HSA. FSA. They sound similar, they both help you save on healthcare costs, and most people aren’t totally sure which one they have — or how to use it.

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But there are some key differences between the two, and knowing how your account works can save you money, time, and stress.

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First: What They Have in Common

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Both Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) let you use pre-tax money for qualified medical expenses. That means:

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• You reduce your taxable income
• You save up to 30–35% on purchases you were probably going to make anyway
• You can use the funds for things like prescriptions, doctor visits, therapy, lab work, dental care, and more

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You can also use both accounts for certain wellness products — like supplements or recovery tools — if you have a doctor’s approval (this is where a Letter of Medical Necessity, or LMN, comes in).

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That’s the overlap. Now let’s talk about what makes them different.

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Key Differences Between HSA and FSA

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1. Who Owns the Account

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• HSA: You do. It’s yours, and it follows you no matter where you work.
• FSA: It’s tied to your employer. If you leave your job, the money usually doesn’t come with you.

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2. What Happens to Unused Funds

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• HSA: The money rolls over every year, no expiration.
• FSA: Most of the money expires at the end of the year unless your employer offers a grace period or lets you roll over a small amount (up to $640).

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3. How You Qualify

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• HSA: Only available if you’re enrolled in a high-deductible health plan (HDHP).
• FSA: Offered by your employer, no HDHP required.

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4. How Much You Can Contribute (2025)

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• HSA:
  
  • $4,150 for individuals
  • $8,300 for families
  • +$1,000 catch-up if you’re 55 or older
• FSA:‍
  
  • $3,200 per year
  • Employers may contribute too, but you don’t control that amount

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5. When the Funds Are Available

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• HSA: You only spend what’s been contributed so far.
• FSA: The full annual amount is available at the start of the year, even if you haven’t contributed all of it yet.

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So Which One Is Better?

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It’s not about better or worse — it’s about using what you have.

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• If you have an HSA, it’s more flexible and permanent. You can save long term or spend now. The money is yours.
• If you have an FSA, you need to pay attention to the clock. You either use the funds during the plan year or risk losing them.

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In both cases, most people don’t use these accounts to their full potential. That’s usually because they don’t realize what qualifies or they’re unsure how to get approval for things beyond the basics.

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How Wellness Pay Helps You Maximize Either One

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Whether you have an HSA or FSA, a lot of the most impactful wellness purchases — supplements, therapies, lab work, even food or recovery tools — require a Letter of Medical Necessity (LMN) from a doctor.

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With Wellness Pay, you’ll get a quick virtual consult to build a personalized plan. Based on your goals, your provider can:

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• Approve eligible wellness products
• Order lab tests (for Premium members) to further customize your care
• Flag what qualifies so you don’t overspend or miss out

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Once you’re set up, we help you track eligible purchases, store documentation, and make sure you’re getting the most out of your benefits — whether your funds expire or not.

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Bottom Line

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HSA and FSA accounts exist to make staying healthy more affordable. But they only work if you use them — and use them right.

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If you’re not sure what qualifies or how to unlock more value from your account, Wellness Pay helps take out the guesswork. Get the doctor approvals you need, know what’s covered, and start spending tax-free on things that actually improve your health.