What is the actual difference between an HSA and an FSA?

An HSA is individually owned and rolls over indefinitely. An FSA is employer-owned and is mostly forfeited at the end of the plan year.

Is it HSA or FSA eligible?

Q: Do employer HSA contributions count toward my limit?

Yes, employer contributions count against the same annual IRS limit as your own contributions -- they are not additional room on top of it.

Q: Are gym memberships HSA eligible?

Almost never. A gym membership only qualifies when a licensed provider documents it as treatment for a specific diagnosed condition, not for general fitness.

Q: Does my state tax my HSA?

Only California and New Jersey decline to conform to the federal tax-free treatment of HSAs. Every other state follows the federal rules.

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OTC Medications

Over-the-counter drugs and remedies, eligible without a prescription since the 2020 CARES Act.

Medical Devices & Equipment

Monitors, mobility aids, and equipment used to diagnose or treat a condition.

Vision & Eye Care

Corrective lenses, exams, and eye care products.

Dental Care

Treatment and prevention, minus anything purely cosmetic.

First Aid & Wound Care

Supplies for treating injuries at home.

Baby & Family Care

Pregnancy, nursing, and family medical needs.

Skin & Sun Care

Sun protection and skin treatment, minus cosmetics.

Fitness & Wellness

The category where most rejections live. Good place to build trust by being honest.

Guides

HSA vs. FSA: What Actually Changes When You Switch How to Claim Reimbursement Retroactively What a Letter of Medical Necessity Actually Requires

Calculators

HSA & FSA Contribution Calculator Updated for 2026 HSA Long-Term Growth Calculator HSA Eligibility Checker

Common Questions

Do employer HSA contributions count toward my limit?

Yes — employer contributions count against the same annual limit as your own, not on top of it. See our contribution limits guide for the full 2026 numbers.

What's the actual difference between an HSA and an FSA?

Ownership and rollover, mainly — an HSA is yours and rolls over forever; an FSA is employer-owned and mostly forfeited at year-end. Full comparison in our HSA vs. FSA guide.

Are gym memberships HSA eligible?

Almost never, unless a provider documents it as treatment for a specific diagnosed condition. See our gym membership guide for what actually qualifies.

Does my state tax my HSA?

Only in California and New Jersey — everywhere else follows the federal tax-free treatment. Details in our state tax guide.