I'm not sure if this is helpful as this is in Canada but I'll post it anyway. My husband's company offers this but it is a company benefit so he doesn't have to put anything towards it. The way it works for him is he is "given" $750.00 to use towards health services in a year to apply it towards health services not covered by his regular benefits. He does not have to use it if he doesn't want too. For example a dental visit with regular benefits is covered for 80%of the cost - he can use money from the HSA for the difference or he can pay out of his own pocket. It can also be used towards recognized alternative medicine practices (naturopath, acupuncture, shiastu, etc) or anything health related (cosmetic surgery is out). At the end of the year if he has any money left he can either receive it in cash or invest it in an RRSP (I think similar to yout 401K). He has had it for two years now and tries not to use it so he can invest it or receive the cash (minus taxes of course).
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