Skip to main content
Shop Plans Learn more about our coverage options including health, Medicare, dental and vision options for you, your family or your employees. Get Started Individual & Family Medicare Employer Vision Dental International Travel Find Care FAQ Blog Members Stay on top of your health care with helpful member resources. Members Home Medicare Health Dental Vision Find Care Member Knowledge Center Member Forms Medicare Forms Library Make a Payment Federal Employees Student Blue Healthy Blue Providers Access tools, policies and the latest information to help you care for our members. Providers Home Network Participation Networks & Programs Claims, Appeals & Inquiries Prior Authorization Services & CPT codes Prescription Drug Search Forms and Documents Policies, Guidelines & Codes Provider News Provider FAQ Contact Us Employers Learn about our coverage options for small and large employers, and access tools and resources for your group. Employers Home Shop Employer Plans Employer Portal Support Member Forms & Resources Find Care Blog Agents Access the tools you need: rate quotes, applications, forms, the latest industry news, marketing materials and more. Agents Home Agent Services Check Eligibility Find Care Member Forms & Resources Medicare Forms Library
Contact Us
Español
Log In
I am ... Please select A member A provider An employer An agent
Log in to Agent Services
Log in to Employer Services Register for Employer Services I'm registered but need portal access
Username Forgot username? Continue to Log In Register for the member portal Need help? Learn how to log in.
Log in to Blue e Register for Blue e Log in to Dental Blue
knowledge center A guide to Health Savings Accounts

A Health Savings Account (HSA) can be a valuable tool for managing health care expenses and long-term financial goals. Discover how HSAs work, who can open one, and the tax benefits that can help you grow your savings.

What is an HSA? 

An HSA is a special savings account that helps you put aside money to pay for medical costs. You can use it to pay for qualified medical expenses like deductibles, copays, prescriptions, dental cleanings, eyeglasses, and over-the-counter medicine. 

Unlike a Flexible Spending Account (FSA), the money you put into your HSA is always yours, and you don't lose it if you don't spend it all in one year. You can even invest the funds in your HSA to help your savings grow over the years.

HSA eligibility

HSAs are typically available through a bank or investment company that can help you manage your funds. You can enroll in an HSA on your own or through an employer plan if you meet certain eligibility requirements.

You may qualify to open an HSA if you:

  • Are enrolled in a qualified High-Deductible Health Plan (HDHP). An HDHP is a health insurance plan with lower monthly costs but a higher deductible than most traditional plans, so you may pay more costs yourself.
  • Don't have medical benefits from any other non-qualified health plan
  • Can't be claimed as a dependent on someone else’s tax return
  • Aren’t eligible for Medicare
Tax benefits of an HSA

An HSA can help you stretch your health care dollars further and help you prepare for your financial goals because accounts have a triple tax advantage. Here's how each of those tax benefits works in action.

Tax-free contributions

The money you put into the account is not taxed.

If you contribute through payroll deductions at work, that money comes right out of your paycheck before your taxes are calculated.

Tax-free withdrawals

Payments are completely tax-free on qualified medical expenses.

You should always confirm what expenses are allowed with your specific HSA. If you're under 65, non-qualified expenses will be taxed, and you may get a 20% tax penalty.

Tax-free growth 

Any interest or investment earnings on the money in your HSA grow tax-free.

This can help prepare for large expenses later. After you turn 65, you can use your HSA funds for any reason without a penalty, though you'll pay taxes on the non-medical costs.

How to fund and use an HSA

You can make regular contributions to your HSA on your own or through payroll deductions, if your employer offers that option. The IRS sets a yearly limit for how much can be contributed, so be sure to check the limit at the start of each year.

You'll likely get a debit card or checks connected to your HSA that make it easy to pay for eligible health expenses with your account. You can also pay out-of-pocket and save your receipts to get reimbursed from your HSA funds later.

In addition to withdrawals for medical expenses, you can choose to invest a portion of your funds through your HSA provider portal. This gives your account the chance to build even more for future health needs or financial goals after 65, like retirement.

Take the confusion out of insurance

Get reliable answers to your insurance questions, such as how to get prior authorization or submit a claim.

Common health insurance terms

Health insurance terms can be complex and confusing. Let us explain what the common health insurance terms mean and why they're important for you to know.

How health insurance works

Discover the importance of health insurance, how to use it, and how it can support your health.

Health insurance options for young adults

Navigating health insurance for the first time can be intimidating. Here's a quick guide to common coverage options and how to choose the plan that fits your life and your budget.

About Us Newsroom Blog Member Forms Transparency in Coverage Find Care Rights & Responsibilities Policies & Best Practices Privacy Policy Website User Agreement Fraud & Abuse Technical Information Contact Us Locations Careers Developers

Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.

Information in other languages: Español   中文   Tiếng Việt   한국어   Français   العَرَبِيَّة   Hmoob   ру́сский   Tagalog   ગુજરાતી   ភាសាខ្មែរ   Deutsch   हिन्दी   ລາວ   日本語

© 2026 Blue Cross and Blue Shield of North Carolina. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. All other marks and names are property of their respective owners. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.