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Tax-Wise Way to Pay Medical Costs
Health Savings Accounts or HSAs which taxpayers can use to help control escalating medical costs have been around for several years now.

What is an HSA? Essentially, it works like this: Individuals

Health Savings Account Basics

Married couples filing jointly can set aside up to $8,750 in 2026 (up from $8,550 in 2025), tax-free, to save for medical expenses. For self-only plans the maximum contribution is $4,400 in 2026 (up from $4,300 in 2025).

Depending on your tax bracket, you can save between 10% to 37% on any costs covered by money in your account. Every year, the money not spent can stay in the account and gain interest tax-free, just like an IRA.

Every year, the money not spent can stay in the account and gain interest tax-free, just like an IRA. 

The accounts are beneficial for small business owners and their employees. Reason: More businesses can now cover workers for major medical problems, such as hospitalization for an injury or illness. Employees can use the accounts to cover doctor visits, lab tests and other costs. 

Employers can contribute to employee accounts. 

Neither employers nor employees pay taxes on money contributed to HSAs.

and businesses buy less expensive health insurance policies with high-deductibles. To qualify in 2026, participants must be enrolled in plans which require them to pay at least the first $1,700 of medical expenses, $3,400 for a family, before the insurance begins to pick up the tab (up from $1,650 and $3,300 respectively in 2025). The high-deductible insurance is combined with an HSA.

Contributions to the accounts are made on a pre-tax basis. The money can accumulate year after year tax-free and be withdrawn tax-free to pay for a variety of medical expenses such as doctor's visits, prescriptions, chiropractic care and premiums for long-term-care insurance.

Participating employers can also contribute to accounts, on behalf of employees. HSAs enable self-employed people and businesses that currently do not have health insurance to utilize high-deductible plans with more affordable premiums.

HSAs are similar to Archer Medical Savings Accounts, but they have several advantages. With an HSA, both employee and employer contributions are permitted in the same year. Annual contributions are allowed up to 100% of the annual deductible, which in 2026 must be at least $1,700 for self-only and $3,400 for family coverage and unused funds can be carried over from one year to the next. The Archer Medical Savings Account pilot program has been hampered by numerous restrictions and has not been widely used up to this point. Taxpayers with Archer accounts can now roll over their balances tax-free into an HSA.

These accounts also have some features of flexible spending accounts (FSAs), with one big difference: They do not have a "use it or lose it" feature. Unlike FSAs, you can carry over any unused funds to the next year.

If you withdraw money from an account and don't use it to pay qualified medical costs, the withdrawal is taxable income and generally subject to a 10% penalty tax.

Another advantage: HSAs are portable — meaning if employees change jobs, they can take the accounts with them.

The National Small Business Association gives the following example of how the new accounts could help employers save money: A small business with 15 employees now pays $72,000 in health insurance premiums a year for a policy with a low deductible. By switching to HSAs, it cuts its premiums to $40,000 a year by changing to a plan with a $2,600 deductible. The business then contributes $1,000 to each of its 15 employees HSAs.

Employees contribute $1,500 each. The company's total insurance cost is $55,000 with HSAs, compared with $72,000 with a low-deductible policy. Employees get to keep any unused money in their accounts.

For more information about HSAs, consult with your tax advisor.

 
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Our firm provides the information in this article for general guidance only, and does not constitute the provision of legal advice, tax advice, accounting services, investment advice, or professional consulting of any kind. The information provided herein should not be used as a substitute for consultation with professional tax, accounting, legal, or other competent advisers. Before making any decision or taking any action, you should consult a professional adviser who has been provided with all pertinent facts relevant to your particular situation. Tax articles in this e-newsletter are not intended to be used, and cannot be used by any taxpayer, for the purpose of avoiding accuracy-related penalties that may be imposed on the taxpayer. The information is provided "as is," with no assurance or guarantee of completeness, accuracy, or timeliness of the information, and without warranty of any kind, express or implied, including but not limited to warranties of performance, merchantability, and fitness for a particular purpose.

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