Can You Have Both an FSA and HSA at the Same Time?

You can have both an FSA and HSA, but only under specific conditions that depend on the type of FSA and your HSA coverage

The short answer is yes — but with real limits. If you have a limited-purpose FSA (also called a dental and vision FSA), you can pair it with an HSA without breaking any rules. If you have a general-purpose FSA that covers medical expenses, you cannot have an HSA in the same year. The IRS treats these as conflicting accounts because they both let you set aside pre-tax money for health costs, and the rules prevent you from double-dipping.

The reason matters: an HSA requires you to be enrolled in a high-deductible health plan (HDHP), and a general-purpose FSA is considered "other health coverage" that disqualifies you from HSA may be able to access. A limited-purpose FSA, by contrast, only covers dental, vision, and sometimes hearing — expenses that fall outside the HSA rules — so it does not conflict.

Key Takeaways

A limited-purpose FSA (dental and vision only) can be held alongside an HSA without violating IRS rules.
A general-purpose FSA that covers medical, prescription, or other health expenses makes you ineligible for an HSA in that same year.
HSA may be able to access requires enrollment in an HDHP, and having other health coverage — including a general-purpose FSA — blocks that may be able to access.
If you switch from a general-purpose FSA to an HSA, you must wait until the next plan year or confirm your FSA balance is zero before opening the HSA.

What counts as a limited-purpose FSA

A limited-purpose FSA restricts what you can spend money on. The account covers dental work (cleanings, fillings, root canals, orthodontics), vision care (eye exams, glasses, contact lenses), and in some plans, hearing aids and hearing exams. It does not cover medical office visits, prescription drugs, or other health expenses.

Check your plan documents or call your employer's benefits administrator to confirm whether your FSA is limited-purpose or general-purpose. The distinction is not always obvious from the plan name alone. Some employers offer both types — a limited-purpose FSA for dental and vision, plus a separate general-purpose FSA — and you would need to know which one you are enrolled in.

If your FSA covers anything beyond dental, vision, and hearing, it is a general-purpose FSA, and you cannot hold an HSA at the same time.

Why a general-purpose FSA blocks HSA may be able to access

The IRS defines HSA may be able to access narrowly: you must be covered by an HDHP and have no other health coverage. A general-purpose FSA counts as "other health coverage" because it pays for medical expenses that an HDHP would otherwise cover. The IRS sees this as a way to avoid the whole point of an HDHP — which is to pair high deductibles with tax-advantaged savings.

If you try to open an HSA while holding a general-purpose FSA, you will either be denied by the HSA provider or, if the error goes unnoticed, you could face tax penalties when the IRS audits your return. The penalty is not small: you would owe income tax plus a 20 percent penalty on any HSA contributions made while ineligible.

This rule applies even if your FSA balance is zero. The account itself — not the money in it — is what matters. You must actually close or terminate the general-purpose FSA before you can open an HSA.

Switching from a general-purpose FSA to an HSA

If you currently have a general-purpose FSA and want to open an HSA, you have two paths. The first is to wait until the next plan year. Most FSAs run on a calendar year (January through December), so if you want to switch, you would need to decline the general-purpose FSA during open enrollment and enroll in an HDHP instead. Then, starting January 1 of the following year, you become HSA-may be able to access.

The second path is a mid-year change if you have a may have access to life event — marriage, divorce, birth of a child, loss of coverage, or a change in employment. You can drop the general-purpose FSA and enroll in an HDHP immediately, which makes you HSA-may be able to access right away. Some employers also allow you to make changes if your FSA plan is being discontinued.

Do not try to close an FSA and open an HSA in the same month without confirming the timing with your benefits administrator. FSAs have a run-out period (usually 60 to 90 days after the plan year ends) during which you can still submit claims for expenses incurred during the plan year. If claims are still pending, the account is technically not closed, and you may not be HSA-may be able to access yet.

How to use an HSA and limited-purpose FSA together

If you have an HDHP and a limited-purpose FSA, you can contribute to both in the same year. The money is separate: FSA funds go to dental, vision, and hearing expenses; HSA funds can go to any may have access to medical expense, including your HDHP deductible, copays, prescriptions, and medical equipment.

This combination is actually efficient because it lets you set aside pre-tax money for two different categories of health spending. You might contribute $2,500 to your HSA for general medical costs and $1,500 to your limited-purpose FSA for dental work, for example. Both reduce your taxable income.

One thing to watch: if your limited-purpose FSA covers dental and vision, and you use HSA money to pay for dental or vision expenses, you cannot then reimburse yourself from the FSA for the same expense. Each dollar of expense can only be paid once, from one account. Track which account you used for which expense to avoid this mistake.

What happens to FSA money if you switch to an HSA

FSA money does not roll over to an HSA. If you have a balance in a general-purpose FSA when you leave that plan, you lose it — this is called the "use-it-or-lose-it" rule. You cannot transfer the balance to an HSA or carry it forward to next year (with rare exceptions for certain employers).

This is one reason to plan ahead if you are thinking about switching. Spend down your FSA balance before the plan year ends, or make sure you have submitted all claims before you drop the plan. If you have a limited-purpose FSA and you are keeping it while opening an HSA, the same rule applies — the limited-purpose FSA balance stays in that account and does not move to the HSA.

Some employers offer a grace period (usually 2.5 months into the next year) during which you can still submit claims for the previous year's FSA expenses. Check your plan documents to see if this applies to you.

Frequently Asked Questions

Can I have a dependent care FSA and an HSA?

Yes. A dependent care FSA (used for childcare or adult care expenses) does not conflict with HSA may be able to access because it is not considered health coverage. You can hold both at the same time without any IRS restrictions.

What if my employer offers both an FSA and an HSA option?

Your employer may offer both, but you still cannot enroll in both if one is a general-purpose FSA. You have to choose: either the general-purpose FSA or the HSA. If a limited-purpose FSA is available, you can take that and the HSA together.

Can I move money from my FSA to my HSA?

No. FSA and HSA are separate accounts with separate rules. Money cannot be transferred between them. You must spend FSA money on FSA-may be able to access expenses and HSA money on HSA-may be able to access expenses.

What if I did not know I was ineligible and opened an HSA with a general-purpose FSA?

Contact your HSA provider and your benefits administrator immediately. You may be able to close the HSA and withdraw your contributions before tax time. If you have already filed taxes claiming HSA contributions you were not may be able to access to make, you should file an amended return to avoid penalties.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.