Before I always thought HSA is savings account, but recently I saw some banks providing HSA Checking.

What is the difference between HSA and HSA Checking account?

Are HSA and HSA Checking having save benefits? Is the only difference just one is savings and one is checking account? Thanks

2 Answers 2


“HSA Checking” is just an HSA account with a checkbook attached to it.

All the same HSA spending rules apply, whether or not your HSA has a checkbook. The checkbook just gives you another way to make payments with your account.

The HSA that I have with my credit union features checks, a debit card, and online bill pay. I can use any of these to make payments with my HSA funds, and the credit union does not require any receipts for my purchases. They report how much I spent out of the account to the IRS, and it is up to me to certify on my tax return whether or not all of those funds were used for qualified medical expenses.

Some HSA banks/custodians take it upon themselves to ensure you are spending the money correctly by requiring receipts for reimbursement. Those HSA accounts might not have a checkbook available as an option.


An HSA account can be operated and accessed like a checking account.

The HSA account I have been using has a debit card. I can use it only a specific types of vendors. This makes it easy to pay co-pays and to pay for prescriptions.

The website can also be used to pay providers. I find this works best If the amount of the bill isn't known until after the insurance company processes the bill.

I can also use the website to pay me back, if I don't use the debit card to pay a medical bill. This involves more paperwork becasue the HSA custodian wants me to submit the Explanation of Benefits (EOB) from the insurance company.

The HSA custodian I use doesn't have a checkbook option. I have found the other two options (debit card and website) meet my needs.

The system connected to the debit card is supposed to not allow you to use the card at non-medcial vendors. It also can be used at pharmacies. The record keeping of the system, along with these restrictions allows me to know that I have only used it for allowable expenses. I don't think the checkbook provides that benefit.

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