Estimate Time4 min

How HSAs can help women save

Key takeaways

  • Women tend to live longer, have less saved, and spend more on health care compared to men, so an HSA can help close the gap by offering potential tax-free growth.
  • HSAs can help women save and pay for qualified medical expenses by using pre-tax dollars for qualified medical expenses.
  • HSAs can also help boost your retirement savings while offering flexibility and reimbursement opportunities.

How can HSAs help women?

When it comes to financial planning, women may need to think a little differently. A health savings account (HSA) is a type of account that helps pay for qualified medical expenses. Anyone enrolled in an HSA-eligible health plan can open an HSA—even if your employer doesn’t offer one. With federal tax advantages, long-term growth potential, and flexibility, HSAs can benefit everyone—especially women, helping them spend efficiently and build financial confidence. As you review your options, especially during open enrollment, consider speaking with a financial professional to find out if an HSA may be a good fit.

Knowing women tend to earn less and spend more on health care over their lifetime, take more career breaks for caregiving, and live longer than men, it’s important for women to leverage every advantage available,1,2,3,4 which is why an HSA can be so impactful to women’s finances. It can be more than just a way to cover qualified medical expenses. It can also help build long-term financial security. Here’s why.

7 benefits of HSAs for women

  1. HSAs can help you save and pay for qualified medical expenses.

    Women can expect to pay 18% more for health care over their lifetime compared to men,excluding any maternity-related expenses. One of the key benefits of an HSA is being able to cover qualified medical expenses with pre-tax HSA dollars, helping to avoid paying those costs with after-tax dollars and ultimately helping to potentially reduce your tax bill and maximize your savings. 

  2. HSAs are triple tax advantaged.5

    You may be wondering what triple tax advantaged means—simply put:

    • Contributions are tax-deductible (or pre-tax via payroll).
    • Earnings can be invested and potentially grow tax-free.
    • Withdrawals are tax-free for qualified medical expenses.

    These HSA tax advantages make it one of the most efficient accounts available for managing health care expenses.

  3. HSAs can help pay for more than you think.

    From family planning and menopause to autoimmune diseases and mental health treatments, women tend to need more health care services than men.6 An HSA can help pay for routine care like your annual physical copays, dental cleanings, and vision checkups, but it can also help you pay for more specialty services than you might realize. Here are a few examples of what an HSA may help you cover.7 Note this is not a full list, and it is your responsibility to determine whether a particular expense is a qualified medical expense:

    • Birth control pills
    • Fertility treatments
    • Hormone therapy
    • Pregnancy tests
    • Menstrual products
    • Postpartum care
    • Lactation expenses
    • Menopause medications
    • Long-term care premiums (restrictions apply)
    • Health care–related travel
    • Therapy
    • Cosmetic surgery (if deemed medical care)8
    • Breast reconstruction surgery
    • Guide dog
  4. HSAs have reimbursement abilities.

    One lesser-known benefit of HSAs is that you can reimburse yourself for qualified medical expenses at any point in the future, as long as the expense occurred after you opened the account. So even if you don’t have your HSA debit card on you at the time payment is needed, simply keep and store the receipts to pay yourself back.

  5. HSAs are both flexible and portable.

    Your HSA is 100% yours to keep. The money is yours even if you change jobs, switch health plans, or retire—unlike the money in a flexible spending account (FSA). And since 3 out of 5 caregivers are women,2 having a flexible account can be helpful. Whether you’re caring for your child, a spouse, or another qualified dependent, an HSA can help support those responsibilities and pay for your dependents’ qualified medical expenses alongside your own.

  6. You can invest your HSA for potential growth opportunities.

    HSAs don’t come with a “use it or lose it” rule like with FSAs. Your balance rolls over from year to year, allowing you to build and grow your savings over time—however, there are annual HSA contribution limits to be aware of. You have full control over how and when you use the account. You can spend on your current needs or save for future expenses. You also have the ability to invest your HSA contributions for potential long-term growth.

  7. HSAs can act as a multipurpose retirement account.

    Even though the namesake focus of the account is health savings, an HSA can be a “stealth” way to save for retirement. At age 65, HSA funds can be withdrawn and used for nonqualified medical expenses without a penalty (though those withdrawals would be taxed as income). That flexibility allows an HSA to function similarly to a traditional IRA—while still offering tax-free withdrawals for qualified medical expenses at any age. Since women tend to retire with roughly $70,000 less than men,9 an HSA can help make up the difference.

Consider a health savings account (HSA)

With an HSA, you can pay for qualified medical expenses in a tax-advantaged way.

More to explore

Investing involves risk, including risk of loss.

1. Andrea Hsu, “It’s Equal Pay Day. Women have lost ground for the second year in a row,” NPR, March 2026, https://www.npr.org/2026/03/26/nx-s1-5758090/equal-pay-day-gender-wage-gap 2. Paul Wynn, "Exclusive: AARP-NAC Report Finds 45% Increase in Americans Providing Care," AARP, July 2025, https://www.aarp.org/caregiving/basics/caregiving-in-us-survey-2025/ 3. Allison Aubrey, “Why do women live longer than men? A study offers clues to close the gap,” NPR, October 2025, https://www.npr.org/2025/10/06/nx-s1-5558184/women-men-longevity-health-life-span 4. "Closing the cost gap: Strategies to advance women’s health equity," Deloitte, April 2026, https://www.deloitte.com/us/en/industries/life-sciences-health-care/articles/womens-health-equity-disparities.html 5.

With respect to federal taxation only. Contributions, investment earnings, and distributions may or may not be subject to state taxation.

6. Dr. Kulleni Gebreyes, Asif Dhar, Dr. Jay Bhatt, Wendy Gerhardt, and Leslie Korenda, "What's causing US women to skip or delay medical care?" Deloitte Center for Health Solutions, September 2024, https://www.deloitte.com/us/en/insights/industry/health-care/why-women-skip-or-delay-health-care.html 7. Funds from a Health Savings Account can be spent for qualified medical expenses only as described in IRS Publication 969. 8. The term “medical care” is defined in IRC Section 213(d), and the term “dependent” is defined in IRC Section 152. For more information regarding HSAs and qualified medical expenses, refer to IRS Publication 969, “Health Savings Accounts and Other Tax-Favored Health Plans,” as well as Publication 502, “Medical and Dental Expenses.” Both are available on the IRS website at www.irs.gov. Or, you may want to contact a tax professional. 9. Gabrielle Olya, “Women Retire With $70K Less Than Men—and It Puts Them at Serious Risk,” Yahoo Finance, February 2026, https://finance.yahoo.com/news/women-retire-70k-less-men-121505881.html

The information provided herein is general in nature. It is not intended, nor should it be construed, as legal or tax advice. Because the administration of an HSA is a taxpayer responsibility, you are strongly encouraged to consult your tax advisor before opening an HSA. You are also encouraged to review information available from the Internal Revenue Service (IRS) for taxpayers, which can be found on the IRS website at IRS.gov. You can find IRS Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans, and IRS Publication 502, Medical and Dental Expenses, online, or you can call the IRS to request a copy of each at 800-829-3676.

Fidelity does not provide legal or tax advice. The information herein is general and educational in nature and should not be considered legal or tax advice. Tax laws and regulations are complex and subject to change, which can materially impact investment results. Fidelity cannot guarantee that the information herein is accurate, complete, or timely. Fidelity makes no warranties with regard to such information or results obtained by its use, and disclaims any liability arising out of your use of, or any tax position taken in reliance on, such information. Consult an attorney or tax professional regarding your specific situation.

The Fidelity Investments and pyramid design logo is a registered service mark of FMR LLC. The third-party trademarks and service marks appearing herein are the property of their respective owners.

Fidelity Brokerage Services LLC, Member NYSE, SIPC, 900 Salem Street, Smithfield, RI 02917

© 2026 FMR LLC. All rights reserved 1266822.1.0