The Use of Health Savings Accounts for Health Care in Retirement

This paper examines the savings needed to cover health insurance premiums and out-of-pocket expenses for health care services in retirement and evaluates the use of health savings accounts (HSAs) to save for those expenses. Proponents of HSAs often tout them as a vehicle for funding future retiree health care costs. However, statutory contribution limits mean that they are unlikely to play more than a minor part in savings for health care costs in retirement. If an individual age 55 in 2009 were to contribute $3,000 to his or her HSA and also contribute the $1,000 catch-up contribution each year for 10 years, $48,300 would be in the account after 10 years at a 2 percent interest rate. And if the interest rate was 5 percent, $55,100 would be accumulated at the end of 10 years. Such savings levels by themselves are inadequate to cover health costs in retirement. A man age 55 in 2009 would need between $144,000-$290,000 by the time he reached age 65 in 2019 (depending upon his use of prescription drugs in retirement) to have a 50 percent chance of being able to cover premiums and out-of-pocket expenses for Medigap and Medicare Part D. Thus, a 55-year-old man would be able to use an HSA to accumulate between 16-32 percent of needed savings for insurance premiums and out-of-pocket expenses in retirement for a 50-50 chance of having enough savings. For a 90 percent chance, the maximum HSA savings would cover between 7-16 percent of the necessary savings amount. Women, who live longer than men on average, will need more. The PDF for the above title, published in the April 2010 issue of EBRI Notes, also contains the fulltext of another April 2010 EBRI Notes article abstracted on SSRN: “Tax Expenditures and Employee Benefits: Estimates from the FY 2011 Budget.”