Lively Releases 2018 Data Showing HSAs Used for Short-Term Fixes, Not Long-Term Savings

While HSAs are a vehicle for smart savings, rising costs leave many at risk of paying out-of-pocket for emergencies and hospital visits

SAN FRANCISCO--()--Lively, Inc., creators of the modern Health Savings Account (HSA), today released its first annual HSA Spend Report, giving a view into the healthcare expenses that cost consumers the most each year. Findings show that the average HSA account holder will spend 93 percent of their savings on everyday healthcare costs: doctor visits and services (41 percent); prescription drug costs (25 percent); dental care (9 percent); vision and eyewear (5 percent); chiropractor (5 percent); lab work (4 percent); and other (4 percent). This leaves only 7 percent of HSA savings to cover the cost of expensive emergency and hospital visits. This trend indicates that people are unable to achieve the long-term benefits of investing HSA assets for the expected $280,000 in health costs in retirement (per couple, on top of Medicare coverage).

“Healthcare costs continue to squeeze Americans, rising faster than wages can keep up,” said Alex Cyriac, Co-Founder and CEO of Lively. “This forces individuals and families to use their HSA funds for everyday necessities - like preventative visits, dental or vision care, and prescription drugs - rather than saving those funds to create a safety net for healthcare costs down the road and into retirement.”

Other trends to note include:

  • HSA funds are primarily being used to pay for rising household healthcare expenses. Personal household out-of-pocket healthcare expenses continue to increase and outpace inflation, causing these costs to grow each year as a percentage share of personal household expenses (37 percent according to the Centers for Medicare & Medicaid Services).
  • Short-term costs limit long-term benefits. While HSAs have clear short and long-term tax advantages, rising healthcare costs are forcing HSA account holders to use more of their funds for expected expenses each year, rather than saving them for later use.
  • Where did the money go? Physician and clinical services were the primary use of HSA funds in 2018 (41 percent), followed by prescription drugs (25 percent), then hospital expenses (7 percent).

“HSAs are the last lifeline in a sea of rising healthcare costs,” said Shobin Uralil, COO and Co-Founder of Lively. “We predict that every health plan will eventually evolve into a High Deductible Health Plan, and our goal is to educate people about their need to couple that health plan with an HSA - and how to use it to its full advantage. Our look into last year’s data shows us that people are just trying to stay afloat.”

“Increasing HSA contribution limits, expanding HSA eligible expenses, and letting more Americans take advantage of HSAs would help put more savings into the pockets of people across the country and further reduce the financial burden of ever-growing healthcare costs,” continued Uralil.

2018 HSA Spend Report Methodology

Lively collected anonymous data from 15,000 randomly selected Lively users who held an HSA account in 2018. This includes accounts with active contributions and ones without. To classify the types of health goods or services that were purchased, HSA debit card spending from January to December 2018 was categorized with Merchant Category Codes (MCCs). No demographic or personal information was provided or used to create these cohorts. As such, any demographic details are based on post-data collection analysis.

About Lively

Lively is a modern Health Savings Account (HSA) platform for employers and individuals. Lively’s user-centric solution creates an intuitive user experience allowing consumers to get the most out of their HSA. Lively HSAs work alongside HSA compatible plans to make healthcare easier for everyone. Lively was started to help consumers optimize their healthcare spending, maximize their savings, and better their livelihood. Lively is headquartered in San Francisco, CA. For more information please visit or follow us on Twitter (@LivelyHSA).


Jennifer Parson



Jennifer Parson