HRA vs. HSA: Navigating the Choices for Health Savings

Deciphering the differences between Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs) is crucial for managing your healthcare finances effectively. Both are valuable tools for offsetting medical expenses, but they operate under different rules and structures. Understanding these can guide you in making informed decisions that align with your financial and health needs.

The Main Difference Between HRA and HSA

HRA vs. HSA: Navigating the Choices for Health Savings Pin

HRA vs. HSA: Key Takeaways

  • HRA: Employer-funded and controlled; used to reimburse employees for qualified medical expenses.
  • HSA: Employee or employer-funded; offers a savings account for medical expenses for those with high-deductible health plans.

HRA vs. HSA: The Definition

What Does HRA Mean?

HRA stands for Health Reimbursement Arrangement. It is an employer-funded benefit plan that reimburses employees for qualified medical expenses and, in some cases, health insurance premiums. Here’s some useful information about HRA:

  1. Employer-Funded Benefit: HRA is established and funded by an employer to assist employees with eligible medical expenses. The employer contributes a specified amount to the HRA, and employees can use these funds to cover qualified medical costs.
  2. Reimbursement for Medical Expenses: HRA allows employees to be reimbursed for qualified out-of-pocket medical expenses, such as deductibles, copayments, prescription drugs, and certain medical services not covered by insurance. The funds can also be used to reimburse premiums for health insurance coverage.
  3. Tax-Advantaged: Contributions made by the employer to the HRA are typically tax-deductible for the employer, and the reimbursements received by employees for eligible expenses are often tax-free.
  4. Flexibility in Plan Design: Employers have flexibility in designing HRA plans, including determining the amount of contributions, eligible expenses, and rollover provisions. HRA plans can be tailored to meet the specific needs of the employer and employees.
  5. Employer Control: Unlike Health Savings Accounts (HSAs), which are owned by employees, HRAs are owned and controlled by the employer. Employees do not own the funds in the HRA, and any unused funds may revert to the employer at the end of the coverage period.
  6. Coordination with High-Deductible Health Plans (HDHPs): HRA plans can be designed to work in conjunction with HDHPs, providing a way for employers to offer additional financial assistance to employees enrolled in high-deductible health plans.

HRA example: An employer may provide an HRA alongside a traditional health plan, allowing you to submit claims for expenses like prescriptions or co-pays.

What Does HSA Mean?

HSA stands for Health Savings Account. It is a tax-advantaged financial account that individuals can use to save and pay for qualified medical expenses. Here’s a detailed description of HSA:

  1. Tax-Advantaged Savings: An HSA allows individuals to set aside pre-tax or tax-deductible funds to cover qualified medical expenses. Contributions to the HSA are tax-deductible, and any interest or investment earnings on the account are tax-free.
  2. Triple Tax Benefits: HSA offers triple tax benefits, including tax-deductible contributions, tax-free growth of funds, and tax-free withdrawals for qualified medical expenses. These tax advantages make HSAs a powerful tool for managing healthcare costs.
  3. Portability: HSAs are owned by the individual, meaning the account remains with the account holder even if they change jobs, retire, or switch health insurance plans. The funds in the HSA roll over from year to year and are not forfeited at the end of the year.
  4. Use for Qualified Medical Expenses: HSA funds can be used to pay for a wide range of qualified medical expenses, including deductibles, copayments, prescription medications, vision care, dental services, and other eligible healthcare costs. The account holder can use the funds for their own or their dependents’ medical expenses.
  5. Eligibility Requirements: To be eligible to open and contribute to an HSA, individuals must be covered by a high-deductible health plan (HDHP) and cannot be covered by other health insurance that is not an HDHP. There are annual contribution limits set by the IRS.
  6. Investment Options: Some HSA providers offer investment options, allowing account holders to invest their HSA funds in mutual funds, stocks, or other investment vehicles to potentially grow their savings over time.
  7. Retirement Savings: After age 65, individuals can use HSA funds for non-medical expenses without penalty, although withdrawals for non-qualified expenses are subject to income tax. This feature makes HSAs a valuable tool for long-term healthcare planning and retirement savings.

HSA: If you have a high-deductible health plan, you can use an HSA to save and pay for medical expenses tax-free, even earning interest over time.

Let’s look at the comparison table below to quickly see the differences between HRA and HSA

Aspect HRA (Health Reimbursement Arrangement) HSA (Health Savings Account)
Tax Treatment Employer-funded, tax-free for employee Employee-funded, tax-deductible
Ownership Employer-owned, portable Employee-owned, portable
Contribution Limit Determined by employer Set by IRS
Eligible Expenses IRS-defined medical expenses IRS-defined medical expenses
Rollover Unused funds can roll over Unused funds can roll over
Investment Generally not allowed Allowed, potential for growth
Withdrawals Reimbursed for eligible expenses Can be used for any purpose
Eligibility Can be offered with any health plan Requires high-deductible health plan
Cost Control Employer has more control over costs Employee has more control over costs

Tips to Remember the Differences

  • Remember that HRAs are employer-funded, while HSAs can be funded by you, your employer, or both.
  • HSAs require a high-deductible health plan to be eligible, whereas HRAs do not.
  • Unlike HRAs, HSAs are portable; they stay with you even if you change jobs or retire.

HRA vs. HSA: Examples

Example Sentences Using HRA

  • Your employer contributes $1,000 to your HRA, and you use this amount to pay for your prescription glasses and dental care expenses not covered by your primary insurance.
  • After visiting a specialist for a consultation, you submit the bill to your employer’s HRA for reimbursement, since the service is among the qualified medical expenses.
  • The company offers an HRA to assist employees with medical expenses.
  • Employees can utilize the HRA funds to cover eligible healthcare costs.
  • The HRA provides valuable reimbursement for out-of-pocket medical expenses.

Example Sentences Using HSA

  • You decide to maximize your HSA contributions for the year, setting aside $3,600 pre-tax from your paycheck, and use these funds to pay for a medical procedure that your insurance does not fully cover.
  • Since your HSA has investment options, you invest part of your balance in mutual funds, hoping to grow your account to cover health expenses in retirement.
  • She opened an HSA to save for future medical expenses.
  • The HSA offers tax advantages for qualified healthcare expenses.
  • Employees can contribute to their HSA to build a financial safety net for medical needs.

Related Confused Words with HRA or HSA


Health Reimbursement Arrangement (HRA) and Flexible Spending Account (FSA) differ in ownership, funding, rollover provisions, and portability:


  • Funded solely by the employer
  • Rollover of unused funds is at the employer’s discretion
  • Not portable if employees leave the company


  • Allows employee contributions
  • Offers a rollover provision or grace period based on plan design
  • Funds are portable within the plan year or grace period, even if employees change jobs


Health Savings Account (HSA) and Health Care Spending Account (HCSA) are distinct in their features and usage:


  • Owned by the individual
  • Contributions from individual or employer
  • Funds are portable and may be invested
  • Tax advantages and rollover of funds


  • Typically owned by the employer
  • Funded by the employer
  • Limited rollover, not portable if leaving the company

Frequently Asked Questions

What are the key differences between an HRA and an HSA?

An HRA is an employer-funded plan that reimburses you for qualified medical expenses up to a certain limit. On the other hand, an HSA is a tax-advantaged savings account that you can contribute to and use for medical expenses if you have a high-deductible health plan (HDHP).

Can someone have both an HRA and HSA at the same time?

Yes, you can have both an HRA and an HSA at the same time, but there are restrictions. Your HRA must be compatible with the HSA, often limited to vision, dental, or preventive care expenses until the HDHP deductible is met.

How do the benefits of an HRA compare to those of an HSA?

The main benefit of an HRA is that it is entirely funded by your employer, and it can pay for a wide range of medical expenses. HSAs, however, offer triple tax advantages, as contributions are tax-deductible, the account grows tax-free, and withdrawals for qualified medical expenses are not taxed.

What are the potential drawbacks of choosing an HRA over an HSA?

One drawback of an HRA is that you do not own the account and cannot take it with you if you leave the job. Also, employers may limit what expenses the HRA can be used for. Whereas with an HSA, the funds are yours to keep, even if you change jobs.

Which is more beneficial during pregnancy, HRA or HSA?

It depends on your individual healthcare needs and financial situation. An HSA allows you to save and plan for medical expenses, such as those related to pregnancy, on a tax-advantaged basis. An HRA is beneficial if your employer contributes funds that cover your pregnancy-related costs.

How does the coverage of a PPO plan differ from that of HRA and HSA plans?

A Preferred Provider Organization (PPO) plan typically offers a network of healthcare providers and higher premiums but lower deductibles. HRAs and HSAs, associated with high-deductible plans, emphasize cost-saving through employer contributions or personal tax-advantaged savings for healthcare expenses.


Last Updated on January 6, 2024

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