Banks, brokerages, and insurers all offer HSAs — your choice depends on what you want to do with the money

You can open a Health Savings Account at a bank, a brokerage firm, an insurance company, or sometimes through your employer's benefits plan. The account itself works the same way regardless of where you open it — you contribute pre-tax money, use it for may have access to medical expenses, and let unused funds roll over year to year. What changes is how much you pay in fees, what investment options you get, and how easy the account is to use day-to-day.

The most common route is through your employer when they offer an HSA-compatible health plan. If your employer doesn't offer one, or if you're self-employed, you'll choose a provider on your own. The decision usually comes down to whether you plan to invest the money or just use it as a checking account for medical bills.

Key Takeaways

  • Banks offer HSAs with low or no fees and easy access to your money, but limited or no investment options.
  • Brokerages let you invest HSA funds in stocks and mutual funds, which can grow the account over time, but typically charge higher fees.
  • Insurance companies often bundle HSAs with their health plans and may waive fees if you use their insurance.
  • Your employer's benefits administrator can tell you which HSA providers are available through your plan, and switching providers later is possible but involves paperwork.
  • Compare annual fees, investment options, and how you'll access the money before choosing a provider.

Opening an HSA through your employer

If your employer offers a high-deductible health plan (HDHP), they typically partner with one or more HSA providers. During open enrollment, you'll see which providers are available and can choose one. Your employer may even contribute to your account as part of your benefits package.

The advantage here is simplicity — payroll deductions happen automatically, and your employer handles the paperwork. You don't have to hunt for a provider or set up contributions yourself. Some employers limit you to a single provider; others let you pick from a list of two or three.

If you leave that job, you keep the HSA and its balance. You can then move the account to a different provider if you want, though the process takes a few weeks and requires paperwork from both the old and new provider.

Banks that offer HSAs

Major banks including Chase, Bank of America, Wells Fargo, and many regional banks offer HSAs. A bank HSA works like a savings account — your money sits there earning minimal interest, and you can withdraw it whenever you need it for medical expenses.

Bank HSAs typically have low annual fees (often $0 to $5) and no investment options. This makes them straightforward if you plan to spend the money on current medical bills rather than save it long-term. You get a debit card or checkbook to pay providers directly, and the account integrates easily with your regular banking.

The trade-off is that your money doesn't grow. If you're young and healthy and expect to have leftover HSA funds at the end of the year, a bank account won't help that money work for you. For someone who uses their HSA primarily as a payment tool for this year's medical costs, a bank is often the cheapest and simplest choice.

Brokerages and investment-focused HSA providers

Firms like Fidelity, Vanguard, Charles Schwab, and Lively offer HSAs with investment options. Once your account balance reaches a certain threshold (often $1,000 to $2,500), you can invest in stocks, bonds, mutual funds, or exchange-traded funds. Any growth in those investments stays in your HSA tax-free as long as you use it for medical expenses.

These accounts typically charge annual fees ranging from $0 to $50 or more, depending on the provider and account balance. Some waive fees if you maintain a minimum balance or use their other services. You'll also pay investment fees if you choose actively managed mutual funds, though index funds and ETFs usually have low costs.

A brokerage HSA makes sense if you're healthy, don't expect to use much of the money this year, and want to build a long-term medical fund. The account can grow for decades, and you only withdraw when you actually need medical care. This is the strategy many people use to turn an HSA into a retirement account.

Insurance companies and HSA administrators

Some health insurance companies offer HSAs directly to their members. UnitedHealthcare, Aetna, and others sometimes bundle an HSA with their HDHP. The advantage is that everything — your insurance and your HSA — is in one place, and the insurer may waive HSA fees if you're enrolled in their plan.

Insurance-based HSAs are usually basic accounts without investment options, similar to a bank HSA. They work well if you want simplicity and your insurer offers competitive fees. However, you're locked into using that provider's HSA as long as you have their insurance, though you can move the account elsewhere if you switch insurers.

Third-party HSA administrators

Companies like HealthEquity, Conduent, and WageWorks specialize in managing HSAs for employers and individuals. These are often the providers your employer contracts with, even if you don't see the company name prominently. They typically offer both basic savings accounts and investment options, with fees that vary widely.

If you're opening an HSA on your own (not through an employer), you may find these companies by searching for "HSA providers" or by asking your health insurance company which administrators they work with. Many of them have user-friendly apps and clear fee structures, making it easy to compare before you open an account.

How to compare HSA providers

Before opening an account, write down what matters to you. If you plan to spend your HSA balance each year on current medical bills, prioritize low fees and easy access to your money — a bank is probably your best choice. If you're saving for future medical costs or retirement, look at investment options and long-term fee structure.

Check the annual maintenance fee, any per-transaction fees, and whether there are fees to invest or transfer money. Ask whether the provider charges to close the account or move your balance elsewhere. Some providers waive fees if you maintain a certain balance or set up automatic contributions.

Look at how you'll access your money. Do they offer a debit card? Can you pay providers directly, or do you have to withdraw and pay yourself? How long does it take to get money out if you need it quickly? These practical details matter more than you might think when you're paying a medical bill.

Moving your HSA to a different provider

You're not locked into your first choice. If you open an HSA at one bank and later want to move it to a brokerage to invest, you can do that. The process is called a trustee-to-trustee transfer, and it's tax-free as long as the money goes directly from one HSA provider to another.

Contact the new provider and ask them to initiate the transfer. They'll handle most of the paperwork and coordinate with your old provider. The process typically takes two to four weeks. Avoid withdrawing the money yourself and depositing it in a new account — that counts as a distribution and can trigger taxes and penalties if you don't follow strict rules.

You can make trustee-to-trustee transfers as often as you want, though doing it multiple times a year may be impractical. Most people open an account, use it for several years, and only switch if fees become unreasonable or their needs change significantly.

Frequently Asked Questions

Can I open an HSA if my employer doesn't offer one?

Yes. You can open an HSA on your own as long as you're enrolled in a high-deductible health plan, whether through the individual market, a spouse's employer, or a self-employed plan. Contact banks, brokerages, or insurance companies directly, or search for "HSA providers" to find options in your area.

Do I have to use the HSA provider my employer chose?

During open enrollment, you can usually choose from the providers your employer offers. If your employer contracts with only one provider, you're limited to that one while you work there. After you leave the job, you can move the account to a different provider.

What happens to my HSA if I change jobs?

Your HSA stays yours. The balance and the account don't disappear. You can leave it where it is, or you can move it to a new provider through a trustee-to-trustee transfer. Your new employer may offer a different HSA provider, but you're not required to use it — you can keep your existing account.

Should I invest my HSA or keep it in savings?

It depends on your timeline and health. If you expect to use the money within a year or two, a savings account is simpler and safer. If you're young, healthy, and don't anticipate major medical expenses, investing can help the account grow over decades. Many people do both — keep a year's worth of expected medical costs in savings and invest the rest.

Are there HSA providers that don't charge fees?

Some banks offer HSAs with no annual fee, though they may charge per-transaction fees or require a minimum balance. Brokerages sometimes waive annual fees if you maintain a high balance or use their other services. Read the fee schedule carefully before opening an account, as "no fee" from one provider might mean something different than from another.