).

Bank of America charges a $2.50 monthly maintenance fee, which gives account holders access to an HSA Visa debit card, unlimited transactions, an investment account, and mobile access. Investment accounts are subject to a $1,000 minimum investment threshold.

Why we recommend it: Reputation and brand familiarity may attract some customers to the Bank of America HSA. The account has straightforward pricing and in-person branch access.

Best for transparency: Lively

Lively is a good HSA choice for users who value transparent pricing and no hidden fees. There are no monthly maintenance fees, minimum balances, or transfer fees. For those who only need basic services and do not intend to use their HSA for investing, Lively is a top choice because of its ease of use and low cost. The basic account is free for individuals and families.

The Lively investment option requires that customers open an additional account with Charles Schwab. The account may appeal to existing Schwab customers, but the extra step may steer some toward the Fidelity account, which has a single login.

Opening a Schwab health savings brokerage account is straightforward. Once open, customers have access to thousands of investment options, including a high yield money market account cash sweep (Schwab Value Advantage Money Fund, SWVXX). Lively does not require a minimum investment, but there is a $24 annual fee for balances under $3,000.

Lively also provides access to the HSA Guided Portfolio through Devenir. No cash minimum is required to invest, but it charges an annual fee of 0.50% of invested assets.

Why we recommend it: The Lively HSA offers a no-fee essentials account that’s simple to understand and easy to use for tax-advantaged savings and managing medical expenses.

Best for large accounts: Optum Bank

Optum Bank is a popular HSA choice for employers, who often cover the monthly fee for employees. Individuals can keep their account if they leave their employer, or they may transfer it to a new employer’s HSA. Optum Bank HSA charges a $3.75 monthly maintenance fee, which is waived for accounts with balances of $5,000 or more, and there are no monthly fees for investing accounts as long as the account balance remains above $2,000.

Optum Bank provides more than 25 mutual fund investments, including several low-cost index funds, target-date funds, and the Vanguard Treasury Money Market Fund (VUSXX). It also offers a digitally managed investment option with Betterment and a self-directed investing option through Charles Schwab.

Individuals new to HSAs may want to avoid Optum Bank because of the monthly maintenance fee and relatively high investment threshold. However, those who have built high account balances through an employer-sponsored plan may find Optum Bank HSA sufficient when considering transferring assets to another account.

Why we recommend it: Optum Bank HSA provides advanced features and investment options via employer and individual plans. Accounts with high balances enjoy lower fees.

Best robo-advisor: HealthEquity

HealthEquity is the largest HSA provider, mainly due to its employer-sponsored HSA product offerings. Additionally, it offers HSAs with no account minimums to individuals, but there is a $1,000 minimum opening deposit to start investing.

The HealthEquity HSA offers three investment strategies. These are:

• Self-directed. A self-directed account gives customers a selection of 31 Vanguard mutual funds. The list does not include a money market fund but does feature a short-term government bond, Vanguard Short-Term Bond Index Fund (VBIRX), for cash savings.
• AutoPilot robo advisor. This is a fully automated option that creates a full service personalized strategy based on a set of questions
• GPS robo advisor. This merely offers investment guidance.

Though a popular choice, HealthEquity could improve its offerings by reducing fees. All three investment accounts incur a monthly fee of 0.03% of the account balance, capped at $10. The AutoPilot and GPS services add another 0.05% per month, capped at $15. For example, accounts with a $33,333 average monthly balance will be charged $120 per year, plus $180, if they choose one of the robo-advisor options.

Why we recommend it: An HSA with multiple robo-advisor options may appeal to participants who want to invest but do not want to make investment decisions.

Methodology

We evaluated 10 of the largest and most popular HSA accounts. All of them offered basic services, such as mobile access, debit cards, and investing options. However, transparency, fees, and investment options varied across accounts. Here are the contributing factors to our five recommendations.

Transparency

Consumers seeking basic account information ought to be able to find it easily on the providers' websites. However, the HSA providers we reviewed differed significantly in how easy it was to access information about fees, investment minimums, and investment options. Many HSA providers could improve their plan transparency by clearly communicating this information and simplifying fee structures.

Fees

Customers value simple fee structures and transparent pricing, and the best plans should have no fees on basic services and investing accounts. Complicated fee structures raise the risk of unanticipated account deductions and customer frustration.

Number and quality of investment options

The best plans offer thousands of investment options, similar to investments available in most individual retirement accounts (IRAs). They should include low-cost index funds (e.g., expense ratios greater than 0.10), stock and bond ETFs, and money market accounts.

Though many plans provide a hand-picked list of mutual fund investment options for self-directed investing, several funds we reviewed had high expense ratios and low performance relative to benchmarks. Self-directed fund investment options are sometimes listed without fund fee disclosures. Expense ratios, loads, and 12b-1 fees should be prominently available when applicable.

Minimum investment thresholds

Minimum investment thresholds can be confusing and may exclude some customers from taking advantage of the tax-efficient investment opportunities that HSAs offer. They usually range from $0 to $5,000, and customers can incur additional monthly fees for advisor services. The best plans don’t have them and charge no investing fees.

Robo-advisor options

Most plans now offer robo-advisor service, either directly or through a third party, and consumers should expect to pay a fee for it. Investors who prefer this option need to consider the methodologies employed and would benefit from being provided with past performance data. Unfortunately, we did not observe any robo-advisor offering such data.

More on health savings accounts (HSAs)

What is an HSA?

An HSA is a tax-advantaged account that must be paired with a high-deductible health insurance plan (HDHP). It helps plan members save for qualified medical expenses. It is tax advantaged triply, making the HSA one of the most tax-efficient savings accounts available if you use funds to pay for qualified expenses.

How does an HSA work?

Customers put pretax dollars into an HSA for future use, often through an employer-sponsored plan, and they can use the money to pay for qualified medical expenses. They can also invest the balance in short- or long-term investments to save for the higher healthcare expenses that generally come with age.

The funds saved in an HSA can earn modest interest, but owners can increase their profit by investing the money over the long term. Providers offer debit cards for spending and mobile apps to keep track of expenses and receipts.

HSAs are portable, meaning that when switching jobs account holders can choose to own and maintain them themselves or transfer them to their new employer. Unused funds carry over from year to year; there is no "use or lose" risk as with flexible spending accounts (FSAs).

HSA tax benefits

HSAs have what’s popularly referred to as the “triple tax advantage”: tax-free contributions, growth, and withdrawals.

1. Contributions. These can be made with pretax dollars, which can lower taxable income. After-tax contributions to an HSA may also be deductible from federal taxes.
2. Growth. Funds held or invested grow tax free. This means that interest income, dividends, and capital gains do not incur taxes, as they usually do.
3. Withdrawals. These are not taxed when account owners use the money to pay for qualified medical expenses,

Eligibility requirements to contribute to an HSA

The Internal Revenue Service (IRS) sets four eligibility requirements to contribute to an HSA account.

• You must have health insurance coverage under a high-deductible health plan (HDHP).
• You can’t have any other health coverage.
• You can’t be enrolled in Medicare.
• You can’t be claimed as a dependent on someone else’s tax return.

Key considerations for your HSA

Transparency

Understand the provider's fees before opening an account. If a plan is too difficult to comprehend or isn’t forthcoming about pricing and fees, find another.

Basic services

Make sure that the provider gives access to the basic tools you need to manage your account. This may include a robust mobile app, online tools, or in-person access to a bank branch. Determine your essential needs and select an HSA that best suits them.

Investment options

Compare the number and quality of investment options in each plan. Self-directed investors should choose a plan that provides low-cost investments that enable easy diversification and rebalancing to maximize ease of maintenance.

TIME Stamp: Fidelity sets the standard for HSAs

Fidelity is our top choice for the best HSA, as its account has no opening or investing minimums and no maintenance fees. Fidelity provides access to thousands of investment options, just as it does in its IRA and Roth IRA accounts. Furthermore, its default cash sweep savings is an outlying attribute among its peers. The company has set the standard against which potential customers should compare other HSAs.

Several suitable options exist for those who prefer another provider. However, be sure that you understand the fees and investment thresholds before signing up. Other providers may have robo-advisor features that could be appealing to some users.

As the HSA market matures further, we hope to see better transparency, more simplified pricing, and low-cost investment options across all varieties of HSAs.

Frequently asked questions (FAQs)

What are the 2024 HSA contribution limits?

The 2024 HSA contribution limits set by the IRS are $4,150 for individual coverage and $8,300 for a family. If you are age 55 or older, you can make a catch-up contribution of an additional $1,000.

Can I roll over funds from an existing HSA to a new provider?

Yes, HSAs are portable. However, some providers may charge a fee for transfers.

Are there any restrictions on HSA withdrawals?

Yes, but not on withdrawals for qualified medical expenses. Those under age 65 can withdraw their money for other reasons but will pay income tax on the amount and a 20% penalty.

Account owners 65 or older can withdraw funds from the account for nonqualified purposes without penalty, but they will owe income taxes on the money. Starting at age 65 the account functions like a traditional IRA, except that there are no required minimum distributions (RMDs).