A 65-year-old couple retiring in 2014 should expect to spend around $220,000 (in 2014 dollars) on out-of-pocket health care costs during retirement [source: Fidelity]. That's a serious chunk of change. Although health savings accounts are primarily marketed as tax-free ways to save money for ongoing medical expenses, they can also play a vital role in paying for expensive medical care during retirement. Especially if you've maxed out your yearly 401(k) contribution, this can be another way to squirrel away some pretax dollars.
If you start early and contribute the maximum amount to your HSA each year, you can put away $360,000 to $600,000 — depending on your rate of return on investments — to cover health care expenses during retirement [source: Carrns]. Amassing so much cash in your HSA requires making the maximum contribution for 40 years and never withdrawing a dime. That means you would need to make enough money during your working years to cover all out-of-pocket medical costs without tapping the HSA.
The same HSA rules apply for withdrawals after retirement. All HSA funds must be used to pay for qualified medical expenses. If you try to dip into the HSA account to pay for a golf outing in Hawaii, you will owe income tax on that cash, but not the 20 percent penalty. That's only for people 65 or younger [source: Carrns]. In that sense, withdrawing from an HSA after 65 is a lot like withdrawing from a traditional IRA, which is also taxed as income.
Don't forget the Medicare rule, though. Once you enroll in Medicare and start receiving Social Security benefits, you cannot make tax-free contributions to an HSA. You can, however, continue to withdraw money tax-free for qualified medical expenses, even when you are enrolled in Medicare.
To really make your money work for retirement, you will need to shift the majority of your HSA funds out of liquid money market-style accounts and into investments. Before you invest in mutual funds or other securities through your HSA, make sure to find out if the bank charges transaction fees for investments along with any ongoing maintenance fees for the account [source: Carrns]. These fees can really eat away at your savings. A website called HSASearch provides fee information on all U.S. HSA providers.
For lots more information on retirement planning and managing health care costs, check out the related HowStuffWorks articles on the next page.