Qualified expenses are anything the Internal Revenue Service allows a medical tax deduction for. Although MSA funds can't be used for medical insurance premiums unless you are unemployed, they can be used for premiums on nursing home insurance. Medical payments, nursing home insurance premiums and nursing home charges after 65 remain tax-exempt. For an example of how an MSA-linked insurance policy works, see How it's supposed to work. So the savings accounts are being offered by a small group of banks and insurers' often in combination with health coverage.
Account holders get a checkbook for making payments.
As is the case with most other providers, Golden Rule doesn't currently offer mutual funds to holders. It and the others will probably do so next year, when balances are bigger. That's why it is extremely important to find out, before you sign up for an MSA account held by an insurance company, whether you can move the savings cccount without disturbing the health coverage. You may find a better deal elsewhere in the future. Many firms will let you move the MSA account, but apparently the law does not require them to.