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Health care account comparisons: FSA, HRA and MSA

Health care spending accounts such as flexible spending accounts (FSAs), health reimbursement arrangements (HRAs), and medical savings accounts (MSAs) are becoming more popular. Do you know the differences among them? The chart below highlights key features.

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To learn more about health care spending accounts, read Medical savings accounts: Another way to pay for health care and HRAs can give you more control over your health dollars.

 

Account features

FSA

HRA

MSA

You own the account?

Yes.

Your employer owns it.

Yes.

"Use-it-or-lose-it" by end of benefit year?

Yes.

Unused funds may be carried over from one benefit year to the next.

Unused funds may be carried over from one benefit year to the next.

You can access your account when you leave your job?

Limited.

Maybe — your employer may opt to give you access, or may keep the money.

Yes.

Rollover unused funds when you leave your job?

No.

Yes, but only if your employer allows you to do so and only for medical expenses.

Yes.

You can contribute to the account?

Yes.

No, only your employer may contribute.

Yes, but you and your employer cannot contribute in the same year.

Must be paired with a high-deductible health plan?

No.

No.

Yes.

May be used in conjunction with other health care spending accounts?

Yes, but limited.

Yes.

Yes.

You may use the money for expenses other than health care?

No.

Yes, subject to tax and penalties.

Yes, subject to tax and penalties.

Tax consequences?

An FSA reduces your taxable income.

An HRA's reimbursements to you are tax-free.

An MSA reduces your taxable income.

Source: Employee Benefit Research Institute

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