HSA vs. FSA

The medical plan you choose helps determine which type of account is available to you. The Aetna High Deductible APCN+ Plan comes with an HSA option, while the Aetna Core APCN+ Plan comes with a Health Care FSA option. Use the chart below to see how the two accounts compare.

HSA vs. FSA Comparison


Account type	Health Care Flexible Spending Account	Health Savings Account
Who is eligible?	You must be enrolled in the Aetna Core APCN+ Plan.	Members enrolled in the Aetna High Deductible APCN+ Plan — a High Deductible Health Plan (HDHP) — who do not have any other non-HDHP health plan, including coverage under Medicare, a spouse’s health plan, or Flexible Spending Account (FSA).
Contribution limits	Health Care FSA: $3,400	Single coverage: $4,500, Family coverage: $9,000
Who owns the account?	Employer	You
Contributions subject to income tax?	No	No
Does interest accrue?	No	Yes
Contributions	Money is deducted (pretax) from your paycheck every pay period.	Money is deducted (pretax) from your paycheck every pay period.
Disbursement of funds	Most employers make the entire annual contribution amount available from the beginning of the year for a Health Care FSA, even if the account is not fully funded yet.	Only funds paid in by you are available for healthcare expenses.
Catch-up contribution for older workers	No	Yes. If you are age 55+, you may contribute up to $1,000 more to their account per year.
Portability and forfeiture	You lose any unused funds when employment is terminated.	This account is portable. HSA balance is not forfeited when you change employers or health plans.
Expiration	Your Health Care FSA includes a rollover feature, allowing up to $680 of unused funds to roll into the next plan year. Any amount over $680 must be used by December 31 or will be forfeited.	Your funds never expire.
Can I change my contribution?	Only during Open Enrollment or if you experience a Qualified Life Event, such as a marriage, divorce, or birth.	Yes, on a monthly basis.
Eligible medical expenses	Qualifying medical expenses are those specified in the plan, e.g., copays, coinsurance, deductible, prescription drugs, and more.	Qualified expenses include medical, dental, vision, and prescription drug expenses.
Proof of expenses required?	Yes. Remember to keep your receipts.	No. However, you should be prepared to substantiate to the IRS that the expense has been incurred, the amount of the expense, and its eligibility.