A Guide to Using an HSA for Long Term Care Costs

A Health Savings Account (HSA) is a flexible, tax-advantaged tool for managing healthcare expenses—both now and in the future. Most people think of HSAs for routine medical bills, but they can also support long-term care (LTC) planning. With healthcare costs rising and LTC needs becoming more common as people live longer, understanding how an HSA can support these expenses is an important part of any financial strategy.

What an HSA is

An HSA is a tax-advantaged savings account for individuals enrolled in a high-deductible health plan (HDHP). The IRS sets annual contribution limits, and both individuals and employers can contribute.

An HSA offers triple tax-advantaged potential: Contributions may be tax-deductible, funds grow tax-deferred or tax-free under federal tax laws when used for qualified medical expenses, and qualified withdrawals for eligible medical expenses are federally tax-free.

Unlike flexible spending accounts (FSAs), HSAs are not “use-it-or-lose-it.” The balance rolls over year after year, allowing the account the potential to accumulate over time. HSAs are also individually owned, and the account stays active even if you change jobs or retire.

HSAs and paying for LTC

HSAs offer several advantages for paying for LTC.

• Tax-free withdrawals for qualified LTC expenses—Many LTC costs qualify as HSA-eligible expenses. This means you can withdraw HSA funds tax-free to pay for them, reducing the financial burden during retirement or periods of declining health.
• Paying LTC insurance premiums—HSAs can be used to pay qualified LTC insurance premiums, up to IRS-approved annual limits based on age. This matters because LTC insurance can be costly, and paying premiums with pre-tax dollars can help reduce overall expenses.
• No Required Minimum Distributions (RMDs)— This allows unused funds to remain in the account for potential tax-advantaged growth until needed for qualified care expenses.
• Flexibility in retirement—After age 65, HSA funds can be withdrawn for any purpose without penalty. If the withdrawal is not for a qualified medical expense, it is taxed as income—but when used for LTC costs, the withdrawal remains tax-free.

Types of LTC costs an HSA can cover

HSAs can help pay for a wide range of long-term care expenses.

Nursing Home Care —If a nursing home stay is primarily for medical care—as opposed to purely custodial care—HSA funds can be used tax-free. Even when custodial care is involved, portions of the cost may still qualify if a licensed healthcare professional deems it medically necessary.

Assisted living facility costs—Assisted living expenses can be paid with HSA funds when the individual requires help with activities of daily living (ADLs) or has a diagnosed cognitive impairment. Eligible costs may include:

• Personal care assistance
• Medication management
• Specialized memory care services
• On-site medical support
• Room and board may qualify if part of a medically necessary care plan.

Home health care—Many people prefer to stay home as long as possible. HSAs can pay for:

• Home health aides
• Skilled nursing visits
• Physical, occupational, or speech therapy
• Personal care assistance when medically necessary

Prescription medications and medical supplies—HSAs can pay for medications and supplies commonly used in long-term care settings.

Managing the Unpredictability

LTC is one of the largest and most unpredictable expenses people face as they age. HSAs offer a way to prepare gradually, tax-efficiently, and flexibly. By contributing to an HSA consistently over time, individuals can build a dedicated healthcare fund that supports financial independence later in life.

SWG6002715-1026a This information is provided as general information and is not intended to be specific financial, legal, or tax guidance. Before you make any decisions regarding your personal financial situation, you should consult a qualified financial, legal, or tax professional to discuss your individual circumstances and objectives. By responding to this information or reaching out for further guidance, you may be contacted by a licensed insurance agent or financial professional. Health Savings Accounts (HSAs) are subject to IRS rules, annual contribution limits, and high-deductible health plan (HDHP) eligibility requirements. Non-qualified withdrawals are subject to ordinary income tax and potential IRS penalties. State tax treatment of HSAs may vary. The source(s) used to prepare this material is/are believed to be true, accurate, and reliable, but is/are not guaranteed.