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How to Track Your HSA Spending in a Spreadsheet

Here are a few ways to track your HSA spending with a spreadsheet, plus tips on why it’s so important to keep accurate records.

When people get their first HSA (Health Savings Account) card, they tend to treat it just like a credit card.

They’ll pull it out at the doctor’s office or the pharmacy, use it to pay their bill and never give it a second thought.

Unfortunately, that kind of thinking can quickly get you into trouble.

While HSA cards work in a similar way to traditional credit cards, they come with restrictions that warrant a more careful approach.

If the IRS comes knocking about a purchase you made with your HSA card, you need to be able to prove that it was an eligible medical expense.

That means keeping, storing and tracking your receipts. 

Why You Should Track HSA Contributions and Spending

Your Health Savings Account (HSA) is a powerful financial tool. It’s a tax-advantaged savings account that allows you to save pre-tax money for most medical expenses.

That money will grow tax-free if left in your account, making it a solid investment vehicle as well as a way to fund your medical expenses.

The IRS has strict rules on what you can use an HSA for. Monthly insurance premiums, elective procedures and homeopathic remedies are generally excluded. Prescription medications, lab work and out-of-pocket expenses for doctor’s visits are allowed.

If you use your HSA card for a non-qualified medical expense, you’ll owe income tax on that amount and pay a 20% penalty.

Some people use their HSA card to pay for medical expenses directly with the provider. If they receive a medical bill, they’ll pay for it with their HSA. 

Others pay for medical costs with their bank account, debit or credit card and then reimburse themselves from their HSA. If you prefer the latter method, remember to track your HSA spending closely. 

Tracking your HSA contributions

First, set up automatic transfers from your bank account to your HSA. This will prevent you from saving too much in your HSA.

The HSA annual contribution limits for 2024 are:

  • $4,150 for individuals with self-only coverage
  • $8,300 for family coverage

Additionally, individuals aged 55 or older can contribute an extra $1,000 catch-up contribution.

Some HSA providers automatically track contributions for you and show when you’re getting close to the annual max, but others don’t. 

If you contribute too much to your HSA and don’t notice until tax time, you’ll pay a 6% excise fee on the extra contributions.

You can use the spreadsheets below to log your HSA contributions.

How to track your HSA spending

Tracking your HSA spending can be a hassle, because those funds are kept separate from your regular checking or savings account. It’s easy to forget about your HSA until you need to use it for medical expenses.

But it’s important to track HSA spending just like you would track your credit card balance. If you’re planning on using your HSA for upcoming surgery expenses and forget that your balance has dipped, you’ll be scrambling when the bill comes.

Your HSA provider may have their own tracking system and an easy customer interface.

Some even allow users to upload receipts directly to prove the eligibility of specific expenses.

But for more control, consider using a spreadsheet to log your HSA purchase date, cost, provider, and whether you used HSA funds or another form of payment.

Additionally, make a note if you’re still waiting to be reimbursed for payment.

Automatically track your HSA in a spreadsheet with Tiller

Track Your Annual and Lifetime Medical and HSA Expenses Spreadsheet

Tiller automatically tracks all your finances in Google Sheets and Excel. This includes your HSA account data.

A member of the Tiller Community created a free, Tiller-powered HSA expense tracker template to help you track and manage medical expenses that qualify for HSA reimbursement.

The template automatically pulls all transactions labeled as “HSA Tracking” from your main transaction data, allowing you to maintain a running record of your eligible expenses. The purpose of this workflow is to:

  1. Keep accurate records of your annual and cumulative medical expenses that qualify for HSA reimbursement.
  2. Maintain a running balance of the amount you can legally withdraw from your HSA when needed, especially during early retirement.
  3. Build an additional emergency fund reserve while allowing your invested HSA dollars to continue growing.

See the template here in the Tiller Community.

Use a simple, free Google spreadsheet

HSA Spreadsheet

A Redditor made a great HSA comparison spreadsheet. Read about it here.

Open the spreadsheet in Google Sheets here.

Every HSA provider is different

Unless your HSA is through your employer, you have the option of changing HSA providers any time you want. If your HSA is part of a company benefits package, you’ll have to stick with that provider. That’s when creating your own spreadsheet comes in handy.

Set up a dedicated time each month to go over your HSA.

Look through your medical receipts, check your HSA account and update the spreadsheet. Look ahead to see if you have any upcoming medical expenses you’ll want to pay for with your HSA, and make sure you’ll have the funds to cover the cost.

Zina Kumok

Zina Kumok

Certified Financial Health Counselor, Certified Credit Counselor, and freelance personal finance writer/speaker. I paid off $28,000 of student loans in 3 years. Now, I teach people how to be mindful with their money. ConsciousCoins.com

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