What is a Self-Directed HSA?

A Self-Directed Health Savings Account (HSA) is a Health Savings Account administered by a custodian that allows the account to invest in alternative assets beyond the stocks, bonds, mutual funds, and ETFs typically offered by traditional HSA providers.

 

Like any HSA, a Self-Directed HSA offers valuable tax advantages. Contributions may be tax-deductible, investment earnings grow tax-free, and withdrawals used for qualified medical expenses are tax-free. The difference is that a Self-Directed HSA allows account holders to invest those funds into a much broader range of assets allowed by law.

 

With a Self-Directed HSA at Directed IRA, account holders may invest in assets such as real estate, private lending, private funds, cryptocurrency, precious metals, private companies, and more.

 

 

Why Haven’t You Heard of Self-Directed HSAs?

Most Health Savings Account providers limit investments to publicly traded assets such as mutual funds, ETFs, and other market-based investments. These providers generally do not administer alternative assets like real estate or private investments.

 

The ability to self-direct an HSA has existed for years, but many investors are simply unaware that they can move their HSA to a custodian that allows alternative investments.


A Self-Directed HSA is not a different type of HSA. It is simply an HSA held with a custodian whose administrative policies allow investments beyond traditional market securities.

 

How Does a Self-Directed HSA Work?

The account holder identifies the investment and directs the custodian to complete the transaction on behalf of the HSA.

Just like a Self-Directed IRA, the HSA—not the individual—owns the investment.


Income generated from the investment returns to the HSA, and expenses related to the investment are generally paid from HSA funds. The custodian administers the account but does not select investments or provide investment advice.

 

What Are the Tax Benefits of a Self-Directed HSA?

Health Savings Accounts are often referred to as having a triple tax advantage because they provide three separate tax benefits.

  • Contributions may be tax-deductible.
  • Investment earnings grow tax-free.
  • Withdrawals used for qualified medical expenses are tax-free.

 

Unlike Flexible Spending Accounts (FSAs), unused HSA funds remain in the account from year to year and can continue to be invested for future healthcare expenses.

 

Who Can Open and Contribute to a Self-Directed HSA?

To make new contributions to an HSA, you generally must:

  • Be covered by a qualified High-Deductible Health Plan (HDHP).
  • Have no disqualifying health coverage.
  • Not be enrolled in Medicare.
  • Not be claimed as someone else’s dependent.

 

Even if you are no longer eligible to make new contributions, you generally may continue to own, transfer, and invest the funds already held in your HSA.


What Can a Self-Directed HSA Invest In?

A Self-Directed HSA can invest in many of the same alternative assets available to Self-Directed IRAs, including:

  • Real Estate
  • Private Lending
  • Private Equity
  • Private Funds
  • Cryptocurrency
  • Precious Metals
  • Promissory Notes
  • Tax Liens
  • Limited Partnerships
  • LLC Interests

 

As with any self-directed retirement account, the investment must be administratively accepted by the custodian and comply with applicable law.


Does the HSA Own the Investment?

Yes.


The investment is owned by the Health Savings Account—not by the account holder personally.

For example, if your HSA purchases a rental property, the property is titled in the name of the HSA. Rental income is deposited back into the HSA, and investment expenses are generally paid from HSA funds.


This separation between the account holder and the account’s investments is an important part of properly administering a Self-Directed HSA.

Can a Self-Directed HSA Invest in Real Estate?

Yes.


Many account holders use Self-Directed HSAs to purchase rental property, raw land, private real estate funds, real estate syndications, trust deeds, and other real estate-related investments.


Like other alternative assets, the investment must be properly titled and administered through the HSA.


Can a Self-Directed HSA Invest in Cryptocurrency?

Yes.

A Self-Directed HSA can invest in cryptocurrency when administered through a custodian that permits digital asset investments.


As with any investment, the HSA—not the individual—owns the cryptocurrency.


Can a Self-Directed HSA Invest in Private Funds or Private Companies?

Yes.

A Self-Directed HSA may invest in private companies, venture capital funds, private equity funds, limited partnerships, LLC interests, and other privately held investments.


Before investing, account holders should understand the investment’s structure, liquidity, valuation requirements, and ongoing reporting obligations.

 

Directed IRA serves as the custodian and does not evaluate or recommend investments.


What Can HSA Funds Be Used For?

HSA funds may be withdrawn tax-free when used for qualified medical expenses as defined by the IRS.


Withdrawals used for non-qualified expenses are generally taxable and may be subject to an additional tax if taken before age 65.


After age 65, non-qualified withdrawals generally become taxable but are no longer subject to the additional HSA penalty.


Can I Transfer My Existing HSA?

Yes.

If your current HSA provider does not allow alternative investments, you may transfer your existing HSA to a Self-Directed HSA custodian.


A transfer allows you to continue using your HSA while expanding the investment options available within the account.


Common Mistakes to Avoid

When using a Self-Directed HSA, account holders should avoid:

  • Titling investments in their personal name instead of the HSA.
  • Paying investment expenses personally.
  • Depositing investment income into a personal bank account.
  • Assuming every investment can be accepted by every custodian.
  • Failing to maintain documentation supporting annual valuations.
  • Investing funds that may be needed for near-term medical expenses without maintaining sufficient liquidity.


Is a Self-Directed HSA Right for You?

A Self-Directed HSA may be appropriate for individuals who:

  • Want to invest healthcare savings beyond publicly traded securities.
  • Have accumulated HSA funds they do not expect to use immediately.
  • Understand alternative investments or work with professionals who do.
  • Want to combine the tax advantages of an HSA with greater investment flexibility.


Ready to Open a Self-Directed HSA?

If you’re ready to invest your Health Savings Account beyond traditional investments, Directed IRA can help.


A Self-Directed HSA allows eligible account holders to invest in alternative assets while maintaining the tax advantages offered by an HSA.


Open a Self-Directed HSA or book a call with a Self-Directed IRA Specialist to learn more.

 

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Self-Directed IRA Getting Started Resources

New to self-directed retirement accounts? These resources are designed to help you understand the fundamentals and get started the right way.

 

Access curated webinars, guides, and educational content covering investment options, account structures, and the rules that govern self-directed IRAs.

 

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