HSA deep dive

ALEX ROCA: Hello, and thank you for joining Women Talk Money. My name is Alex Roca, and I will be your host for today's conversation. Today, we're talking all about Health Savings Accounts, or HSAs, and why they can be such a powerful tool for your health and your finances, especially for women who tend to have unique health considerations to plan for. We're going to start talking about the basics of how they work. Then we'll explore how you can use an HSA at different stages of your life. And we'll wrap up by answering some of your most asked questions.

With me today are two fantastic panelists, part of the Fidelity family. We have Karen Volo, Head of Health and Benefit Accounts, and Julie Marxen, Workplace Financial Consultant in the California market. We've got a lot to cover, though, so let's dive in.

Julie, we're here to talk about HSAs, which is a tax-advantaged account that can help you save and pay for qualified medical expenses not only today, but also in retirement. So why might women want to consider this type of account?

JULIE MARXEN: Thank you, Alex. Well, the flexibility of the HSA, in my opinion, is its greatest feature. We're going to be talking a lot about this today during today's session. And you can use this money now in your HSA if you need it for an unexpected medical expense, or you can allow the account to potentially grow and compound over time and use it as another retirement savings vehicle. It's an account that can satisfy many financial goals at various time intervals throughout your life. HSAs can be beneficial to all, but women have some unique factors to consider when planning that can make an HSA especially useful.

Women tend to have higher health care costs. In fact, women tend to pay almost 18% more for health care over their lifetime. Women tend to visit health care professionals more often, and the services we receive often surpass deductibles. Plus, women live longer than men. This longevity can be a very good thing. More years with loved ones, more years to pursue your interests. I tell people my great grandmother, she lived until 105. Longevity is on our side.

But with longevity can also come higher health care costs in retirement. A woman retiring in 2025 can expect to pay on average of about $180,000 on health care costs and medical expenses. And all of these factors mean that a tax-advantaged account like an HSA can be a really helpful way to make a difference over your lifetime.

KAREN VOLO: And Julie, I would just add that if folks take one thing away today, it's that it's so important to put health care expenses, both now and in retirement, into your financial planning. You don't know what your health is going to bring, and you want to make sure that you've set yourself up for comfort and care. And an HSA is just a great way to help do that.

ALEX ROCA: Absolutely. And that's exactly what we're going to cover in today's conversation, ways that you can help make the most of an HSA at different points in your life. Now, before we really dig into the fundamentals, I think we should debunk some misconceptions about HSAs with a quick speed round. I'm going to share a statement about an HSA, and you're going to tell me if it's true or false. So let's start with you, Karen. An HSA is use it or lose it, meaning you have to spend all the money on qualified medical expenses by the end of the year. True or false?

KAREN VOLO: False. Unlike a flexible spending account, a health savings account, or an HSA, is an account that you own. You own that throughout the year, as well as any money that's left over after the year. So as you contribute, that money is yours. If balances carry over from year to year, that money belongs to you as well. And then you can also invest it for more growth in the future.

And if you leave your job, no matter where you go, you take that account with you. So you can take-- you can leave it where it is. You can roll it into another HSA that you might open. Even if you're not currently enrolled in an HSA-eligible health plan, you can still pay for qualified medical expenses from your HSA, even if you're not able to contribute to one.

ALEX ROCA: Interesting. And it really helps set the HSA apart from some of those other employer benefits. Let's keep going. Julie, true or false? If you're self-employed or your employer doesn't offer an HSA, you can't open one.

JULIE MARXEN: This is also false. A key distinction is that while you must be enrolled in an HSA-eligible health plan to contribute-- keyword is contribute to an HSA-- you do not have to be one to open one.

So for example, you might be retired and you want to transfer your current HSA with another provider to Fidelity. You can still open one in that instance. But if you aren't enrolled in an HSA-eligible health plan, you can't contribute new funds. So remember, contributions mean you must be in that HSA-eligible health plan.

You could also be employed by a company and enrolled in an HSA-eligible health plan. Even if they do not offer access to an HSA, you can still open one on your own and make your own contributions. And we'll talk more about eligibility requirements later.

ALEX ROCA: So that's really good to know. You can open and establish your own HSA. OK, Karen, true or false? After the age of 65, you can also use your HSA to pay for other expenses, not just qualified medical expenses.

KAREN VOLO: OK, this one is true. Once you're 65, you can use your HSA funds to pay for any expense. But keep in mind, you have to pay ordinary income taxes if you take the money out and it's not used to pay for a qualified medical expense. Think of it like a traditional IRA when you're 65 or older.

ALEX ROCA: Hmm. And we will get into more ways to use an HSA in retirement. We know that it's top of mind for many of you attending today. Julie, last one. True or false? You can reimburse yourself for your qualified medical expenses using your HSA even years after they've incurred.

JULIE MARXEN: Yes, this is largely true. It can come in handy. If money's tight in the future, you can tap into those HSA savings, federal tax-free, if you have unreimbursed qualified medical expenses. There are some parameters, though.

You must have incurred the qualified medical expenses after you open the HSA, and there's no double dipping. The qualified medical expense can't have been used as an itemized deduction on your tax return, and the medical expense could not have been previously paid or reimbursed from another source, like your health insurance, or an FSA, or any other tax-advantaged, health-related account. It's really important in this instance if you're going to be repaying yourself, perhaps years down the road, make sure you save your receipts. You're going to want to be prepared in case the IRS audits you. The distribution or the reimbursement must match the receipt to the penny.

ALEX ROCA: OK. So just to make sure I understand, this means if you have the means, in theory you can pay for those qualified medical expenses out-of-pocket, but then save those receipts for a rainy day, because then I can reimburse myself at a future date. This is a lot. And these myths and misconceptions, they're the kind of thing a professional can help you clear up. Now, let's dive into the essentials. Karen, can you share more about what the HSA is and how it works?

KAREN VOLO: Absolutely. So an HSA is a tax-advantaged account that can be used to help save for medical expenses in the short term, as well as in the long term, pay for qualified medical expenses like co-pays, prescriptions, dental care, certain over-the-counter medications as well.

While you have an HSA, you can be a spender, a saver, or an investor, or you could be all three at once. So spenders are spending the money that they contribute each year, or a good portion of it. Savers are saving at least a portion of that. And investors are actually looking for long-term growth in that account by investing some of the assets that they're not using in the current time for sometime later in life, potentially for retirement. We'll talk a little bit about investments later, but the advantage of the investments is that it helps you grow over time.

Now, one of the biggest advantages of an HSA it is the only triple tax advantage account that you would find. So if you see here on the screen, it's triple tax advantaged because your contributions go in tax-free. Anything in your account grows tax-free. And so long as you're using that account for qualified medical expenses, it also comes out tax-free. So it's not taxed while it's in the account. It's not taxed when it comes out.

Keep in mind, these are federal taxes we're talking about, so you'll want to understand how the state tax rules are applied, depending on where you live. There's also IRS tax limits, which you see here, for how much you can contribute to an HSA in any given year. These are the 2026 limits, and the 2027 action just came out. So if you have individual coverage plan, you can contribute up to $4,400. If you have a family coverage plan, you can contribute up to $8,750.

And we'll talk a little bit more about it later, but if you're older than 55, you can also make a catch-up contribution of $1,000. And this is also to include any contribution your employer might be making on your behalf. Many employers do make a contribution to an HSA account on behalf of their employee, so you want to make sure that those are included in the limit as well.

ALEX ROCA: I know that not everyone is eligible to open and contribute to an HSA, even if they are enrolled in an HSA-eligible health plan. Is that right, Julie?

JULIE MARXEN: Yes, that is correct. We have a slide that helps explain this. Generally, you're eligible to open and contribute to an HSA if you are currently enrolled in an HSA-eligible health plan. This can be through your employer, through individual coverage, or through coverage with a spouse or a parent. Additionally, can open an HSA even if your employer doesn't offer one. I think that's sometimes a common misconception.

Most employers have benefits enrollment in the fall of each year, or if you experience maybe a qualifying event like a marriage or a new job. Enrollment is when you can choose to enroll in an HSA-eligible health plan if you're interested. And be sure to take your time comparing health plans to weigh if the combo of an HSA-eligible health plan and an HSA makes sense for you. There are some exceptions to the general rule. If you're claimed as a dependent on someone else's tax return or you're enrolled in Medicare, you cannot contribute to an HSA.

ALEX ROCA: Thank you for that, Julie. I definitely think it's a great resource to figure out what your options really look like. Can you talk to me a little bit more about what the situation looks like if you're married? Julie, I'm keeping this one with you.

JULIE MARXEN: Yes, sure. Married couples aren't allowed to have joint HSA accounts, even if they are covered by the same HSA-eligible health plan. Only one spouse can be listed as the account owner for a given HSA-- very similar to a retirement account-- even though that spouse's HSA may be used to reimburse the medical expenses of either spouse.

That said, you can establish your own HSA if you are eligible. And if both spouses are HSA-eligible and at least one spouse is covered by a family coverage HSA-eligible health plan, then the maximum amount that the couple can collectively contribute to its HSAs is associated with the family coverage annual limit for that year. That maximum amount is split evenly between both of you unless you agree on a different split. And I think Karen had mentioned those limits earlier. They are also both able to take advantage of any catch-up

contributions of $1,000 each once they turn 55, but you must have two HSA accounts to do that.

ALEX ROCA: Thank you, Julie, for covering that. Karen, what expenses can I use an HSA for? Are there any surprising things that you can't claim?

KAREN VOLO: So the short answer is you can probably use the HSA to pay for more than you think. If a medical doctor prescribes something, a procedure or device, a prescription, it's more than likely covered. The slide shows you a couple of examples of qualified medical expenses, and there is an IRS list which we'll link here as well that will give you the detail of every single expense that is considered a qualified medical expense under the IRS code, and therefore would be eligible to be paid for from your HSA.

I like to think of it as using your HSA at different points in your life. So maybe when you're young and you're starting out, you want to use it for some preventative care. If you're thinking about growing your family, you can use it for fertility treatments like IVF or pregnancy tests. If you're breastfeeding, you can buy a breast pump with it. You can use it for other family planning procedures as well, like a vasectomy. Then later in life, you want to start thinking about long-term care insurance and Medicare. And you can use it to pay for the premiums for both of those programs as well. Doesn't include your Medicare supplement premiums, but it does include your Medicare premiums from the start.

ALEX ROCA: That's excellent. Thank you, Karen. I want to stay with you because that was such a good list to think of what the qualified medical expenses are. What are some expenses to watch out for that aren't included?

KAREN VOLO: Yeah, the nuances can be really complex. I mentioned family planning, but you can't use an HSA for surrogacy costs. You can't use it for maternity clothes or diaper services either. And while you can use it for dermatology care like your annual skin checkup, you can't use it for cosmetic procedures like electrolysis, for example, or maybe teeth whitening.

If you have an HSA with Fidelity, we offer a debit card for the HSA. We also have the Fidelity Health app. Both of these can help you take the guesswork out of what a qualified medical expense is and what it isn't.

So say you're at the pharmacy. You can use the Fidelity Health app to scan a product's barcode. It'll let you know whether or not that can be paid for using your health savings account, or even your health care flexible spending account, if you have one.

You can also use it to save and manage your receipts. Julie mentioned earlier keeping your receipts in case you want to reimburse yourself later. You can scan and pay your health care bills through the app, and then monitor your account balances and more. And you can download it on your device by scanning the QR code here on the screen. And I think we'll be following up with this information as well, so you can download it later.

ALEX ROCA: Absolutely. Thank you for sharing that, Karen. That app is so convenient just to keep track of everything and just to have records of what you've done. Now Julie, I want to turn to you for a question that I'm sure you get quite often. What's the difference between an HSA and a health care FSA? And how do you know which one might be the right one for you?

JULIE MARXEN: Thank you, Alex. Yes, a very common question. I get asked this a lot when I'm in one-on-one meetings with participants and clients. So both HSAs and health care FSAs, or Flexible Spending Accounts, can help you pay for qualified medical expenses. They each have different benefits, however. We don't have time to go through each one, but this slide helps you lay out the major differences. And we're sharing a link in the chat if you want to learn more.

One difference is that a health care flexible spending account, a health care FSA, is for expenses typically that you expect to incur within a one-year period. So basically, in the short term. The health care FSA is a use it or lose it account that may be available as part of your employer benefits.

So say you elect to contribute $1,000 in total throughout the year. That $1,000 is all immediately available to you at the start of the year. If your current health plan doesn't qualify for you to contribute to an HSA, a health savings account, remember that in order to contribute to an HSA, you must be in an HSA-eligible health plan. This is when you may want to consider the health care FSA for the tax savings and to help you pay for qualified medical expenses that you'll incur now or today.

A question that I get a lot is, can I contribute to an HSA and an FSA at the same time? And the answer is no, but there is one very specific exception. There's actually something called a limited purpose FSA, limited purpose flexible spending account. This allows you to pay for qualified dental, vision, and preventative care services. This is something that your employer may or may not offer. You can look into it during annual enrollment for your benefits or if you experience a qualifying life event.

KAREN VOLO: So Julie, I shouldn't admit it, but I'm going to admit that I was not aware of the limited purpose FSA. So a long-time HSA user, but wasn't aware of the limited purpose. And here I am, responsible for this business at Fidelity. And it's just been a great addition to both the ability to pay for your medical expenses, particularly dental and vision, while you continue to save in your HSA for something later in life.

ALEX ROCA: Thank you for that, Karen. I'm sure that a lot of people feel like that, and they're not even in the field. So I think it's so important to cover these nuances where it comes to the different plans. And remember, you can always sign up to talk to somebody if you're still not 100% sure what's available to you or what the right next step is.

Now, I want to switch gears just a little bit. I've been seeing a lot of questions in the chat about HSAs and retirement. So Karen, what should we be thinking about in the years leading up to retirement?

KAREN VOLO: Well, a bunch of things, including there's always still time to save. And as you start thinking about long-term care and retirement, you have to make sure that health care expenses are a part of that plan. I've said it before, and I'll continue to say it. It's so important. We talked about the incredible amount of money, the obligation that we're going to have in retirement to pay for health care expenses. We need to make sure we have a savings in place to do that.

So we're taking a look here at a late start and catch-up contributions. We've mentioned catch-up contributions a couple of times. So think about saving your HSA up to the IRS limits. And then once you turn 55, you have the ability to save the extra $1,000 a year as well.

So in this example, an individual starts contributing the 2026 maximum plus catch-up contributions, and does that for 10 years. And they're investing those contributions, so getting the benefit of the market as well. They don't use the funds during this time for qualified medical expenses. By age 65, they could potentially have over $80,000 saved. Remember that number, $180,000 on health care expenses in retirement for women. So saving in the years leading up to retirement can be so helpful.

And if you're looking for ways to catch up on those savings and you have an HSA and you're 55-plus, you put the extra $1,000 in if you're eligible. And remember, if you're married and your spouse is the HSA account owner, you don't have to miss out on the catch-up contribution, as Julie said before, but you'll need to open your own separate HSA account.

So the rules can get a little complicated as you approach 65, but we have another slide that lays out some of the common scenarios. So think about the scenarios as you're retiring early, you're starting Medicare when you turn 65, or you're going to continue to work after 65.

If you're retiring early and you're on COBRA or unemployment, you may be able to use your HSA to pay for your health care premiums during that time. If you plan to start Medicare coverage the month you turn 65, make sure that your IR-- make sure that your HSA contributions stop before your birthday month. And if your birthday month is on the 1st, make sure that you no longer make contributions to the beginning prior month.

And then if you decide to work after 65, you need to stop making contributions to your HSA up to six months before beginning Medicare Parts A, B, C, or D. And you'll want to make sure that your employer doesn't make contributions during this time either.

ALEX ROCA: Such a good kind of segue. I'm seeing a lot of questions in the chat about when to stop contributing to your HSA as you approach retirement. Can you tell us a little bit more about how this works and how we can avoid penalties?

KAREN VOLO: Yeah, this is really tricky. And we knew it was top of mind, so we put together this slide with a couple of examples. There's something called the six-month lookback period when you approach Medicare.

So when you first receive Social Security retirement benefits or Medicare, your Medicare Part A coverage is backdated, but no earlier than the first month you're eligible for Medicare. This gives you up to six months of backdated benefits. If you contribute to your HSA during that lookback period, you may face the tax penalties for those contributions. The six-month lookback starts when you begin Medicare or your Social Security retirement benefits.

So if we look at these two examples in Scenario 1, person enrolls on December 15, which means their Medicare coverage is backdated six months to June 15. In this example, the person and their employer would need to stop making contributions to their HSA before June.

In the second scenario, the person enrolls in Medicare on the same day, but their 65th birthday is in August, which is the first month they are eligible for Medicare. So in this instance, the lookback period is shorter, and the individual would want to stop making HSA contributions before August. Now, some people decide to work past 65, and they defer Medicare and they maintain their current employer-sponsored health plan. If that's the case, they can continue contributing to an HSA until they retire.

ALEX ROCA: Now, let's go back to this. Once we're enrolled in Medicare or, let's say, taking Social Security, we can no longer contribute to an HSA. That's what I understood. But we can continue using it for spending and investing, right?

KAREN VOLO: Absolutely. Exactly. Once you start taking-- you're enrolled in Medicare or taking Social Security, you can no longer contribute to the HSA. But remember, that account belongs to you. You own that account. You can continue using it for spending and investing.

Examples might include paying for your Medicare or long-term care premiums or prescriptions during your retirement. Plus, as we mentioned earlier, after 65 you can withdraw the money for any use. Just keep in mind you'd have to pay ordinary income taxes if it's used for something other than qualified medical expenses. And of course, you can continue to invest that money and have it help grow for your expenses later in life.

ALEX ROCA: So let's talk a little bit more about that. We talked about the spending versus the savings versus investing the HSA dollars. Julie, how do you help people find the right balance between those things?

JULIE MARXEN: Yeah. Thank you, Alex. First, I want to stress, it is OK to spend your HSA dollars today. Just like you have an emergency savings account, the HSA is there for when you need it. I've been telling this story quite a bit this year. So late last year, I got shingles, and I got shingles on my face. For anybody who's gotten or experienced shingles, and especially on the face, I empathize, because it was extremely painful and very difficult to go through.

The shingles virus was on my face, and it ended up going to my eye. And I had to pay a pretty penny on a concoction of eye drops that saved my vision, and I was so stressed about these added costs. And my ophthalmologist, because I was so stressed out-- which, of course, when you have shingles, you don't want to get stressed out.

But my ophthalmologist asked me. He said, what price would you pay to save your vision? And that really put it into perspective for me. I used my HSA to pay for all of these eye drops that I've needed to continue taking just to maintain my vision.

And you know what? Stuff like that happens. That is life. Sometimes these unexpected events are going to happen. And I'm just so grateful that I had the HSA and that I was able to rely on. And it didn't derail my other savings that I have, such as my emergency fund or my rainy day fund for my home or for my children.

As we mentioned, the HSA can be a powerful tax-advantaged savings account for health expenses and more in retirement. Investing a portion of those savings can help you potentially save more in the long run.

But there's a lot of people that actually never do that. They don't invest. Karen showed the potential difference of investing your HSA dollars and the difference that that can make for someone in their 50s. The longer that the money is in the HSA, the more time there is to experience the benefits of compound, tax-free potential growth.

Again, this is most accounts, such as traditional IRAs or Roth IRAs or brokerage accounts. The ability to grow and compound your money over time is amazing. The HSA is even more amazing, because it does have those triple tax savings where you get a tax deduction going in, tax-free growth, tax-free withdrawals for those qualified medical expenses. So take advantage of the opportunity to grow and invest this money because of the compound growth.

And you don't have to choose either saving, spending, or investing. As I said at the start, and as I've experienced with my shingles debacle, you can be a spender, a saver, and investor all at the same time. Here's some tips that you see here on the screen. Calculate. Determine what you expect your out-of-pocket medical expenses may be for the year. Reserve. Plan to reserve that amount in cash. Once you've saved it, keep it there. Invest the rest. Invest the surplus of your tax-advantaged growth potential. Consider setting up auto investments. Anytime that you can automate your investing in savings, you're more likely to hold yourself accountable and to be successful.

If you have a Fidelity HSA through your employer, you can set an amount that you want to reserve in cash. And when the balance, the cash balance goes above that amount, it will auto invest in the investments that you choose. And again, you can use those invested dollars for qualified medical expenses in retirement, or when you need them later, or even today.

ALEX ROCA: Thank you for that, Julie. I can't even imagine what shingles in the face and the eye must have felt like. That sounds so scary. Karen, can you talk to us a little bit more about the Fidelity HSA?

KAREN VOLO: Absolutely. One of my favorite topics. So Fidelity is proud to offer an HSA both through the employer, as well as directly to our retail customers. Some of the unique aspects of the Fidelity HSA include no annual account fees or minimums to open or invest, a wide range of investments available to all of our customers. Typically, we're offering higher interest rate on our cash balances. So for those of you who are spenders and savers, you want to make sure that you're maximizing the opportunity to earn while you're in those accounts.

And then we also give you a couple of different options for how to be an investor. We give you some robo advisor offerings, as well as some curated lists of funds that you might want to choose from. And then of course, you can do do it yourself investing as well.

You can have more than one HSA at a time. Again, this is the account that belongs to you. You own it. You take it with you wherever you go. You might have one through your employer to receive your employer's contribution and another with the provider of your choice that offers different investment options, or you might have one from a previous employer as well.

You want to be sure that your total contributions across all of these accounts don't exceed the IRS annual limits, but it is OK to own more than one. You can also consolidate them and transfer them into one HSA if that works better for you. You can certainly transfer your current HSA into a Fidelity HSA without any tax consequences. And sometimes that just helps streamline things.

ALEX ROCA: So Julie, what happens to your HSA when you die?

JULIE MARXEN: This depends on who you've named as the beneficiary. Public service announcement. Make sure that your beneficiaries are up to date, not just on your HSA, but on all of your accounts. Retirement accounts, brokerage accounts, 401(k)s.

If it's your spouse-- so if your spouse is the beneficiary on your HSA, the HSA will automatically become theirs on the date of your death, and it will retain its tax-advantaged status.

If it's anyone else-- your unmarried partner, your mom, your child, your sibling-- it loses its tax-advantaged status. And the entire fair market value, or whatever the account is worth, becomes taxable income to that person in the year of your death. So again, you can see there is some slight advantages with naming a spouse as the primary beneficiary on your HSA. For that reason, you're going to want to consider building your HSA into your retirement income strategy and making sure that it's a very key and integral part in just the total financial plan when it comes to retirement planning.

ALEX ROCA: Got it. OK. So it's important to know who we're leaving it to and make sure that those beneficiaries are up to date. Thank you for that, Julie. Karen, this one's for you. What if your spouse is enrolled in Medicare, but you're not? If you're otherwise eligible, can you contribute to an HSA?

KAREN VOLO: So as a reminder, while you and your spouse can both use an HSA for your qualified medical expenses, you can't be joint owners of the account. What that does for you, because HSA eligibility is determined on the individual level, is even if your spouse is enrolled in Medicare, it does not affect your eligibility to establish and contribute funds to an HSA. So if you're enrolled in family coverage, you can contribute up to that amount. If you're enrolled in individual coverage, you contribute as much as the individual coverage limit as well.

ALEX ROCA: Excellent. Thank you. Julie, what if your adult child is on your health plan, but they're not claimed as a tax dependent? Can they still use their parent's HSA?

JULIE MARXEN: Great question. So if they're not claimed as a tax dependent, they cannot use their parent's HSA, but they can open their own HSA and contribute up to the family maximum. This is a really great way to get a head start on their HSA savings so that when they enroll in their own HSA-eligible health plan later, they already have a foundation of savings there.

ALEX ROCA: Who can you ask for help if you have questions about your HSA?

JULIE MARXEN: We are here to help. We at Fidelity are here to help. So we can help you and help you determine how an HSA may fit into your overall financial plan. And if you have an HSA through your employer, you can also reach out to your workplace financial planner. That's actually my role here at Fidelity as a workplace financial planner. I'm assigned to various plan sponsors.

And I will work directly with those participants and the employees of that company just on optimizing their workplace plan benefits from their 401(k) or 403(b) to their HSA, but also give them an idea of how their benefits through their employer are going to play a very integral role in their broader financial planning, and of course, giving them a good pulse check for how they're pacing towards retirement. So highly encourage those of you out there who perhaps maybe have some workplace benefits with Fidelity to consider reaching out to the workplace financial planner.

ALEX ROCA: Excellent, Julie. Thank you so much for that. Now, this is all about you and the questions that you have asked us, so we're going to keep this going. We talked a lot about the saving versus the spending versus the investing. And some of the questions that have come through is, how much do I need saved in my HSA in order to invest? Julie, can you answer that for us?

JULIE MARXEN: Well, you can start saving or investing that money immediately in your HSA. There's no right or wrong number. And as I always say when it comes to these tax-deferred accounts, the sooner that you start investing this money, the more power and the more magic of compound growth will actually apply on the account.

KAREN VOLO: Now, if I could just add to that, I would say it depends on your HSA provider as well. Fidelity offers first dollar investment, so you can invest right away with your very first dollar. Not every provider offers that, so you want to make sure that you check with your provider.

And then as Julie mentioned before, you can also set limits for cash before investment and then set auto enrollment after investment. Again, the power of the investment over time is so strong that I would encourage you to consider it.

ALEX ROCA: Excellent add-in. Karen, actually, I want to build on that. Do we invest the HSA funds the same way that we do our IRAs? Is there a special consideration?

KAREN VOLO: So what I would say is you probably want to look at your overall investment strategy and consider the goals you have for your HSA as part of that. If you think that you're going to be spending some of that money over time, you might want a more conservative investment approach. If you can raise the cash to pay for those expenses and leave the investments invested where they are, that's OK as well. But I think you have to look at your total portfolio picture and just be aware of what all of your goals are for your different buckets of money, and then what you intend to use them for, and how long your investment horizon in those particular areas will be for.

So for HSA specifically, I think that you should be looking at whether or not you're going to spend that money in the short term or you're really looking to save it and invest it for the long term. And I think that should help drive your investment strategy.

ALEX ROCA: Excellent. Thank you for that, Karen. I want to switch gears a little bit and talk about the actual opening of the account. We had some questions around, is it only-- I'm sorry. Can I open an HSA outside of the annual enrollment? So if I'm actually establishing the HSA through my employer, do I only get to do it during the open enrollment window, or can I open it whenever?

KAREN VOLO: Yeah, I'm happy to answer that one. You can only enroll in your health plan during annual enrollment or when you have a life event, but you can open an HSA any time. As long as you are currently enrolled in an HSA-eligible plan, you can open an HSA and make contributions to that HSA any time during the year.

JULIE MARXEN: And I'll piggyback off of that a little bit. For those of you who maybe your employer doesn't offer an HSA, but you are in that HSA-eligible health plan, again, you could utilize Fidelity to open an HSA. It doesn't need to come or be sponsored by your employer. And I think anybody who's on our website would find that it's very intuitive to get those account opened and established and get those monies started investing as well.

ALEX ROCA: And so Julie, excellent segue. Does that mean if I'm self-employed, this is also an option for me? How does that work?

JULIE MARXEN: Absolutely, yes. I get this question a lot. I'll meet with participants of some of my planned sponsors, and maybe they don't have an HSA, and their spouse is self-employed. And they've learned about this awesome account called the health savings account with the triple tax savings, and they want to jump in. They want to be part of it. Sometimes they think that they don't have access to that because it's not sponsored through an employer.

Not the case. As long as that self-employed individual is enrolled in an HSA-eligible health plan, they can go to Fidelity.com, open that HSA, fund the account, and again, get it invested using a lot of the resources that we have on Fidelity.com. That can just help guide you.

I think Karen had mentioned one investment option that we have called Fidelity Go where you can actually have a robo advisor manage the account for you. And that robo advisor will build what we call a profile questionnaire to help determine, what type of investor are you? What's your financial profile? And what are you looking for these funds to do? And the robo advisor will actually manage that HSA for you.

ALEX ROCA: Thank you for that, Julie. What are the pros and cons to getting a separate HSA from your spouse?

KAREN VOLO: So I would say we know that you can only have one account owner, but many of you can use the account. We also offer dependent debit cards. So even if you had one HSA with multiple users, we can offer those multiple users their own separate debit card account.

So I think there's probably not a whole lot of advantage to having separate accounts from your spouse, because you're still subject to the IRS limits of the family plan, the family coverage plan, until you get to age 55 and you're looking for the catch-up contribution. Then you can't make that in your spouse's account. You have to have your own account.

So I would say there's not a lot of advantage until 55 for having a separate HSA from your spouse, particularly because anybody covered under the family plan can use the funds in that HSA. Once you hit 55 and you want to make catch-up contributions to help contribute to the long-term savings for your HSA, then I'd say it's the time to open your account.

ALEX ROCA: Thank you for that. If you have more than one HSA at a time, is the annual amount that you can contribute per account, or is it for the year? Whoever wants to answer.

JULIE MARXEN: It is an aggregate amount, very similar to IRAs, Individual Retirement Accounts like a Roth IRA or a traditional IRA. You want to keep in mind, those are aggregate numbers or aggregate limits. So if you do have multiple HSAs, you just want to make sure that you're not going over those IRS limits that are set for you.

KAREN VOLO: And Alex, I would just add that the burden is on the individual to keep track of those. So if you have multiple HSAs with contributions going to each, the burden is really on you to make sure that you're staying underneath the IRS tax limits. You want to know that number, and you want to know what your contributions total, as well as what your employer contribution might total.

ALEX ROCA: Absolutely. And it sounds like maybe consolidating some of those HSAs to keep an eye on them is a good idea. Karen, is there a fee to move your current HSA that's held outside of Fidelity to Fidelity?

KAREN VOLO: So there's no fee from Fidelity's perspective. Some providers do charge a transfer fee, so you'd want to check with the provider of where your account is today.

ALEX ROCA: I appreciate that. And we're almost at time, so last question. What is the one takeaway that you would want to leave our audiences with today? Karen, I'll start with you.

KAREN VOLO: OK, I'm going to sound like a broken record. Make sure paying for medical expenses now and in retirement is part of your overall financial plan. Make sure that you can take care of yourself with comfort and care as you age and through the different life stages that you have. And make sure that you are using health savings accounts or other savings vehicles to put money aside for that, because the obligation is going to be enormous.

ALEX ROCA: Thank you for that. And Julie?

JULIE MARXEN: Don't underestimate the flexibility of the HSA, and know that it's OK to start using those monies today if you need it. I had to do it, and I'm so grateful that I had that resource and that I did use it.

ALEX ROCA: Thank you, Julie. And mine is simple. Make sure your beneficiaries are up to date, regardless of the account that we're talking about. Karen, Julie, this was such a helpful session. Thank you so much for chatting with me and for all of the great information that you've shared today. To all of you watching, thank you for joining, and we'll see you again next month. Have a great day.