Health Savings Account

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Active employees and official retirees can use this tool to compare medical benefits, as well as plan costs.

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Stanford Benefits is partnering with Fidelity Investments to administer the health savings account (HSA) and flexible spending accounts (FSAs), including our tax-free Child Care Subsidy Grant (CCSG) and the dependent day care FSA, effective Jan. 1, 2024.

Learn more about this transition by visiting Fidelity's website.

Set aside before-tax money to reimburse yourself for eligible medical expenses if you are enrolled in a high deductible plan. HSAs are more than a spending account for medical expenses; they are a great way to plan for the future.

At Stanford, the HSA works in conjunction with the high deductible health plans. Unspent funds roll over each year; there is no “use it or lose it” rule as with health care flexible spending accounts (FSA). Use your HSA to pay for eligible expenses for you, your spouse, or your dependent children – even if they aren’t covered on your health plan.

There are limits to what your family can contribute to HSAs each year, but not how much you can save in them over a lifetime.

Stanford’s contribution

When you enroll in the Stanford Choice High Deductible Health Plan, you can set up payroll deductions for your contributions. Plus, Stanford will contribute to your HSA, even if you don’t.

2024 Stanford Contribution: $1,152 for employee-only coverage or $2,352 for family coverage.

2024 HSA Contribution Limits: $4,150 for employee-only coverage and $8,300 for employee + dependents coverage. If you are age 55 or older, you may contribute an additional $1,000 catch-up contribution. Keep in mind that your personal contributions and Stanford’s contribution cannot exceed these annual limits.

Set contributions every year

Each Open Enrollment, you must actively elect your contribution amount for the following plan year as your election amount from the previous plan year will not automatically carry over. To receive the university's contribution, you must make an HSA election (even if it's $0).

Plan information

Eligibility	When you elect a high deductible plan, you are also eligible to elect an HSA, with these restrictions: You are not covered by other health insurance You are not enrolled in Medicare Part A or B You are not listed as a dependent on someone else's tax return You do not participate in a health care FSA Your spouse is not enrolled in a health care FSA (because the FSA covers spouses automatically per the IRS). Your spouse may enroll in an HSA however. Live in the United States and have a US address on file with Stanford. NOTE: If you are enrolled in the ACA Basic High Deductible Plan, Stanford will not contribute to your HSA.
How to Enroll	You can set up an HSA with any financial institution that provides HSA services. With Fidelity: In 2024, Stanford is partnering with Fidelity for HSAs, so you can set up your account in the My Benefits portal when you enroll in an eligible health plan as a new hire, during Open Enrollment, or when you experience a qualifying life event. There are no set-up fees. With any other financial institution: Setup your account as early as the effective date of your coverage. Your confirmation statement from the My Benefits portal is evidence of enrollment. There may be fees, minimum deposit or balance requirements depending on the bank.
How it Works	HSA contributions and accounts are unique tax-qualified savings accounts designed to have a triple federal income tax advantage, including: Tax-free contributions to the HSA account; Tax-free interest or investment earnings on your HSA account; and Tax-Free withdrawals from the HSA account, as long as they are spent on IRS-qualified health care expenses (such as copays, deductibles, and other out-of-pocket expenses, Medicare Part A and B premiums, etc.). However, some states levy taxes on your HSA contributions, while others tax interest or investment earnings on your HSA account: California and New Jersey tax HSA contributions New Hampshire and Tennessee tax any interest or investment earnings on your HSA account, but not contributions. Use your HSA to pay for eligible expenses for you or any of your eligible dependents – even if they aren’t covered on your health plan. However, you’ll be taxed if you use HSA funds for your domestic partner’s expenses (even if qualified); the HSA is a federal program, which doesn’t recognize domestic partnerships even if the state of residency does. In California, you can cover your domestic partner on the Stanford Choice High Deductible Health Plan, and you can contribute to the HSA up to the family maximum. However, the only way a domestic partner can be recognized for federal tax purposes is if the partner qualifies as a legal tax dependent. If you use your HSA to pay for non-health-related expenses, the amount will be taxable; if you are under age 65, you may pay an additional tax penalty. The IRS may require you to show proof of your expenditures, so you should keep your own records. Typically, your contributions are made in equal amounts each month; however, Stanford will allow you to make a lump-sum contribution for the year from your first paycheck in January (or, for new hires, your first paycheck after you make your election). Call the University HR Service Team for help. When you enroll in Medicare, you are no longer eligible to contribute to your HSA; however, you still have access to all HSA funds to pay for Medicare premiums and out-of-pocket expenses. Active employees who turn 65 should defer Medicare coverage to continue HSA contributions; we recommend you contact Social Security to understand how long you can defer Medicare to continue contributing to your HSA.
Contribution Limits	2024 HSA Limits $4,150 for employee only $8,300 for employee + dependents + $1,000 catch-up contribution if you are age 55 or older NOTE: These limits include any contribution amount you receive from your employer, as well as any contributions your spouse makes to another HSA.
When Coverage Ends	You own your HSA and it is yours when your employment ends. If you take a job elsewhere or retire but don’t have coverage under an HSA-eligible health plan, you can still use your HSA to pay for qualified medical expenses. However, IRS rules don’t allow you to deposit money into your HSA and receive tax benefits if you aren’t enrolled in an eligible health plan. Once you retire, you can continue to receive tax benefits when you use the HSA for qualified medical expenses. After age 65, there is no penalty for withdrawing your money, even if you enroll in Medicare. You can use your HSA to pay your Medicare premiums, deductibles and copayments; after age 65 you may also withdraw money from your HSA for non-medical purposes without penalty, although it is treated as retirement income and subject to normal income tax.

If You Already Have an HSA

If you already have a personal HSA, you can still open one with Fidelity. Just be sure the total amount you contribute to both accounts, plus Stanford's contribution, does not exceed the annual contribution maximum.

Resources Your HSA Reference Guide

Your HSA Reference Guide (Spanish)

Health Savings Account FAQ

Is there a limit on how much I can contribute annually (deposit) to my HSA?

Yes, there is an annual limit, determined by the IRS, and published each year. See the section on Contributions on this page. These limits include any contribution amount you may receive from your employer. While there is a limit on how much you can deposit into your HSA each year, there is no limit on how much you can save in your HSA over the long term.

If you are 55 or older, you can also make “catch-up” contributions ($1,000 additional annual contribution). Please note: if your spouse is also covered by an HSA-eligible health plan and has an HSA, the law says that the two of you together can only contribute up to the family limit, either to individual HSAs or to one or the other’s HSA.

Can I make a lump-sum contribution to my HSA account?

Yes. You can request to make a lump-sum contribution to your HSA account from the first pay period in January (or for new hires during the year from the first check after your HSA election is processed) by contacting the University HR Service Team at 877-905-2985 or 650-736-2985. Please note: your lump-sum contribution cannot exceed your annual HSA election amount and will be taken from a single pay check. Lump sum contributions cannot be spread over multiple pay periods.

Can I contribute to my HSA if I’m enrolled in Medicare?

Once you enroll in Medicare Part A or Part B you can no longer contribute to an HSA, but you can continue to withdraw the funds and use them to pay for expenses such as Medicare premiums and out-of-pocket expenses (including Part A and Part B deductibles, copays and coinsurance, and long-term care insurance premiums). You may also use these funds to pay medical expenses for your spouse and your dependent children.

If you are age 65 or older and still working we recommend that you contact Social Security to understand how long you can defer Social Security payments and Medicare Part A and B in order to continue contributing to your HSA. (Also keep in mind that when you sign up to receive Social Security payments you are automatically signed up for Medicare Part A. So if you sign up mid year and the Social Security benefit begins retroactively, you are required to repay contributions, possibly back to the beginning of the current calendar year.)

Can I use the HSA for my spouse or dependents if they are not covered under my plan?

Yes. The money in your HSA can be used to pay for qualified health care expenses of any family member who qualifies as a dependent on your tax return.

For example, if you are covering your 24-year-old on your medical plan, your adult child must still be a tax dependent in order for his or her medical expenses to qualify for payment or reimbursement from a parent’s HSA. If the adult child is not a tax dependent but is covered by a parent’s HSA-eligible health plan, he or she may be able to open his or her own HSA. In these circumstances, it is best to consult with a competent tax advisor.

What happens to my HSA if I leave my current employer or retire?

You own your HSA account and it stays with you when your employment ends. If you take a job elsewhere or retire but do not have coverage under an HSA-eligible health plan, you can still use your HSA to pay for qualified medical expenses. However, IRS rules will not allow you to deposit money into the HSA and receive tax benefits if you are not currently enrolled in an HSA-eligible health plan.

Once you retire, you can continue to receive tax benefits when you use the HSA for qualified medical expenses. If you are 65 years old or older, there is no penalty for withdrawing your money, even if you enroll in Medicare. When your Medicare coverage starts, you can use your HSA to pay your Medicare premiums, deductibles and copayments. After you turn 65 or become entitled to Medicare benefits, you may withdraw money from your HSA for non-medical purposes without penalty. The withdrawal is treated as retirement income and is subject to normal income tax.