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Smart Health, Smart Savings: The Ultimate FSA vs. HSA Breakdown

As we approach the end of the year, it’s the perfect time to review your health benefits—especially your FSA or HSA funds. These accounts can help you save significant money on medical expenses while keeping you and your family healthy. Understanding how each type of account works will also help you make confident decisions for the upcoming year.

Below is a clear breakdown of what FSAs and HSAs are, how they differ, and how to determine which option fits your lifestyle and healthcare needs.

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What Is an FSA?

A Flexible Spending Account (FSA) is a special employer-sponsored account that allows you to set aside pre-tax dollars to pay for qualified medical expenses for you, your spouse, or your tax dependents. Because this money is deducted before taxes, most people save around 25% on every dollar contributed.

Key FSA Features

  • Paired with most traditional health plans

  • Full yearly election available on day one of the plan year

  • “Use-it-or-lose-it” — unused funds are forfeited at the end of the plan year (plus applicable grace period)

  • Cannot earn interest or be invested

  • Changes allowed only with a qualifying life event


What Is an HSA?

A Health Savings Account (HSA) is a tax-advantaged account available only to individuals enrolled in a high-deductible health plan (HDHP). Like an FSA, it allows you to set aside pre-tax money for qualified medical expenses—but HSAs also provide long-term savings benefits, including tax-free growth and rollover.

Key HSA Features

  • Must be paired with an HSA-qualified HDHP

  • Only the money already contributed can be used

  • Funds roll over year to year with no expiration

  • Can earn interest and be invested

  • Contribution amounts can be changed at any time

  • Fully owned by you—even if you change jobs


FSA vs. HSA: What’s the Difference?

Below is a simple side-by-side comparison to help you quickly understand how these accounts differ.


FSA vs. HSA Comparison Table

Feature

Flexible Spending Account (FSA)

Health Savings Account (HSA)

Type of Health Plan Required

Paired with most traditional health plans

Must have an HSA-qualified high-deductible health plan

When Funds Are Available

Full annual election available immediately

Only funds already contributed can be used

Do Funds Expire?

Yes. Must be used by plan deadline; unused amounts are forfeited

No. Funds roll over and never expire

Can You Change Contributions?

Only with qualifying life event

Change anytime during the year

Can Funds Be Invested?

No

Yes—earnings grow tax-free

Ownership of Account

Belongs to employer; unused funds are not portable

Belongs to you, even if you change jobs

Use-It-or-Lose-It Rule

Yes

No

Eligible Expenses

Deductibles, copays, coinsurance, first aid supplies, glasses/contacts, acupuncture, certain OTC meds (may require prescription)

Same as FSA—plus more flexibility for long-term savings

Best For

Predictable medical expenses and traditional plan users

Those with HDHPs who want long-term health savings

How to Choose the Right One for You

Choose an FSA if:

  • You prefer a traditional health plan

  • You expect predictable, recurring medical expenses

  • You want instant access to your full annual amount

  • You don’t need long-term investment benefits

Choose an HSA if:

  • You are enrolled (or plan to enroll) in a high-deductible health plan

  • You want to save for future or long-term medical expenses

  • You prefer tax-free investment growth

  • You want funds to roll over indefinitely

Review Your Past Year’s Medical Use

A great indicator of how much to contribute is reviewing:

  • Last year’s doctor visits

  • Chiropractic care frequency

  • Any ongoing conditions

  • Planned medical procedures for next year


Use Your FSA or HSA Before It Expires—Your Chiropractic Care Is Eligible

If you’re part of our chiropractic family at Spinal Solutions Chiropractic, remember: Chiropractic care is an eligible medical expense for both FSA and HSA accounts.  Your adjustments, corrective care, exams, and supportive therapies can all be paid with FSA or HSA funds.

Because FSAs are “use it or lose it,” this is the time to schedule those end-of-year visits before your remaining balance disappears.

Even if you have an HSA, this is still a great opportunity to invest in your health and start the new year aligned, pain-free, and functioning at your best.


As we move into a fresh new year, it’s important to stay mindful of your health by listening to your body, maintaining your regular chiropractic care, managing stress through movement and proper posture, and using your available health benefits to support your wellness goals. Prioritizing these habits now can help you start the year feeling aligned, energized, and ready to take on everything ahead.



Nawan Chittasevi


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