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A summary of the articles included in the December 2025 edition:

  • What To Know If You’re Nearing Age 65 With an HSA: Some Retirees Have ‘Meaningful’ Balances
  • GAO: Information on Features and Use, and Characteristics of Health Savings Account Holders
  • The Vital Role of HSAs: More Than Just a Health Care Spending Vehicle
  • Top 20 HSA Market Concentration – 2025 Midyear Update
  • IBD’s Best HSA Accounts For 2026: How To Find The Right One For Your Retirement Goals


What To Know If You’re Nearing Age 65 With an HSA: Some Retirees Have ‘Meaningful’ Balances

Anyone who owns a health savings account is probably familiar with its generous tax advantages. If you’re nearing age 65, though, it’s worth making sure you’re aware of some key rules.

HSAs come with a triple tax benefit: Your contributions are made pre-tax, any growth is untaxed and withdrawals are tax-free as long as they are used for qualifying medical expenses. And while these accounts are more prevalent among younger generations, a growing number of people are reaching retirement with one in tow.

“More retirees are sitting on meaningful HSA balances without a clear plan for how to use them most effectively,” said certified financial planner Tom Geoghegan, founder of Beacon Hill Private Wealth in Summit, New Jersey.



GAO: Information on Features and Use, and Characteristics of Health Savings Account Holders

To open or contribute to an HSA, an individual must be enrolled in an HSA-eligible high-deductible health plan. These plans have relatively high deductibles, but often lower premiums and may be available to individuals through their employers, health insurance marketplaces, or issuers.

Of the nine HSA providers we interviewed, eight focused their marketing efforts on employers, and all had at least one fee associated with their HSA that account holders may have to pay.

In 2022, an estimated $43.6 billion in contributions and $25.4 billion in withdrawals were reported among the 16.5 million tax returns reporting HSA activity, according to Internal Revenue Service (IRS) data. Of the reported contributions, about 84 percent were from an employer or employee through payroll deductions, and 16 percent were from individuals directly to their HSAs. Of the reported withdrawals, over 97 percent were for qualified medical expenses; the remaining were for non-qualified expenses—such as groceries—that are subject to taxes.



The Vital Role of HSAs: More Than Just a Health Care Spending Vehicle

For plan sponsors aiming to strengthen employee financial wellness while managing benefit costs, health savings accounts represent an underutilized opportunity. Far more than a payment method for medical expenses, HSAs can drive long-term financial security, tax efficiency and retirement readiness.

By elevating the role of HSAs within an organization’s benefits strategy, employers can help their workforce thrive while reinforcing a culture of smart, sustainable financial planning.



Top 20 HSA Market Concentration – 2025 Midyear Update

Using data from our 2025 Midyear HSA Research Report, we measured HSA market concentration using the Herfindahl-Hirschman Index (HHI) and found it increased 8% to 1,409 from 1,302 a year ago. This growth was driven primarily by strong equity market performance, which boosted investment asset values, along with continued organic account growth among the largest HSA providers. Despite this increase, concentration within the HSA market currently remains minor according to the index. Market share, as measured by total assets, is now 75% among the top 5 providers, up from 73% at the 2024 midyear point.



IBD’s Best HSA Accounts For 2026: How To Find The Right One For Your Retirement Goals

Health savings accounts, or HSAs, have been around for more than 20 years. But a strong stock market and a growing commitment by Gen Z and millennial workers are fueling a new boom in both HSA adoption and assets.

Survey data from HSA research firm Devenir shows that in 2015, HSA accounts held a total of $30.2 billion in assets, of which $26 million was in deposits and $4.2 billion was invested. Estimates for 2026 show total HSA assets reaching $189 billion, comprising $94.8 billion in deposits and $94.2 billion in investments.

HSAs are well-known for their tax advantages. But it’s clear that younger workers also understand their value as long-term investment vehicles.