What do I need to save if I want to reimburse HSA-eligible expenses say in 20 years? Invoice and proof of payment?

I think the receipt is all. Mine allows you to upload all of that now so you don't have to save it. I assume most would have that as a standard function.

You could upload it now and then send them a message to see if it is adequate for later reimbursement

What's the motivation?

Whitetail said:

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What's the motivation?

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Tax free contribution, growth, and withdrawal if used for med expenses. The withdrawal doesn't have to be within any specific timeframe of the expense, so a lot of people use these funds as a bridge when retiring early. Or just for retirement purposes period. Just a pain keeping track of med expenses for that long.

sherminator said:

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What do I need to save if I want to reimburse HSA-eligible expenses say in 20 years? Invoice and proof of payment?

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Making digital copies is easy to keep up with. Also, assume you will have medical expenses in the future, like long term care or insurance premiums.

I believe current law does not allow HSA funds to be used for insurance premiums except in very specific scenarios. I looked into this possibility recently as a bridge for early retirement and it didn't look feasible.

Receipts are key. So could be proof that you were enrolled in an eligible HDHP plan for the dates the expenses were incurred. Keeping the plan EOB for each year wouldn't be a bad idea.

https://employee-resources.lumity.com/help/hsa-receipt-documentation

On your link it says
"Even if you're no longer on a HSA-eligible health plan, you can still spend money from your HSA. (You can always spend your HSA dollars. You just can't contribute to your HSA if your plan isn't eligible)."

So why would it matter about when you were enrolled in an HSA?

agdaddy04 said:

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On your link it says
"Even if you're no longer on a HSA-eligible health plan, you can still spend money from your HSA. (You can always spend your HSA dollars. You just can't contribute to your HSA if your plan isn't eligible)."

So why would it matter about when you were enrolled in an HSA?

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In the case that medical expenses pre-date the opening of an HSA. You can spend HSA dollars from a time when that HSA didn't exist. But yes, once you open an HSA, you have that account u lentil it's drained of money.

Aggie71013 said:

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I believe current law does not allow HSA funds to be used for insurance premiums except in very specific scenarios. I looked into this possibility recently as a bridge for early retirement and it didn't look feasible.

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If you are retired and not eligible for Medicare, you can pay for insurance with the HSA dollars. https://www.bcbsm.com/amslibs/content/dam/public/employers/documents/share-resources-employees/individual-files/hsa-retirement-flyer.pdf

Medicare premiums are HSA eligible expenses (part b is currently ~176 a month) also after age 65 you can take money out of the HSA for non medical expenses and just have to pay to income tax on the withdrawal (same as traditional IRA or tax deferred 401k) but no penalty. So the HSA is a 'stealth ira' and should be maxed out after getting your company match before maxing out pre tax 401k

I have just under 90k in my HSA, 100% invested in s&p500 index funds. Sitting on about 11k in receipts and have never made a withdrawal from the account.

txaggie_08 said:

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agdaddy04 said:

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On your link it says
"Even if you're no longer on a HSA-eligible health plan, you can still spend money from your HSA. (You can always spend your HSA dollars. You just can't contribute to your HSA if your plan isn't eligible)."

So why would it matter about when you were enrolled in an HSA?

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In the case that medical expenses pre-date the opening of an HSA. You can spend HSA dollars from a time when that HSA didn't exist. But yes, once you open an HSA, you have that account u lentil it's drained of money.

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At a minimum, you need to have evidence of when your HSA was established if you're going to be using it as a stealth IRA.

In my case, my HSA accounts have been sold, consolidated and transferred four or five times in the almost 20 years I've been participating. 25 years from now when I start to make withdrawals, how do I prove to the IRS my receipts from 45 years earlier correspond to a contemporaneous HSA? Fidelity has no record of when my original HSA was opened.

Best evidence may be copies of your earliest Form 5498-SA. Old W-2s showing employer HSA payroll deductions would probably work or I suppose if you held onto your Form 1040s. Saving a copy of your earliest HSA statements would be good. I just would not count on the record keeping of your financial institution or the benevolence of the IRS a few decades from now.

I have been growing my HSA and not spending out of it…I just didn't realize you shouldn't keep receipts. Guess I need to start.

On bullet point 3, how would you be able prove this without a copy of every tax return?

ETA- these screen grabs are from Publication 969.

At the end of the day it's your word against theirs. I.e. how do you prove bullet point 2, that the expense wasn't reimbursed by an insurance company. It's kind of hard to prove something didn't happen.

I would think a receipt paired with an EOB would show that insurance didn't pay for it. Though yes, ultimately it's impossible to prove the negative.

My eye doctor isn't in network so I pay out of pocket and mail the eob to my insurance for reimbursement. So I have the eob and credit card receipt and it's on me not to submit that for reimbursement from the HSA.