HSA's are nice, depending how they're set up. Some companies offer them instead of providing health insurance. If this is the case, BOO!
My company pays my health/dental/vision insurance (and my kids'). Then, we can participate in the HSA if we choose. With kids, I set aside $150/month for the HSA (it was great to max out during the years my wife was pregnant). Comes out of my paycheck pre-tax. You can buy a lot of things with the HSA account. With ours, we have to submit for reimbursement, but it takes about 2-3 days from submitting to receive reimbursement. But some places, like Walgreen's, breaks out things that generally qualify for HSA accounts separately on a receipt, so it's easy to track. Plus, you can use at the doctor, dentist, chiropractor, etc.
The biggest benefit is that we all spend money on HSA qualifying expenses. For tax purposes, you have to exceed a certain floor tied to your income before you can deduct medical expenses. But the HSA allows you to essentially lower your taxable income. Look at this very plain, basic, calculation:
No HSA: $80K taxed at 30% = $24000 (so if you spend $3K in health care, you spent a total of $27K)
W/ HSA: $80K minus $3K = $77K taxed at 30% = 23100 (so between tax and health care, you spent $26,100)
This is a plain example, but if you spend money on health-related items, you can save yourself a little money. When my second daughter was born, we were on the brink of a tax bracket. We had put just enough money in the HSA to lower my taxable income and get a lower tax rate, so for us, we actually saved quite a bit of money that year.
