The Best HSA Account Administrators (Updated for 2021)

If you don’t have a good HSA account provider, there’s never been a better time to move your HSA funds to a new one. This article will review my updated research and picks for the best HSA accounts available to individuals and families (outside of employer-sponsored offerings) for 2021.

The entrance of Lively and Fidelity into the Health Savings Account (HSA) space, each with very competitive offerings, has resulted in a number of other administrators lowering their fees and improving their investment options, so this article is a complete annual re-write of my picks for the top HSA accounts, to help you make a switch for 2021.

best HSA account

The Benefits of HSAs: The Best Account for Health Care Costs

Why curate and maintain a list of the best HSA accounts? I have previously noted that the HSA is my pick for the best retirement account (employer matching funds aside), in addition to being the best account for health care costs. Why are HSAs the best? Here are just a few of the reasons:

  1. A unique combination of tax-free (pre-tax) contributions and withdrawals for qualified medical expenses, employer contributions, and growth through investments.
  2. HSA maximum contributions are significant – $3,600 per individual and $7,200 per family in 2021. That is a very significant amount of tax savings!
  3. HSA account contributions fully roll over from year-to-year (unlike with FSAs). In other words, the funds are not “use it or lose it”.
  4. You can do a one-time IRA to HSA rollover to boost your funds.
  5. If you have an employer sponsored HDHP with HSA, you may be eligible for bonus incentives.
  6. You are the owner of your HSA account and your employer can’t take the funds away from you.
  7. HSAs are portable. This means that you can take an HSA with you from one employer to another, or even to self-employment.
  8. You can withdraw funds from HSA accounts in retirement similar to an IRA, without penalty, for any reason, starting at age 65.
  9. HSAs don’t have required minimum distributions at retirement age, like IRAs do.
  10. HSAs can now be used to pay for OTC medications, feminine hygiene and menstrual care products – in addition to all of the previous qualified medical expenses like doctor visits, prescription drugs, and more.

Remember, you must have an HDHP to get access to and then continue contributing to an HSA. For more basics on HSAs, check out the above links and the full IRS HSA guidelines.

The Challenge with HSAs

The challenge with HSAs, however, is that a lot of the big name financial players aren’t in the HSA space. And many administrators have a maze of fees to navigate. If you get stuck with the wrong one, it can be a huge drain on your account balance. As with most things, it definitely pays to shop around. In this article, I will do some of the heavy lifting, to get you started.

The HSA marketplace is still young, but quickly growing. HSAs are fairly new to the health insurance and investing worlds. They weren’t established until 2003. In 2008, only about 6 million Americans had one. But that number has more than quadrupled since, and there are now 28 million HSA accounts in the United States.

HSA accounts can be started with banks, brokers, credit unions, and even insurance companies. Any company that offers an HSA is referred to as an “administrator” or “custodian”. HSAs were originally designed for modest deposits through payroll, followed by frequent small withdrawals. This is why most started and are still administered by banks and credit unions, which makes investing tricky, because most banks and credit unions don’t have their own investing platform. But, the good news is that you are not locked in.

What Criteria to Look for in the Best HSA Account

There are far more HSA account administrators out there than there are IRA account administrators. This makes finding the best HSA account very difficult. Most HSA accounts are through banks and very few of them allow you to invest your savings in anything outside of their own money market accounts, CDs, and other in-house financial products. And with bank rates as low as they have been in recent years, those yields are very small. Unfortunately, most online brokers do not offer an HSA account option.

When it comes down to it, here are the things you should look for when selecting an HSA account:

  1. Debit Card: does the HSA come with a debit card for simple HSA-eligible qualified medical expense tracking? The best HSA accounts do.
  2. Setup Fees: are there setup or opening fees? I would stay away, if so. No HSA accounts with setup or opening fees ranked on this list of top accounts.
  3. Maintenance Fees: are the fees close to zero or very minimal? For a number of years, most HSAs had very high fees, including annual or monthly maintenance fees. Those with high fees will not rank on this list.
  4. Savings, Investment, or Both: Does the HSA have only a save-and-spend savings account, or also an investment account? The top ranking accounts have both. If you can’t invest a portion of your funds in higher yield investments, as you would in a 401K or IRA, your HSA contributions will erode compared to high health care inflation every year. I also want to note that since all HSA accounts have a saving account option, and savings rates at nearly every one of them is close to zero with interest rates being so low at the moment, the proficiency of savings rates did not factor in to my best HSA account ranking at all this year.
  5. Self-Directed Brokerage or Managed Funds: if the HSA offers an investment account, do you only have a small list of managed funds to choose from? A self-directed brokerage account option is preferable here, so you can choose low cost options.
  6. Investment Fees: if the HSA offers an investment option, what are the fees to invest, as well as the ongoing expense ratios of the funds you have to choose from? The lower the fees the better.
  7. Reputation: is the bank, credit union, broker, or other administrator reputable and do they have good customer reviews?

The Best HSA Accounts

Based on the criteria listed above, I’ve ranked my picks for the best HSA accounts below. I think that Lively and Fidelity are a step above the pack in two essential areas: fees and investment options. Both have no maintenance fees, which is a rarity. And both offer a self-directed brokerage account option (Lively through TD Ameritrade and Fidelity through Fidelity). I like that Lively is 100% focused on HSAs – it’s their expertise, whereas HSAs are a new and small part of Fidelity’s overall portfolio. Lively’s website and support is very transparent, detailed, and responsive – a rarity in the HSA space. So I’ve ranked them #1 overall.
Best HSA Account Ranking:HSA Administrator:Monthly Fees:Setup Fees:Other Fees:Investment Options:
1Lively HSA$0NoLively HSA feesTD Ameritrade self-directed brokerage option. $0 commissions for online US stock, ETF, & option trades. Managed option w/ Devenir has 0.5% annual fee.
2Fidelity HSA$0NoFidelity HSA feesFidelity brokerage account. Check out my in-depth look at Fidelity HSA account details. $0 commissions for online US stock, ETF, & option trades.
3Elements Financial HSA$0 if ave. savings balance is $2,500+. $4 if below.NoElements Financial HSA feesInterest dividend based on account balance, or self-directed brokerage option through TD Ameritrade if balance > $2,500. $0 commissions for online US stock, ETF, & option trades.
4HSA Bank$0 if ave. balance is $3,000+, $2.50 if below, for savings account.NoHSA Bank feesSelf-directed through TD Ameritrade. $0 commissions for online US stock, ETF, & option trades. Or, Devinir pre-selected funds (% annual fee invoiced quarterly). For accounts w/ balances > $1,000.
5Further HSA (formerly "Select Account"$1, $3, or $4/mo. options.NoFurther Fees$18 fee per year: Further investment options when balance exceeds $1,000. If balance > $10,000, you can open a self-directed account w/ Schwab.
6Health Equity HSAUp to $3.95 ($0 if combined cash & investment balance > $2,500). NoHealth Equity feesChoice of 23 Vanguard mutual funds. .033% monthly investing admin fee for self-directed.
7Optum Bank HSA$3.75. $0 if ave. savings balance is $5,000+.NoOptum Bank feesChoice of 31 funds or managed portfolio with Betterment.

Can you Switch HSA Accounts? Or have Multiple HSA Accounts?

When I first signed up for an HSA, I wondered how married I would be to a particular HSA account. Could I switch if I didn’t like mine, just like I could with an IRA? Could I have more than one account? I’ve since done a lot of research on this topic.

If you or your employer have picked a poor HSA account admin, the good news is that you are not stuck with them. Just as with IRAs, you can switch if you are not happy with your administrator’s policies and fees. A person contributing to an HSA is under no obligation to contribute to his or her employer-sponsored HSA. And you can contribute to an HSA outside of employer payroll deductions. Employers, however, may require that direct payroll contributions be made only to their sponsored HSA plan.

You can have more than one HSA account. And you can make transfers between accounts if you do not like one. Full HSA transfers or partial HSA fund transfers can be initiated at any time by starting a new account with the HSA provider of your choice.

Best HSA Account Provider Discussion:

  • Who is your current HSA account administrator and what are their fees, policies, and investment options?
  • Have you invested within your HSA account?
  • What is your pick for the best HSA account?

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