You can use the money in your HSA to pay your insurance deductible when qualified medical expenses arise. One of the biggest advantages for having an HSA is that, unlike flexible spending accounts (FSAs), any unused savings in the HSA accumulate year-over-year with tax deferred earnings can be used to pay for qualified medical expenses in the current or future years for you, your spouse, or your dependents. With HSAs, you use pretax dollars to pay for future medical expenses. The contributions you make to your HSA are tax deductible, and the earnings accumulate on a tax deferred basis. Your HSA distributions will be tax free if they are used to pay for qualified medical expenses. Any unspent account balance will continue to accrue earnings each year, so there is no “use it or lose it” provision.