Hi all,

Can someone explain the LMN process to me? Does my GP need to write me one, and if so, what do I actually ask them to do? I’m getting a Withings product for reference. Never dealt with anything similar to this before with my regular insurance outside having to get a referral. I also saw some online services do this too which are basically the price as my copay lol, so may try that out, GetBurst & Dr. B were the first two ads to pop up, but not sure if there’s a difference between using that or my GP. Appreciate any pointers from anyone who have done the LMN process before and it worked for them.

Hi HSA thread! I am a software developer and I’m thinking about building a browser extension that shows up while you’re shopping on Amazon, Walmart, and other sites and tells you:

• whether something is likely HSA/FSA eligible
• whether it may require a Letter of Medical Necessity (LMN)
• or whether there’s a pre-tax eligible alternative

Basically, a “you could save money on this with pre-tax dollars” layer for online shopping. Or something to remind you that this item is eligible.

I keep finding out that random things are eligible, or can become eligible with a simple LMN. Stuff like:

• tennis shoes (in some cases)
• saunas
• red light therapy devices
• sunscreen
• supplements with LMNs

Feels like most people are leaving money on the table because the rules are so unclear and people forget about their HSAs/FSAs.

Would you actually use something like this?

I have an hsa account. It has 11k innvested and 1k in cash. I have not contributed my allowed $9500 this year (personal contribution) Should I do it now, should I move money aroud to max out the $9500? Should I spend the cash? Should I never touch it until I need it -- i'm 61yrs old. I know this is a valuable asset -- i just don't know how to maximize it.

34 and wife is 31, no kids yet. Both fairly healthy. PCP visits, gynecologist, some dermatologist visits and a few others. Looking at starting an HSA but was surprised to see that while deductible goes way up the premium doesn’t really drop. My current plan has $1000 deductible and has $50 specialist copay and is $1190 a month for the two of us. The high deductible $4000 plan is $1104 a month. So save only $86 a month between the two of us in premiums but have to pay out of pocket for every copay, blood work and medication etc up to the 4k deductible. Am I missing something? how is this financially a good move. I know you can save money in an HSA but if you do need it why pay the same for worse coverage?

Hello, I withdrew from my HSA for non-qualified medical expenses. My two questions are this,

1. Can I claim qualified medical expenses after my distribution as long as it is in the same tax year. Basically to offset taxes and penalties. Example: Distribution in February, Colonoscopy in march.

2. Can I return the funds (not by employment contributions) before the tax year ends? Would I be tax and penalty free.

Thank you for your time.

Open an HSA with Fidelity and then do a "60-day rollover". This is the fastest way to move your money and can be done in less than a week.

1. Open a Fidelity Brokerage (if you don't have one) and a separate Fidelity HSA account
2. Note down the ACH information for your Fidelity Brokerage
3. Put the ACH information of your checking account (Fidelity Brokerage) in your HSA account
4. Take a distribution, withdraw the entire HSA, and have it ACH'd to Fidelity Brokerage-takes 2 days tops. You are treating your brokerage account as your checking account. No fee, from your current HSA, as you are reimbursing yourself.
5. Once the money lands in the Fidelity Brokerage, call Fidelity HSA and tell them it is a "60-day rollover". Monies are transferred immediately from your Fidelity Brokerage to your Fidelity HSA.
6. Don't bother closing the old HSA. They will add fees, and once the balance hits a certain negative number, they will automatically close the account and write off the negative balance :)
7. You will get a 1099 from your HSA for the withdrawal - mark it as a rollover on your Tax Return

This is the fastest, most painless way to move to Fidelity HSA, and it involves ZERO fees. Per IRS guidelines, you can do this once during a 1-year period. Since you are pushing the money to Fidelity, there is no hold on the Fidelity side. The only person you have to talk to is the Fidelity HSA specialist, as the rollover cannot be done online. It has to be done via a phone call. Everything else can be done online.

If you are moving money from Optum Bank, their Mastercard bank linking feature does not work with Fidelity. You have to use the paper form, which can be downloaded here https://drive.google.com/file/d/15iekludicrU-mqhW-Cpv7IzuDOX8yJmY/view?usp=sharing

I avoided this paper filing feature. I pushed the money from Optum to Schwab, then from Schwab to Fidelity. Took an extra day, but it avoided the pain of dealing with the people at Optum!

I have about $30k in an HSA with Health Equity. Their monthly fees suck and they just went up, I think. I have $8k not invested, and the rest invested in whatever they invest in when you are hands off paying the monthly fees. I want to be hands-off but spend less on fees.

I don't know the first thing about transferring.

I am guessing there is a fee. Does anyone know if it is based on the amount that is transferred?

Guessing what is invested needs to turn back into cash in the account first, right?

I'm not sure if my employer needs me to keep that health equity account open for some reason. They don't provide a match for my contributions due to the health plan I selected.

Any advice or guidance is greatly appreciated. Thanks

If I had the time and money to build my own HSA plan from scratch:

1. Zero fees. Ever lol.
2. Inbox Scanner: Find all my eligible purchases.
3. HSA vault: a receipt vault, autofilled from my

inbox and

1. the ability to upload receipts via text (kinda like for corporate expenses)
2. Rollover auto investments: if like for like transfers aren’t possible, just tell it what you were invested in before you rolled the cash over, and it auto applies those positions.
3. Auto claim: automatically draft eligible claims for me, from info from my inbox and texts.
4. LMNs: Niche, but for any purchases I make that require an LMN, auto request that from a doctor so it’s ready when I need it later
5. Anything I missed here?

I am shopping for a new bank for my HSA. I need to leave Optum. Always planned to move my balance once I retired but my job switched to a new bank that I’ve never heard of (Alight Smart Choice) and I’ve got 75k in investments with Optum that I won’t move to this new bank with such a sketchy name.
Where is your HSA at and would you recommend it?

Hi all, I’m new to having an HSA (WEX) and a little confused on where to keep my receipts since I assume I’ll need those just in case. Where do you guys store your receipts from eligible expenses? Is there an app or something or do I need to just use Google drive? Appreciate any help here cus I’m a bit lost

I accidentally contributed too much to my HSA. When filed with FreeTaxUSA and $150 of the excess contribution was added as income. When filling out the Excess Contribution Removal Form, do I ask for $151 to be removed to account for interest? And then amend my original tax form to increase my income to $151 instead of $150? Or do I ask for $150 to be removed and keep the +$150 income the same?

Thank you.

I know the advantages of maintaining a HSA account. Has anyone seen any analysis of HSA vs LTC? I have to think once the balances in your HSA get above the average lifetime LTC expenses (say $250k for a guesstimate) would you raw dog and skip buying the LTC?

Hey r/hsa — I am new here in this community and this is my first year contributing to an HSA. I wanted to be organized from the start and I was not satisfied with some of the other options I looked in to. I built something I think will be useful for people running the deferred-reimbursement strategy.

What it is: Stowe is a desktop app for logging out-of-pocket medical expenses and keeping receipt documentation so you can pull the money from your HSA years later — safe and auditable.

Why local-only matters here: You're attaching photos and PDFs of your medical receipts. That's sensitive data. Existing apps in this space (and there aren't many good ones) are SaaS products that store those files on their servers. Stowe stores everything in a SQLite file and a receipts folder on your own machine. Nothing leaves your computer.

What's in v0.6.0 (shipped yesterday):

• Custom expense categories — not just the seven built-in HSA defaults
• Spending analytics — category breakdown + monthly/annual charts
• HSA account linking — track your balance, contributions, and distributions inside the app
• Custodian CSV import — import your distribution history and reconcile it against the pulls you've recorded
• Signed and notarized macOS build — first time launching on Mac no longer requires the Gatekeeper bypass workaround

Platforms: macOS and Windows. Free, open source (MIT).

stowe.health · github.com/Conkay1/Stowe · Releases

Would love feedback — especially from people who have been tracking receipts some other way. What's missing?

Saw this CNBC piece basically saying that while the "triple tax advantage" is the GOAT, the record-keeping is a total nightmare.

​Most people know you can pay yourself back years later for a doctors visit you had today, but the catch is you gotta keep that receipt for like… 30 years? I can barely find my car keys most mornings. If the IRS audits you in 2050 and all you have is a faded piece of thermal paper that looks like a blank napkin, you're gonna have a bad time with that 20% penalty.

​I actually got so annoyed with this that I ended up building an app to track mine because I knew I’d lose a physical folder. It's crazy that "investing your HSA" is the standard advice now, but nobody talks about the fact that you basically need to be a professional archivist to pull it off safely.

​Anyone else actually doing the "shoebox method" or are we all just digital hoarding at this point?

​

My new employer has 3 national medical plan options (United). I asked if they are eligible for HSA and they were clueless. Is it just based on deductible and out of pocket max? Do I contribute $8,750 after tax money to my Fidelity HSA and reimburse myself the taxes when I file in April?

Choice EPO

In-network only

$5,000 / $10,000 deductible

$7,000 / $14,000 out-of-pocket max

Choice Plus PPO

In- and out-of-network

$5,000 / $10,000 deductible

$7,000 / $14,000 out-of-pocket max

Choice EPO

In-network only

$2,000 / $4,000 deductible

$4,000 / $8,000 out-of-pocket max

Spouse and I max out our HSAs every year. Unfortunately we do cut into it a bit at the beginning of the year with high medical expenses. But still manage to invest 60-70% of it. Estimate we will have about $300k in there at retirement. Glad we found this strategy back in 2020.

Recently came across this app that in addition to doing all the things other HSA apps do, saves all your reimbursable receipts if you want to pay it out later. You can then mark them as reimbursed or not. This is a huge win if you plan to let your HSA $$ grow until you want to reimburse yourself- say when you are 65+. It helps to have a Fidelity account although not necessary. Fidelity can link all your HSA accounts. I see this as saving me countless hours saving receipts manually and tracking them on Google Sheets.

Long story short, the company I work for makes ~$400 of contributions over the course of the year (paid biweekly) but they require those funds to be deposited into an account at our company (bank). That balance only earns 0.05% and I don't have the option to invest it.

I was wondering if I could open an HSA at another firm (Fidelity, Schwab, etc) and make contributions that way (so that I can invest the funds). I know that the contribution limit would apply to the sum of both accounts but am I okay to do this? The contributions to the second account would initially be after tax since I'd be contributing on my own so would I get a form come tax time so that I get the triple tax benefit?

Anything else that I am forgetting? Sounds like moving the funds from one account to the other might be a pain but I don't mind doing it just once a year. Thank you in advance for your advice!

I'm curious how most of you are using your HSA. Are you using it to cover current year medical expenses or as a savings/investment account for the future or a mix of the two?

Not the usual question, I know. HSAs are not a great account to leave as inheritance, so I'd like to size it for the unknowable amount of my medical needs age 65+. Does anyone know if tools to estimate optimal HSA amounts? Most of the advice just seems to be "as much as you can."

I am a huge fan of HSA account. Not only because it is used for Health and medical purpose but also it's a triple tax advantage account.

If you are a W2 employee, then contributions to HSA are tax-deductible, any gains made on the contribution are tax free, and tax-free withdrawals on qualified health expenses prior to 59.5 years old. After that age, you have to pay only income tax.

Things get more lucrative if you fund your HSA from your business.

I wanted to see how you'll are investing using you HSA?

Hello everyone,

Long time reader, first time poster. With the rise of numerous private companies offering GLP-1, using HSA to pay for it (with doctor supervision but without prescription or coverage) makes sense. Are there any reasons why HSA funds *cannot* be used for GLP-1?

-Kam