HSA and FSA Open Enrollment 2027: Dates, Limits, and How to Choose

Open enrollment for 2027 health coverage starts November 1, 2026.

It's also when most people decide whether to use a Health Savings Account (HSA) or Flexible Spending Account (FSA) next year, and how much to put in.

This guide covers the 2027 open enrollment dates, the 2027 contribution limits, and how to decide between an HSA and an FSA.

What are HSAs and FSAs?

Health Savings Accounts and Flexible Spending Accounts are tax-advantaged savings accounts that help you to pay for healthcare expenses, including some that insurance might not cover. You can think of them as a complementary healthcare fund that lets you put money away for out-of-pocket medical fees while also reducing your taxable income.

You can use either account for qualified medical expenses as defined by the IRS, such as copays, deductibles, prescriptions, and many dental and vision costs. For longer lists, see our HSA eligible items list and FSA eligible items list.

Tax advantages of HSAs and FSAs

These specialty savings accounts are tax-advantaged which means that you don’t pay taxes for money you put in or take out (as long as it’s for a qualified medical expense).

Contributions also lower your taxable income for the year, whether or not you spend the money right away.

How Do You Open an HSA and FSA?

There are different requirements to open an HSA vs. an FSA, which we’ll review below.

Open enrollment period: What to know

For 2027 coverage, HealthCare.gov open enrollment runs from November 1, 2026, to January 15, 2027. Enroll by December 15 if you want coverage to start January 1. State-based marketplaces can set different dates.

If you use the Health Insurance Marketplace to find healthcare coverage — whether via HealthCare.gov or your state-based marketplace — this is when you can re-enroll or make changes to your existing plan, or sign up for a new plan.

If you get insurance from your employer, your employer sets the enrollment window, usually a few weeks in the fall. That's also when you elect an FSA and set up payroll contributions to an HSA.

Opening an HSA

To contribute to an HSA, you need to be covered by an HSA-eligible health plan and have no other disqualifying coverage. Traditionally that means a high-deductible health plan (HDHP); for 2027, an HDHP must have a deductible of at least $1,750 for self-only coverage or $3,500 for family coverage. Starting in 2026, bronze and catastrophic plans also count as HSA-eligible; our guide to the 2026 HSA eligibility expansion explains the details.

HDHPs usually have lower premiums and higher deductibles, and an HSA lets you set aside pre-tax money for the costs you pay before the deductible is met. Our PPO vs HDHP guide compares the two kinds of plans.

Once you're covered by an HSA-eligible plan, you can open an account. Some employers will offer an HSA (and potentially help contribute to it), or you can open one on your own. You can look at various HSA providers (such as Lively, HealthEquity, or Fidelity), see if your health insurance company recommends one via a partner, or even ask your bank.

You can open an HSA at any time of year, but you can only contribute for months when you're covered by an HSA-eligible plan.

Opening an FSA

FSAs are employer-sponsored benefit plans, so your employer must offer one (you can't open an FSA on your own). Unlike an HSA, an FSA doesn't require a high-deductible health plan, but you generally have to sign up during your employer's open enrollment or after a qualifying life event.

Contribution limits for 2027

Part of the process for opening an account means choosing your contribution amount for the upcoming year.

HSA contribution limits:

For 2027, you can contribute up to $4,500 with self-only coverage or $9,000 with family coverage, according to IRS Revenue Procedure 2026-24. If you're 55 or older, you can add a $1,000 catch-up contribution.

Note that you can choose to contribute however and whenever you want. Some may make a lump sum contribution while others choose to make recurring contributions throughout the year (employers may even offer an option to have it automatically taken out of your paycheck).

Can you change your HSA contribution at any time?

Unlike an FSA election, an HSA payroll contribution can be changed during the year. Employers generally let you change it at least once a month.

FSA contribution limits:

The health FSA limit is $3,400 for 2026. The IRS hasn't announced the 2027 limit yet, and we'll update this guide when it does. If your plan allows a carryover, up to $680 of unused 2026 money can roll into 2027 (IRS Revenue Procedure 2025-32).

Typically, you have to designate how much you will contribute when you sign up for your plan with your employer and you cannot change the amount.

There are some exceptions if you experience a qualifying event. These include a change in marital status, number of dependents, or employment, and other cases that may be outlined in your specific FSA plan.

What to Think about When Choosing an HSA or FSA

Once you are qualified for an HSA or FSA, there are other considerations to be mindful of:

• An HSA doesn't mix with a general-purpose FSA: being covered by a general-purpose health FSA, including a spouse's, makes you ineligible to contribute to an HSA. A limited-purpose FSA, which typically covers dental and vision costs, can be paired with an HSA (IRS Publication 969).
• Does your employer contribute? Some employers add money to your HSA or FSA, so check before you decide how much to contribute yourself.
• Fees: Some HSAs may charge for things like opening or closing the account or have a monthly maintenance fee.
• Banking options and features: Debit cards are common, but not guaranteed. Other services like online banking or an app are other things to consider.
• Deposits: How will you make pre-tax deposits? This can vary between providers.
• Investment options (if you have an HSA): Some providers offer this as a built-in service.
• Rollovers, carryovers, and grace periods: HSA money rolls over every year. FSAs have a use-it-or-lose-it rule, though your plan may offer a carryover (up to $680 into 2027) or a grace period of up to 2.5 months, but not both.

Key differences between an HSA and FSA

There are a few important distinctions between Health Savings Accounts and Flexible Spending Accounts, namely who owns the account and whether money rolls over into the next plan year.

This table helps highlight some of the key differences:

How to Make the Most of Your HSA or FSA in 2027

It pays, or rather, saves, to plan ahead when it comes to your HSA or FSA. Here are a few things to keep in mind when thinking about the year ahead (or beyond).

Use-it-or-lose-it deadlines

FSAs come with a use-it-or-lose-it rule: money you don't spend by the end of the plan year (often December 31) is forfeited unless your plan offers a carryover or grace period. Our guide to FSA use-it-or-lose-it rules covers the deadlines. Choosing your election carefully is the best way to avoid losing money.

Plan ahead

Historically, when it came to health insurance, most people would look at their past year’s spending at the doctor’s office, or think about any surgeries or specialists they may need in the coming year, and choose health insurance accordingly. If you were of a certain age and certain health, you could reasonably estimate what your upcoming healthcare costs might be, but you were limited to what your insurance covers.

A practical starting point: add up what you spent out of pocket this year on copays, prescriptions, dental, and vision, then adjust for anything you know is coming, like a planned procedure or new glasses. Our HSA eligible items list and FSA eligible items list cover what generally counts as a qualified medical expense.

Build a healthcare safety net

Because HSA money never expires, many people keep part of their balance as a cushion for unexpected medical bills. An FSA works differently: you choose the amount up front, so base it on costs you expect.

Reduce your annual tax bill

Because money you put into your accounts is pre-tax, it lowers your overall taxable income at the end of the year. That means that by contributing you will pay less taxes no matter what, and you may even be able to move into a lower tax bracket, depending on your income and how much you contribute.

Consider investing

Unlike an FSA, an HSA can be invested once your balance passes your provider's minimum. Many people build their HSA over a career and use it for healthcare costs in retirement. Our guide to investing HSA funds explains how it works.

Delay reimbursement

Again, HSAs provide a useful way to offset future costs. To begin, you are permitted to take a distribution from your HSA at any time according to the IRS. This means that you can pay-out-of-pocket today, invest your HSA, let it grow over the years, and then reimburse yourself years later for the qualified medical expense (as long as you have the receipts).

Avoid using funds for nonqualified expenses

This is a big one.

If you use HSA money for non-qualified expenses before age 65, you'll owe income tax on the withdrawal plus a 20% penalty. An FSA can only reimburse qualified expenses, so this penalty is an HSA rule.

After you turn 65, HSA withdrawals for qualified medical expenses are still tax-free. Withdrawals for anything else are taxed as income, but the 20% penalty no longer applies.

Make Your 2027 Elections With a Plan

Open enrollment is the one time of year most people can set their FSA election, so it's worth a few minutes: compare your 2027 plan options, estimate your out-of-pocket costs, and pick an amount you're confident you'll use. For a side-by-side comparison of the two accounts, see HSA vs FSA.