[Benjamin]

Does anyone pay medical expenses out of pocket, keep the receipts, and let HSA funds grow?

If so, how do you plan to keep track of all the info so that you’re able to reimburse yourself later?

Is this really worth the hassle of filing and keeping up with records for 20-30 years just to get some additional pre tax growth?

[Bill]

We invest the hsa and don’t save any receipts. It’s pretty likely we’ll have some medical expenses during 40-50 years of retirement to claim.

[Matthew]

Yes! I’m a nerd about the HSA. We tally up all qualified healthcare expenses at end of the year and I date and upload a picture of each receipt at the time we pay out of pocket for anything.

Treating the HSA this way creates a supercharged retirement account and allows us to pull money out for any reason in the future, regardless of whether we use it for healthcare.

It’s a fair argument to not worry about capturing receipts and just earmark it for inevitable healthcare in the future, but we use Qube Money so our healthcare expenses are automatically categorized and then it’s just a simple picture of a receipt that I save in a drive.

Not a lot of effort for access to tax free cash whenever needed.

[Sean]

yes, it’s worth it. In 30 years those investments could be 10-15x higher.

[Julie]

This is exactly what we are doing. Have a few receipts but not too worried about it.

Will use for medical expenses in retirement.

[Shelina]

Yes — I create a folder for each year in Google drive — including a spreadsheet I can update easily while waiting for my appointment or prescription and save a pic of each receipt (labeled with date, item and expense) in the same folder.

In case I don’t have time to do this at the moment I keep the pics in a folder on my phone and do it later when I have time.

(I’m self employed and need to track all this for tax time anyways).

[Becca]

We do. Invest all funds and don’t touch them. Pay for expenses out of pocket, usually credit card hacking larger bills to use for travel
I save receipts and then tally them up in Feb for the previous year.

I scan each year’s worth of receipts and email to ourselves plus save a pdf to our google drive.

I also usually upload to our hsa administrators site (but don’t reimburse myself) so our records are the same.

I don’t have any faith that the HSA admin will maintain the records for 30 years, which is why we keep our own.

I currently still have the paper originals in a file, but likely won’t maintain that long term.

We had $25k total in receipts the years of our two children’s births (relatively uncomplicated, but two caesareans and minor issues for each kid their first year) so that’s a big chunk we can pull down the road if we needed to.

[Michelle]

I pay my expenses out of the HSA as I get them because I can’t afford to Max all other tax preferred space without doing so, but if I did let it grow I wouldn’t bother with receipts except for maybe some big ones.

I would just use the HSA for new medical expenses and Medicare premiums in retirement.

[Ron]

Exactly right!
I have had an HSA for about 5 years and only deposited, never taken a dollar out.

It’s all invested as well.
Lots of receipts

[Michael]

I pay out of pocket and let the HSA grow. I keep “major” receipts but I’m pretty sure I’ll have sufficient future medical expenses to pay out of the account.

[Rebecca]

Yes. Spreadsheets and pdf support for claims. The growth is worth it.

Reimbursing later is just transferring your own money to yourself

[Christopher]

In practice, we just keep track of the big ticket items. Child birth, emergency services, stuff like that.

Those large balances are enough to drain our HSA, without needing to keep track of every bandaid and bottle of ibuprofen we purchase.

[Eddie]

We contribute to HSA and pay some expenses through it. Some we don’t. When I self-pay I email a pic to an HSA specific email address I made.

(my email followers by HSA). Simple and should be a permanent digital record.

[Matt]

Yes. I have saved all eobs and statements in google drive and keep track of the amount and dates in a spreadsheet.

[Caro]

Yes, but like others I don’t have a bunch of receipts saved. I do mean to back the last 2 years and capture a few big ones.

But we’re 36/37 and we have about 40K in invested HSA funds.

I think I am going to pause investing all of it and actually cash out some next year as my son has some costly medical contacts that we keep losing

[Chrissy]

Yes, I take a pict of each receipt and upload it into a folder on google docs, I have a folder for each year in my HSA- receipts to be reimbursed file.

[Megan]

I just scanned the receipts or print to PDF. All in my cloud drive in an organized manner.

I Do assume that I will have health expenses through the end of my life so I don’t sweat it if I don’t have every single receipt from now.

But you bet I invest it.

[Joel]

I have never spent a dime of HSA dollars. So far. It’s likely to change in 2025. I’m 60 and on ACA and may need a source of tax free cash flow.

Better the HSA than my Roth IRA. The HSA makes for a really bad inheritance for my kids. I have no spouse to inherit.

The HSA is north of $120K. I haven’t kept everything, but I have a OneDrive with a set of receipts and spreadsheets with details for most of my medical expenses going back maybe 8+ years.

I could probably claim about $50-60K today – I haven’t kept a running total.
My insurers have always provided me with downloadable EOBs and I could download a summary of insurance claims as well.

I didn’t bother with anything over the counter that might have been claimable.

I just make sure I download these statements at least once or twice/year.

I have 17.5 months worth of COBRA from when I FIREd that I can claim as well. I’m not sure where I put that, but I think I’ve collected proof of those payments as well.

Is it worth it? Probably. I imagine my current balance is more than twice the amount I’ve actually contributed over the years.

My first contribution was in 2008; but my employer imploded in 2008, so the account balance was less than $2K for 5 years.

My last employer switched over to an HSA eligible HDHP in 2013 and I contributed to that for 9 years – mostly at the family level since I also carried my girlfriend on my insurance.

All in, I’ve probably contributed about $50K or so. The additional $70+K came from tax free investing. Probably 10-20% of that comes directly from tax savings. Or about $7-14K. Split the difference and call it $10K.

I’ve probably spent about 2 hours/year on record-keeping. That’s about 20 hours of work to keep records.

I figure I’ll need to spend another 5-10 hours compiling records to justify my expenditures, so let’s call it 30 hours of recordkeeping.

That means the HSA will have effectively paid me about $10K/30 hours or about $333/hour for my recordkeeping.

After I spend down the money based on my current records, I may still need to keep records, but I’ll probably just reimburse myself as I go, which should simplify things a bit.

Probably a good thing since the tax savings will be in part a function of my balance.

So, how much is your time worth? I know I wasn’t being paid $333/hour when I was working…

[Alan]

It is easy enough to scan with your phone and store in a folder. I should store everything but generally store only significant ones which do add up.

[Loraine]

Yes, I take pictures of the receipts but don’t really anticipate needing them. HSA works like a 401k at 65, that is if money is not used for medical.

We most likely will.

[Kristen]

I’m not saving receipts I think when it comes time to use it or closer to time then there will be plenty of receipts

[Eli]

Great question! I’ve been wondering the same. I’ve downloaded some pdf explanation of benefits from my insurance co website.

Basically anything over $100. Hopefully that will be sufficient in the future.

[Angela]

I’m letting it grow but I’m not saving all that stuff. I’m sure I’ll have enough medical in the future to use it all up at that point in time.

[Tom]

I take pictures of receipts and log them in a spreadsheet. I also occasionally make doctors offices print out a full transaction history.

[Barbara]

Worth it to me, it’s really not that much hassle. I keep a spreadsheet, scan the receipts to a Google Drive, and keep any physical copies in a folder.

Plus, my HSA website has some records too.

The tax benefits are greater than just the initial pretax contributions.

[Daniel]

Google sheets/drive to keep track and save receipts.
I only save the bigger expenses, no need to nickel and dime it, I’ve easily accumulated 25-30k of receipts

[Rick]

Yes and no.
Yes, I saved “receipts” into a cloud drive and backup that to another cloud drive.

Receipts are rarely just receipts though as they often failed irs substantiation rules.

Usually, it is receipt with additional provider summary doc or eob or similar.

No, I don’t save them for 30 years. Hsa has limited, aka not unlimited, value.

For me, it was last two years of income, aka Roth qualified income, to do a two years Roth contributions that was the right landing spot for about $15k in saved hsa medically eligible expenses to grow tax free with grater flexibility.

[Steven]

I download the expenses from the insurance website annually and save them to my computer.

It downloads in a spreadsheet, very easy.

[Susan]

I have not saved them for 20-30 years, but I have saved them for 5+ years and allowed the money to grow before withdrawing for another reason.

I literally just kept paper receipts in a folder.

After withdrawing, they are still paper receipts sitting in a folder with my tax return.

I have heard that certain receipts can fade over time, so you will probably want a better plan than what I did.

[Author]

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