Tag Archives: Reimbursement

HSA Taxes When Paying Bills Out of Pocket

This was an Ask to Answer question submitted on Quora. If you have questions, send them to evan@hsaedge.com

If I pay for medical bill from my pocket instead of using HSA account, will I get tax credit for paid amount?

Yes – although it might work differently than your question suggests.

When you contribute to a Health Savings Account, that contribution reduces your taxable income, lowering your taxes. This occurs whether you spend the HSA funds that year or not.

With HSA’s, you can pay for qualified medical expenses out of pocket and reimburse yourself later. That reimbursement acts as a transfer from the HSA to your bank account, in effect paying for the previous purchase using HSA dollars. Since those HSA contributions were tax free, you are paying for the medical purchase tax free as well.

The benefit of this method is it provides an amount in your HSA that you can “reimburse” yourself at any time, and meanwhile that money can be invested and grow, also tax free. You can use a tool like TrackHSA.com to track these reimbursable amounts to justify to the IRS any transfers you make.

Reimbursing HSA purchases from prior years

This was an Ask to Answer question submitted on Quora. Send your questions to evan@hsaedge.com

Can I withdraw from my HSA this year for a medical expense paid by cash during the previous financial year?

You can definitely do this, and in fact this can be a recommended strategy.

Your HSA is used to pay for health services and avoid paying tax. However, there are many methods you can use to implement this. The most straightforward is using a debit card linked to your HSA to purchase qualified medical expenses, so that that cost is immediately removed from your HSA. Another option is to pay for health services using a non-HSA method (cash, credit, check) and then reimburse yourself from your HSA. The reimbursement is generally just a bank transfer from HSA > checking account (or wherever) but can occur at any time.

The 2nd option is the one you are using, with a 1 year delay. You made a purchase in the prior year, and are now reimbursing yourself using your HSA. When you file Form 8889 for the reimbursing year, this amount will appear on lines 14 (distributions) and 15 (distributions paying qualified medical expenses), so there is no tax impact. Playing it exactly by the book.

The reason you may want to employ this strategy is it builds up reimbursable “credits” in your HSA account. You have this money as a safety net that you can withdraw at any time, since you already paid for the expense. Moreover, if you are investing your HSA, you are allowing that money to grow tax free.

Can You Cash Out an HSA?

After saving diligently, using either individual or employer contributions, you may want to take your money out of your health savings account and use it for something different. Before you go to the ATM or HSA website and withdraw all of your HSA funds, take heed: there may be tax consequences to improperly withdrawing money. Let’s discuss the implications and options.

Part of the advantage of an HSA is that the money is triple tax advantaged – you are able to save significantly on taxes by contributing to the HSA. The catch is, this money is required to be used for qualified medical expenses. As such, the government does not look fondly at taking a tax advantage and then not playing by the rules.

Nevertheless, let’s discuss 3 options for removing money from an HSA account:

1) Non Qualified Withdrawal (Penalty Tax)

This is the hard way, just rip the money out and pay the price. From the IRS HSA page:

You can receive tax-free distributions from your HSA to pay or be reimbursed for qualified medical expenses you incur after you establish the HSA. If you receive distributions for other reasons, the amount you withdraw will be subject to income tax and may be subject to an additional 20% tax.

Yes, that 20% tax sure bites, as it was your money to begin with but it is stuck in a “special” government account. That said, this is always an option. When you file your IRS Form 8899, you will have to call out this withdrawal and the tax will factor in.

2) Use for Qualified Medical Expenses

This is the right way to remove funds from an HSA account, paying for (or reimbursing) qualified medical expenses. Assume you have a doctor appointment that you pay for out of pocket using a credit card, debit card, or cash. Since this is a qualified medical expense, you are immediately entitled to reimburse yourself for that expense out of your HSA. This is simply a transfer from HSA to other account for the amount of the expense, justified by the receipt. Little by little, you can gradually drain your HSA as you use it to pay for qualified medical expenses.

Alternatively, you can preempt this situation by building up a nice stack of pending reimbursements. This would involved paying for medical expenses out of pocket and delaying your reimbursement from the HSA. You are then entitled to that reimbursement at any time. Eventually, these reimbursements can add up and you can withdraw a large sum from your HSA.

3) Invest your HSA, offset by separate account withdrawal

We know that you can invest your HSA account in stocks, bonds, ETF’s, etc. to let it grow over time. If you need cash, consider other sources first. Instead of raiding your HSA, consider withdrawing funds from a different investment account with no / less penalty. Then, you can invest your HSA to “replace” your prior withdrawal.

For example, assume that I need $2k for some reason. Instead of withdrawing from my HSA and facing a penalty, I could withdraw this from a more liquid account (such as an investment account). I could then offset this by investing my HSA in the same instruments that I just sold, so my investment position is maintained. This could also work if the other account (such as a 401(k)) has a withdrawal penalty but it is smaller (say, 10%) than that of the HSA (20%).


Note: if you have an HSA, you need to file IRS tax Form 8889 each year you make contributions or withdrawals. Please consider using my automated service EasyForm8889.com to quickly and easily generate your HSA Form 8889. In 10 minutes, it asks you simple questions that correctly populates Form 8889 no matter your situation and delivers you the completed PDF.

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