S.R.
We used one on a high deductible plan, we even got visa debit cards that we could use for payments. I'll see how the taxes go next week but it one way it is similar to an IRA. If you don't use it for medical then it can be an IRA down the road. With that said, if you put money in an HSA and withdraw money for something other than medical you will get taxed like you are doing an early withdrawal on a 401k or IRA. The nice thing is you don't lose it at the end of the year like you would on a Flexible Spending Account that you can get through a regular employer so its a great long term savings plan that you can use for medical as needed. Hope that helps.