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Managing healthcare costs can be tricky, especially when trying to figure out which tax-advantaged account helps you save more — a Health Savings Account (HSA) or a Flexible Spending Account (FSA). Both accounts allow you to set money aside before taxes to pay for medical expenses, but whether you can have both is tricky.

Let us break it down so you can make the right choice for your situation.

HSA vs. FSA

Both HSAs and FSAs are designed to make healthcare more affordable by reducing taxable income. The key difference lies in who owns the account and how flexible it is.

An HSAis available only if you are enrolled in a high-deductible health plan. You own the account, and the money rolls over year after year. That means you can save and invest funds for future medical needs, even after changing jobs. In 2025, the IRS allows contributions of up to $4,300 for individuals and $8,600 for families, with additional catch-up contributions for those 55 and older.

An FSA, in contrast, is owned by your employer. It lets you use pre-tax dollars for eligible medical expenses, but the balance usually does not carry over and most plans follow a “use-it-or-lose-it” rule by the end of the year. A few employers allow a short grace period or small rollover, but it is more restrictive than an HSA.

Here’s Why You Can’t Have Both at the Same Time

Here is where things get tricky: you generally cannot contribute to both an HSA and a traditional FSA in the same year.

The reason comes down to ownership and eligibility rules. HSAs are personal savings vehicles tied to high-deductible plans, while FSAs are employer-based and available with traditional health insurance. The IRS prohibits individuals from having “other coverage” that pays medical expenses before the HSA deductible is met — and a standard FSA does precisely that.

Therefore, if you are contributing to an HSA, your employer cannot also provide you with a general-purpose FSA.

Exceptions: Here’s When You Can Have Both

There are a few exceptions that allow you to pair both accounts.

A Limited Purpose FSA is the most common exception. It only covers dental and vision expenses, which means it does not interfere with your HSA eligibility. Many employers offer this option specifically for employees who want to keep maximizing their HSA contributions while still saving pre-tax dollars for routine vision or dental care.

Another option is a Dependent Care FSA (DCFSA), which covers daycare or elder care expenses, not medical costs. Because it does not overlap with your health coverage, you can have a DCFSA alongside an HSA without issue.

A third, less common hybrid is a Post-Deductible FSA. With this setup, you can only use FSA funds for dental and vision expenses until you meet your annual HSA deductible. Once that deductible is met, the FSA can then be used for other qualified medical expenses for the rest of the year.

Deciding Which Account Works the Best for You

The choice between an HSA and an FSA depends on your health plan and spending habits. If you have a high-deductible plan and want long-term flexibility, an HSA is usually the smarter pick. Your contributions can grow tax-free and remain yours forever, even if you switch jobs or retire.

Conversely, if you are covered under a traditional health plan and tend to have predictable medical costs each year, an FSA may make better sense.

Bottom Line

While both HSAs and FSAs help ease the rising medical costs, you cannot double up on the tax benefits by using both at once unless your FSA is limited in scope. Understanding how these accounts interact can help you prevent costly mistakes and maximize your healthcare dollars.

If you are unsure which option suits your needs best, talk to your HR department or a financial advisor. The right choice depends on your health plan, how often you visit the doctor and how you prefer to save. With a bit of planning, either account can become a powerful tool for managing your healthcare spending efficiently.