Quick answer
An HSA belongs to you. A health FSA is an employer-sponsored spending arrangement with deadlines. An HRA is employer-funded reimbursement under plan rules. Contribution eligibility and eligible expenses need a separate check.
Compare the main features
| Feature | HSA | Health FSA | HRA |
|---|---|---|---|
| Who funds it? | You and/or an employer, subject to eligibility and limits. | Usually employee salary reductions; an employer may also contribute. | Employer only. |
| Unused balance | Remains in your account. | Generally forfeited, with a permitted carryover or grace period only if the plan provides one. | Carryover depends on plan terms. |
| Leaving the job | The account stays yours. | Access generally ends under plan rules; claim deadlines or continuation rights may apply. | Access and continuation depend on plan terms. |
| When funds can be used | Up to the available account balance for eligible expenses. | The annual health FSA election is generally available during the coverage period, subject to rules. | Reimbursement follows the employer’s arrangement. |
Owning an HSA and contributing are different
You can keep and use an existing HSA even after you are no longer eligible to contribute. Contributions generally require qualifying coverage and satisfaction of other conditions involving additional coverage, Medicare enrollment, and tax-dependent status. A general-purpose health FSA or HRA can affect eligibility. Ask about limited-purpose arrangements and current rules before contributing.
Use the right deadlines and records
Illustrative example
An employee elects $2,000 for a health FSA. Subject to the plan’s rules, eligible expenses during the coverage period can be reimbursed up to that election before all payroll deductions have occurred. An HSA generally pays from money already in the account.
Keep receipts and avoid reimbursing the same expense twice. A dependent-care FSA is a different arrangement and does not use all the same rules as a health FSA.
Before choosing an amount
- Check the plan year, expense eligibility, claim-submission deadline, and any carryover or grace period.
- Confirm current contribution limits and your personal eligibility with the administrator or tax adviser.
- An account card is a payment method; it does not by itself prove an expense qualifies.
Benefit Experts can explain benefit arrangements and connect specialist resources. We do not provide tax advice.
Sources checked September 19, 2026. General information; your plan and circumstances matter.
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