Categories
Expenses Investing

Investing An HSA: Our Retirement Healthcare Fund

BLUF: Retirement healthcare expenses add up over your lifetime. Saving and investing all HSA funds before retirement gives you a large pot of money to cover many of those retirement healthcare expenses.

I’ve written previously about how powerful Health Savings Accounts (HSA) can be as a quadruple tax advantaged account. Given that you can save into an HSA with pre-tax money and then spend that money tax free on medical expenses, why wouldn’t you spend that HSA money today?

I’m looking to play the LONG game. Medical expenses as we age are one of the largest expected spending categories. In this article I’m going to help you understand some average costs for healthcare in retirement and some ways to use the HSA to cover those future costs. I’ll show you our plan to save in our HSA’s, invest and NOT spend them until retirement to cover those healthcare expenses.

Healthcare Costs In Retirement

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Note: all data in this section is from this HealthView Services report.

In the US paying for healthcare is one of the biggest threats to wealth building during our accumulation phase and preservation in retirement.

It’s a cost that’s hard to anticipate and plan for when you’re young. You’re likely in good health and expensive situations are infrequent. You don’t need a large line item in your budget to cover those expenses. As a 41 year old I had a number of procedures last year to investigate a GI issue and it cost me $3,150 out of pocket on our HDHP.

When it comes to premiums, they’re probably fairly affordable when covered by an employer sponsored plan. I’m fortunate that it only costs me about $100/mo for medical, vision and dental premiums and my company subsidizes the rest.

As you can see below, it can be rude awakening when transitioning from an employer sponsored plan to Medicare where you are 100% responsible for the premiums.

Average Healthcare Premium Cost Comparison of 64-Year-Old Couple (Pre-Retirement)
to 65-Year-Old Couple (In-Retirement)
**Medicare Parts B and D, and supplemental insurance Plan G.
Source – Table B

For a healthy 65 year old couple retiring in 2020, they’re projected to live until 87 (male) and 89 (female) and spend $387,644 in healthcare costs over their lifetimes NOT including long term care costs. Those costs include:

  • Premiums for Medicare Parts B and D, supplemental insurance (Mediagap), and dental insurance
  • Out-of-pocket costsrelated to hospitalization, doctor visits, tests, prescriptions drugs, hearing services, hearing aids, vision, and dental.

In 2020 dollars, this means that 65 year old couple would spend the following per year on healthcare.

Future Annual Healthcare costs per year for a healthy 65 retired couple.
Source: http://testing.hvsfinancial.com/hvsfinancial/wp-content/uploads/2020/03/Health-in-Retirement-Planning.pdf

This is all driven by 4.41% healthcare inflation costs per year in addition to you just needing more care as you age.

In a sick twist, the healthier you are, the more money you’ll need for healthcare in retirement. Why? Look at an example between a healthy 55 year old woman and one with type 2 diabetes. The diabetic pays more per year but because her life expectancy is 9 years shorter her lifetime healthcare costs are $266k compared with $424k. Yikes!

Building That HSA Money Machine For Retirement

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Now that I’ve sufficiently scared you (sorry) with this future costs to plan for, it’s time to discuss some ways that an HSA can be used to cover these future expenses

Spend HSA Money On Current Medical Expenses

This is the most common way that an HSA is used. Similar to how people use a flexible spending account that doesn’t carry over year to year, many people use an HSA to pay for medical expenses on demand. Money goes in pre-tax and you can use it to pay your medical expenses tax free.

There’s nothing wrong with this approach. You get the tax savings of funding with pretax money and paying the expenses tax free. However, you’re effectively using the HSA like a checking account. Your money isn’t making you any additional money to pay for future expenses.

Let’s create an example where you have a 40 year old couple that just started their HSA’s with $0. They contribute the max $7,300 to their HSA’s for every year until they turn 65. However, they spend half of it ($3,650) each year on current medical expenses. The other $3,650 is invested getting a 5% real return (nominal – inflation) for 25 years. This is a bit conservative as historically this is 10% nominal returns and 3% inflation.

Over those 25 years you would have contributed $91,251 and it would have grown to $181,775 in todays dollars (net present value).

Certainly a nice chunk of change. That would cover more than half the average retirees medical expenses.

Pay Out Of Pocket For Medical Expenses, Invest the HSA

There is another way though. You could max that HSA and pay all your out of pocket medical expenses with after tax dollars instead of using the HSA money.

Why do that? Two reasons really:

  1. You’re giving more time for that sweet tax free forever money to compound.
  2. By paying your current medical expenses with after tax money you’re paying taxes today instead of making your future retired self pay income taxes to cover medical expenses (when your HSA runs out). Very similar to investing in a Roth / Roth 401k where you pay the taxes today and your future self doesn’t have to.

I think of it as taking one less risk out of retirement by letting that HSA grow as large as possible. After all, if you don’t need it you can always spend it on non-medical expenses and be taxed as ordinary income.

Let’s run the same scenario for that 40 year old couple except this time they’re going to save and invest the full $7,300/yr for 25 years.

With 5% real return you end up with a net present value of your HSA after inflation of…double! You contributed twice as much at $182,502 and that money doubled to $363,550. That’s pretty close to the $387,000 to the projected retirement healthcare expenses!

How sweet would it be to not have to worry about your main portfolio covering your healthcare?

Our HSA Investing Plan

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One reason that I love thinking through and writing about financial topics is that it makes me take a hard look at my own actions and see if I need to make a change in our own plan. This article is one of those cases.

Our Old Plan

For the last few years we’ve been paying out of pocket for all medical expenses and investing those HSA funds to let the money compound. I knew we would use that HSA money in the future, but I hadn’t thought through our planned time horizon and how we might use the money.

I had been investing our HSA’s inline with the asset allocation of our overall portfolio – roughly 75% stocks, 25% bonds/cash. VTI for a total US market index and TLT for long term treasury bonds. The bonds being for stability and in case we needed the funds. You can see that below in my HSA account. Mrs. MFI’s HSA investment account is invested similarly.

Our New Plan

Our new plan gets more specific on the planned time horizon to use the money and how we might use the money. And, because we have a plan for the money, an adjustment in the asset allocation.

Time Horizon: Use our HSA money starting at age 65.

Money Use: You can use HSA money for Medicare part B,C & D premiums so we’d use the money then. Normal medical expenses as well.

Asset Allocation Changes:

If you have 24 years (age 41 to 65) with no planned need to touch the money then there’s no reason for us to be in bonds right now. We have enough in cash to cover our HSA deductibles. As such, I’m going to move these buckets of money to a 100% stock allocation.

While the US market is great, and has been on a tear for many years, I think it’s prudent to mix in international stock exposure. I compared a VTI/VXUS (VGTSX is similar) mix to 100% VT (simpler) in portfolio visualizer to see how they compared. VT is 60% US, 40% international stocks so this is the true apples to apples comparison. The VTI/VXUS (VGTSX) outperformed by almost a percent per year compounding annual growth rate (CAGR) for the last 14 years (2008 – 2022).

Since I want to allocate a little heavier towards the US I’m going to go with 75% US / 25% international stock index funds . The past performance difference grows wider of course give the US markets performance although that doesn’t guarantee the future. It’s entirely possible that international markets perform better over the next 20 years but I’m not one to bet against the US.

So that’s what I went with and I executed that change this past week and moved all my bond positions into VXUS giving me a 100% stock allocation in my HSA. I’ll be changing over Mrs. MFI this week. VXUS is a low expense ratio (0.08%) international fund that invests in non-US equities.

This puts me right at a 75% allocation is the US total stock market with VTI and a 25% allocation in the non-US international stocks markets with VXUS.

HSA Growth Projections

We currently have $30,000 in HSAs at age 41. We plan to keep maxing out those HSAs at $7,300 total per year for the next 10 years. At a 5% real return (actual return – inflation) that would give us $144,000 in todays dollars.

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If we then kept that money invested for another 14 years, from age 51 to 65, with no contributions that money would grow at 5% real returns to $290,000.

At that point we would have glided to a more conservative 60/40 stock/bond portfolio. $290,000 in today’s dollars covers a good portion of the $387,000 in healthcare costs expected for a couple over their lifetime but there clearly is a shortfall.

It’s hard to find a calculator that lets you increase the withdrawals but this one let me add a % increase to my withdrawals through the use of the inflation adjustment. Since I’m using real returns inflation is already accounted for in the returns.

I put 6% for the expenses to increase each year which aligns pretty good with a 65 year old couple spending $12,000/yr and then that increasing to $21,000 by 75 and $34,000 by 85 (estimation provided earlier).

With a 5% real return we’d run out of HSA money at 87 years old.

Note: Withdrawal setup to start at $12,000/yr and increase at 6%/yr.
Calculator: https://www.tcunet.com/Plan/Calculators/Planning-Calculators/Investment-Savings-Distributions-Calculator

A small shortfall if we live that long that would need to be paid out from other money. Although, given how many assumptions go into these projections, this potential shortfall is something to worry about when we get closer to 65.

One elephant in the room that I haven’t mentioned are long term care costs. Those are non-medical costs related to help you perform everyday life tasks that you can’t do on your own. That’s a risk in retirement that can be handled in many ways so we’ll cover that topic on it’s own at another time.

One other thing is that there are FAR cheaper options for quality healthcare outside of the US. If you’re concerned about these costs and not tied to living in the US then that could be an option for you.

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What’s your HSA plan? Do you spend it or invest it? How does that fit into your retirement healthcare plan? Comment below, I’d love to hear from you.

Categories
Taxes

The Retirement Tax Triangle: Give Yourself Options

BLUF: It’s impossible to predict how future tax laws will change. By saving in all retirement tax triangle accounts with diverse tax treatment we give ourselves more options to control our taxation in retirement.

When you get into the details of saving for retirement, one thing you figure out is that not knowing the future makes planning really hard. One planning area where this is especially difficult is the area of taxation. One this is for certain though, you’re going to have to deal with taxes in retirement.

Income taxes, capital gains taxes, federal, state, foreign…big brother wants a piece of your money. If you’re…human, then you despise taxes and want to do what you can to minimize those taxes and keep that money.

In this article we’re going to talk about the different ways that you can diversify your investment holdings from a taxation perspective. We’ll walk though examples of how those different tax treatment buckets gives you options to minimize your taxes in creative ways.

The Tax Triangle – Helping To Plan For Future Tax Uncertainty

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Why is this topic important in retirement planning? As previously mentioned, paying taxes are one certainty that isn’t going to change. Taxes add on to your future liabilities so you need to account for them in your FI number.

In retirement and early retirement it’s likely that your effective tax rate will fall as most of us will have less income, but it won’t be zero. The 4% rule of thumb doesn’t account for taxes so you need to plan for that as a separate expense.

Oh, and the government changes the tax laws A LOT. Here’s just a sample of the major legislation impacting taxes that has passed over the last 25 years. Well within a normal retirement period. I don’t envy the CPA’s that have to keep up with all of this!

As you can see, it’s a near certainty that US tax laws are going to change over the course of any persons retirement. The laws tend to change in some way every 3-5 years.

As you’ll learn, putting money in all three tax buckets give us some amount of control of our tax rate. We don’t make the tax laws but the amount of income that we can draw from each tax bucket allows us to manipulate our effective tax rate in any given year.

Retirement Income Sources

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Many people are working for others as either a 1099 contractor or W-2 employee to make a living. Other than contributing to tax advantaged retirement accounts you don’t have much control over how you’re taxed.

In retirement, however, you have the ability to draw from a number of potential income sources which get different tax treatment.

  • Guaranteed Income – Pensions, social security (ordinary income taxes), annuities (taxation varies)
  • Business Income – Real estate income, other business income (taxation varies)
  • Taxable Investment Accounts – Brokerage accounts (capital gains taxes)
  • Tax Deferred Investment Accounts – Traditional IRA accounts (ordinary income taxes)
  • Tax Free Investment Accounts – Roth IRA, Health Savings Account (HSA) spent on qualified expenses (tax free)

Guaranteed income is great, but your options are limited on controlling taxation of that money. Business income is very situation specific and is outside the scope of this article. We’re going to focus on the last three investment account options for giving us tax options in retirement since those are more broadly available.

The Retirement Tax Triangle

The tax triangle is a way to describe three different categories of investment accounts that each receive different tax treatment. These categories are: tax free, taxable and tax deferred.

Tax Free Accounts

No taxes are due on the sale of investments or withdrawal of money in tax free accounts as long as the correct rules are followed.

Roth versions of retirement accounts are the most common. You can buy, sell and withdraw contributions at any time. After age requirements are met you can withdraw investment gains tax free. You contribute to them with after tax money.

I wish my parents had started a Roth account for me as a teen, or had at least knew about the Roth early in my 20’s. At $6k/yr it requires a lot of time to build up a lot in that bucket unless you have access to the mega backdoor Roth.

HSA’s, covered extensively here, can be invested. Buying and selling of investments in those accounts is not taxable. When you withdraw money from the account for qualified medical expenses the money is tax free even though you got to contribute to the account with pre-tax dollars!

Cash! There’s no tax on the withdrawal of cash held in bank accounts or taxable investment accounts.

Taxable Investment Accounts

These investment accounts are your standard brokerage accounts at Schwab, Fidelity or Vanguard. You move after tax money into these accounts and invest your money as desired. These could also be crypto brokerage accounts.

Any sale within these accounts is a taxable events and income distributions in the form of interest and dividends are subject to tax. However, investments held for a year and a day and sold get the advantage of special long term capital gains (LTCG) treatment. If you don’t hold investments for over a year and sell them they are considered short term capital gains (STCG) and are taxed as ordinary income like your paycheck.

LTCG get taxed at 0%, 15% and 20% LTCG taxation rates in 2022 which is MUCH lower than ordinary income tax rates. For example here’s how the ordinary tax rate has compared to the the LTCG tax rate in recent years.

Notice that 0% tax bracket? That’s a taxation sweet spot that we’ll discuss more. We definitely want to take advantage of that when possible!

*Starting in 2018 the ordinary income tax brackets aren’t tied to the LTCG tax brackets. They’re close for the 0% and 15% brackets, quite a bit different for the top of the 15% bracket

Tax Deferred Investment Accounts

These are some of the most common retirement accounts as they’ve been around the longest. The money is called tax deferred because you get to contribute to the accounts pre-tax, let the money grow without taxation and then the taxation happens when you withdraw the money from the account.

The money withdrawn from the accounts are taxed as ordinary income when withdrawn from the account at your marginal tax bracket. These taxation rates for ordinary income and their taxable income ranges are shown below.

These are most commonly called traditional accounts. Examples of common retirement accounts that are tax deferred are the tradition versions of an IRA, 401k, 403b, 457b and Thrift Savings Plan (TSP).

How Income “Stacks” For Taxation

Before we talk about some of the ways that the tax triangle can be used to minimize taxes in your situation, it’s important to understand the ordering rules for taxing of your income.

Think of taxation order as a cake and the layers are taxed starting at the bottom and working your way up.

Standard Deduction: Your standard deduction is removed from your ordinary income layer first. In 2022 this is $25,900 for joint filers. If for some reason your ordinary income is less than your standard deduction then it’s used to reduce your long term capital gains.

It’s important to remember that when you look at income tax tables, what is shown is the taxable income left AFTER the standard deduction is removed.

For example, if you made $40,000 in ordinary income as a married couple in 2022, your taxable income after the standard deduction is $40,000 – $25,900 = $14,100. Taxed all at the 10% marginal bracket you’d pay $1,410 in tax for the year on that $40,000 income.

Ordinary Income: Everything that is taxed as ordinary income falls into that layer as the bottom layer. All earned income resides here including salaries, interest income, bonuses, short term capital gains and traditional IRA withdrawals. Social security has some unique tax treatment so it isn’t just taxed completely as ordinary income.

Frequently misunderstood: Bonus tax treatment.

Bonuses are taxed as ordinary income. Your employer may withhold extra money from a bonus but it’s not taxed any differently than your salary. In the end, if you paid extra extra tax on a bonus up front then you’ll get it back at tax time.

Long Term Capital Gains: Investments sold in taxable investment accounts and qualified dividends paid (whether reinvested or not) are all income that receives long term capital gains treatment. As you can see below, the tax rates are FAR lower than ordinary income.

Tax Free Income: Income from Roth withdrawals is tax free as is withdrawals from bank accounts or cash inside brokerage accounts.

LTCG Calculation Example

This may seem obvious to some, but it’s critical to understand how to calculate long term gains properly. It is common to confuse the gains of a sale with the overall cash received from a sale. Let’s walk through an example to make sure that it’s clear.

In 2021 you purchased 200 shares of VTSAX in a taxable brokerage account for $100 per share. This is your cost basis for the investment – what you payed for it. In 2025 those shares were worth $150 per share and you sold all 200 shares.

Your brokerage account would show $30,000 in cash from the sale, but you’re only taxed on the capital gains. In this case, you’re taxed on $10,000 of long term capital gains.

Newer investments that haven’t had time to appreciate as much will have less capital gains as a percentage of the sale. Older investments that have had more time to grow will have more capital gains as a percentage of the sale.

Examples Of Tax Triangle Drawdown Flexibility

Now, for the fun part. Showing how having funds in all three buckets of the tax triangle gives you options to control your tax rate. I know, I have a weird idea of fun.

Let’s pretend that for all scenarios a married couple (age 60) needs $60k/yr after taxes to live and are retired. They have no pensions and they won’t take social security until 67. The year is 2021 and those tax brackets will apply. The couple lives in a state that has no state income tax.

Scenario #1: $2M in traditional 401k’s. No money in Roth or taxable accounts. Withdrawing enough to live on, $60k after taxes.

In this case you have limited options. All that money is taxed as ordinary income. You need to pull out $64,310 which will result in you paying $4,310 in federal income taxes. Your effective tax rate is 6.7% ($4,310 / $64,310).

Source: Nerdwallet 2021 Federal Tax Calculator

Scenario #2: $2M in traditional 401k’s. No money in Roth or taxable accounts. Withdrawing enough to live on, $60k after taxes. Also, complete $60k in Roth conversions (net of taxes) to reduce future required minimum distributions (RMDs).

Once again, your options are limited to just withdrawing more money from the 401k accounts pushing you into higher tax brackets to pull enough money to cover the Roth conversions. As a result, you need to pull $135,972 from the 401k paying $15,972 in federal income taxes. Your effective tax rate is 11.7% ($15,972 / $135,972).

Scenario #3: $1M in traditional 401k’s. $500k in Roth and $500k in a taxable account. The couple needs $60k to live and wants to do a $60k Roth conversion. The $60k to live is pulled from the Roth IRA.

In this case, the couple is going to do the $60k Roth conversion from their 401k. That money is all taxable income and they pay $4,310 in taxes just like in scenario #1. Since $60k in Roth money is withdrawn to live on that is tax free. In total $4,310 in tax was paid on $124,310 ($64,310+$60,000). A total effective tax rate of $4,310 / $124,310 = 3.46%.

Source: Nerdwallet 2021 Federal Tax Calculator

Scenario #4: $1M in traditional 401k’s. $500k in Roth and $500k in a taxable account. Taxable account has 5,000 shares of VTSAX at a $50 cost basis, $100 current share price. The couple needs $60k to live and wants to do a $60k Roth conversion. The $60k to live is pulled from the taxable account.

In this case, the couple is going to do the $60k Roth conversion from their 401k. That money is all taxable income and they pay $4,310 in taxes just like in scenario #3.

Source: Nerdwallet 2021 Federal Tax Calculator

To get $60k to live on the couple sells 600 shares of VTSAX at $100/ea resulting in $60k in their account. The capital gains on those are 600 shares * ($100/share – $50/share cost basis) = $30,000.

The taxable income is $39,210 in ordinary income from the Roth conversion + $30,000 in LTCG taxes = $69,210 in taxable income. Since this amount is less than $80,800 it’s in the 0% LTCG bracket and the couple will pay $0 in tax on that $30,000!

This makes the taxable account act like a tax free Roth account as in scenario #3. In total $4,310 in tax was paid on $124,310 ($64,310+$60,000). A total effective tax rate of $4,310 / $124,310 = 3.46%.

There are obviously an infinite number of scenarios that could play out using the combination of these accounts. In other words, lots of options!

What’s The Ideal Tax Triangle Mix?

We all love to have definitive answers to questions like this. Unfortunately, there is no perfect answer. The key is to understand the impact of having money in the account mix that you have and coming up with a plan for how you will empty those accounts in retirement.

I think there’s power in trying to save some percentage in all of these accounts as you saw from the earlier scenarios. It gives you the flexibility to deal more effectively with future tax legislation changes.

Some things to think about:

  • Think about your own retirement plans and how these accounts will fit into them. Begin with the end in mind and see if your current account mix would work with a drawdown plan.
  • If you have a long period planned with no or low income, you can get away with larger tax deferred balances. You can withdraw or Roth convert down those balances before social security or pensions start.
  • Roth contributions today instead of traditional IRA contributions eliminate a tax liability in retirement.
  • Long term capital gains tax rates have historically been much better than ordinary income tax rates.
*Starting in 2018 the ordinary income tax brackets aren’t tied to the LTCG tax brackets. They’re close for the 0% and 15% brackets, quite a bit different for the top of the 15% bracket

What Am I Doing?

If you read my last article about our portfolio composition, you saw this portfolio breakdown below. Traditional 401k accounts dominate our portfolio at the moment at 62.5%. At the moment we’re also saving $50k into tax deferred accounts each year which is also the most that we add to any account. This will accelerate the imbalance although the goal isn’t necessarily to be in balance.

The goal is to make sure that you have some diversity in investment locations and a plan for how to unwind those in a tax optimized way. It’s good to plan but don’t get too fixated on it. Tax planning is based on many variables that are out of control that change frequently. Taxation levels, tax laws and your relationship status (single/divorced/widowed vs. married) all can have major impacts.

In 2026, if no tax legislation changes first, the Tax Cuts and Jobs Act of 2017 will expire and ordinary income tax rates will increase. 12% -> 15%. 22% -> 24%. 24% -> 28%. Mrs. MFI and I both have options to invest in Roth 401k accounts.

Current tax rates are historically low but at our high income they’re still higher than I’m likely to encounter in retirement. Do I want to pay a locked in 24% tax today by switching to a Roth 401k to avoid paying taxes in retirement that are likely lower, but still variable in rate? I don’t know. That’s a tough one that I’m going to have to ponder some more and do some math.

Key Takeaways:

  • Tax legislation is ever changing and impossible to predict.
  • Investing in a mix of tax deferred, taxable and tax free accounts gives you the greatest flexibility in retirement tax planning.
  • Investing in tax deferred accounts today means avoiding taxes at todays ordinary income tax rate in exchange for taxation on this money at future ordinary income tax rates. There will be RMDs. However, keep in mind that you’ll be declaring less income in retirement so your taxes should be far less because you’ll lower tax brackets.
  • Investing in Roth accounts today means being taxed at todays ordinary income tax rate in exchange for no taxation in the future. There are no RMDs.
  • Investing in taxable accounts today means being taxed at todays ordinary income tax rate in exchange for special tax rates in the future. There are no RMDs.

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