HSA funds continue growing so long as you aren't using them. If you're healthy and actually middle class or better they act as a 3rd retirement vehicle, since after 65 you can use it for whatever and they don't penalize you.
Of course, it's not a massive menu of investment options but it has all the basics like SP500, target date funds, bond funds, dividend funds, etc. The cash portion, and it is literally called a savings account, is really bad rate, this 0.05% rate is really good compared to mine 😂. For my plan you have to keep at least $1000 in the savings account before you can invest.
Exactly this, they're best used as a tax free investment account rather than anything health related. If you're on a plan with high enough a deductable to be eligible for an HSA and can afford it you should max out your HSA contributions before even a penny of unmatched 401k contributions. Personally I'd argue that you're better off maxing out the HSA and using post-tax money to pay medical expenses unless close to the end of your career. It's one of it not the single most easily taken advantage of ways to not pay tax at all on a long term investment.
The system is indeed stupid but the least you can do is take advantage of it where possible and for the middle class the HSA is one of the best ways.
Once you hit 65, you can withdraw HSA funds for any purpose, tax free, like a Roth IRA. 401k withdrawals will be taxed as ordinary income, so an HSA dollar is worth about $1.20 in a 401k.
You know, I can look up the definitions of HSA and FSA and things like that, and I can have the definitions right there in a document on my screen, but they still don't make any sense to me in terms of how they relate to me specifically. A lot of times they seem like they depend on me predicting things in the future that are unknowable, like my future health or how and where I will be billed for something. And that's assuming I also look up related terms like APY and deductible and figure out what those mean. If I ask any HR people they're like "just contact the provider for an explanation" and I'm like yeah, I totally want to deal with the phone menus and hold times of some faceless corporation, just to have them pull some BS like OP's talking about.
Sorry about the rant. I guess that's what I find mildly infuriating.
FSAs do depend on you kinda predicting or hedging bets against your own health since they only last the year. You can also use them to buy certain health/exercise equipment though.
HSAs can often be invested (in stock market) thus act like an IRA with extra tax avoidance if you manage not to use it for long enough. It's counter to the stated purpose but it's basically better to not withdraw or reimburse from it unless you need to.
Deductibles are Deductibles. How much you have to pay before insurance "kicks in". There are per visit deductibles and yearly deductibles which are as they sound. HSAs are only available to plans with high deductibles. FSAs are available to plans that aren't just high deductible.