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If you are uninsured is that by choice?

It can be.

Belonging to an HSA is a personal choice, it is also expensive if you are not an above average earner.

It may not be a personal choice. Some employers fund HSAs for their employees in conjunction with employer offered HDHP (High Deductible Health Plan) insurance. I suppose it's a 'personal choice' whether to accept that insurance from your employer, but I would not say that HSAs are always a 'personal choice' any more than being uninsured is always a 'personal choice'.

The deductible is the killer once you pass that it is really cheap.

The deductible is not a function of the HSA - the deductible is a function of the HDHP. You are only allowed to fund an HSA for the current year if you are covered by an appropriate HDHP plan, but you can be covered by HDHP insurance without having an HSA.

The best advantage is the savings portion.
The tax treatment is just like a 401k.


Not really. While the contributions for both types of accounts do decrease your taxable income, there the similarity ends.

With HSAs, you are allowed to withdraw funds both tax-free and penalty-free for covered medical expenses, and once you are age 65 or over, you can withdraw funds for anything, but will be taxed on withdrawals that are not used for covered medical expenses.

With traditional 401(k)s, you can withdraw penalty-free, but not tax-free, as early as the year you turn 55.

And, while 401(k) balances can be rolled over into an IRA (and vice versa, if the 401(k) plan allows), HSA balances cannot be rolled into an IRA. However, once during your lifetime, you can use funds from an IRA to fund an HSA.

AJ
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