L1 visa: HSA account vs 401k plan

Question

I have recently relocated to USA. I am currently trying to figure out my options regarding my savings. My understanding is that I can contribute up to $18500 into 401k and up to $6750 into HSA. My employer would contribute a flat amount into both accounts.

I have in mind a certain overall budget that I want to save, I am thinking about the allocation between HSA and 401k. But there is catch: it is likely that I return back to my home country in a couple of years.

So the question is what happens to HSA account (I am clear about 401k)? Initially, I thought I could use the HSA account for eligible costs in my home country, but after reading several articles I am somehow confused.

Are there any official references on the subject?

Answer 1

It is my understanding that the money in the HSA is yours to keep forever, even if you leave the country.

When you leave the country and no longer have an HSA-eligible High Deductible Health Plan, you will no longer be able to contribute new money to your HSA. However, you can still spend the money on eligible medical expenses, even if these expenses are outside the U.S. However, there are a few caveats:

1. The HSA money will remain in a U.S. HSA bank account. You won't be able to transfer the entire account to a new account in your home country without paying taxes and penalty. Therefore, you need to have a mechanism for accessing and transferring the money from abroad, so that you can reimburse yourself as you have medical expenses, until the HSA account is empty.

2. Even after you leave the U.S., as long as you have the HSA in place, you will need to file a U.S. tax return (form 1040NR) in any year that you have an HSA distribution.

3. If you decide to take the money out without medical expenses, you will need to pay income tax on the money plus a 20% penalty.

See How do I withdraw all money from my HSA account as a non-resident? for more information.