Medical FSA vs. HSA comparison

Medical Flexible Spending Arrangement (FSA) and Health Savings Account (HSA) Benefits Comparison

Eligibility to contribute You do not have to enroll in a specific insurance plan in order to be eligible for the Medical FSA. You are eligible only if you enroll in a high-deductible health plan (HDHP) with a health savings account (HSA) and are not enrolled in Medicare.
Annual contribution dollar limits The annual election maximum is $2,750. If you and your spouse both have a Medical FSA, you may each set aside up to the annual maximum amount (i.e. there is no household maximum). In 2019, the single contribution limit is $3,600 and the family contribution limit is $7,200. These limits include contributions made by your employer.

If you are 55 or older you are eligible to contribute an additional $1,000 to the above contribution maximums.

Account ownership Your Medical FSA is owned by your employer. Your HSA is set up for you when you enroll in the HDHP. You own the health savings account.
Access to your money You have access to your entire annual election amount at any time during the year, even if you have not had the entire election deducted from your pay. You have access to your health savings account funds as they are contributed into your HSA.
Funding Employee salary reduction. Can be funded by the individual, through employee salary reduction dollars, by your employer or by others, (e.g. family member).
Use it or lose it Yes, any funds you do not spend in your Medical FSA are forfeited to the program administrator after March 31 of the following plan year. No, any unused funds in your HSA at the end of the plan year remain available in the account, and roll over from year to year.
Qualified medical expenses Qualified medical expenses as defined in Section 213(d) of the internal revenue code (available at

Not permitted: Any type of health insurance premium.

Qualified medical expenses as defined in Section 213(d) of the internal revenue code (available at

Retiree health insurance premiums (except Medicare supplement plans)

COBRA premiums

Long term care insurance premiums

Health insurance premiums if receiving unemployment

Certain types of insurance premiums

Option to change contributions You can only change your election amount if you experience a special open enrollment event (qualifying event) such as marriage, divorce, birth of a child, etc. You must contact your payroll or benefits office to find out how often you can change your election amount.
How your income taxes are affected Employee’s contributions are taken out before taxes and reduce taxable gross income. Employee’s and employer’s contribution are taken out before taxes and reduces taxable gross income.
How to enroll Go to our enrollment page. Visit SEBB’s page on HDHPs with HSAs.