2023: Gender Lens in Health Savings Accounts (HSA)

The cost of healthcare is a common concern among employees. In one survey, 61% of pre-retirees reported being concerned about having enough money to pay for healthcare in retirement.1 Estimates show that an average 65-year-old couple retiring today will need about $296,000 to cover out-of-pocket healthcare costs in retirement.2 A Health Savings Account (HSA) is a resource for employees to manage and fund their immediate and long-term healthcare expenses. Since first being introduced in 2003, HSAs have grown to $104 billion in assets and 35.5 million accounts at year-end 2022—a 24% annual growth rate over the past 16 years.3


HSA Gender Lens Study: 2023 Edition

Our new HSA gender lens study is the third study released and was conducted to aid in understanding potential gender differences in the financial behavior and actions of plan participants.4 It is estimated that a healthy woman’s lifetime healthcare insurance premiums are nearly $200,000 higher than those of a healthy man.5 That gap heightens the importance of women carefully planning to help cover their present and future medical expenses. This is particularly important given the fact that women’s longevity is generally greater than men.6


Key Study Findings

  • HSA contribution rates for women and men are comparable
  • Very few participants are maximizing their HSA contributions
  • HSA distributions for women and men are comparable at the median but lower for women at the 75th percentile
  • HSA savings are lower for women than for men
  • HSA cash and investment balances of women are lower than those of men across all generation groups

Read the full study

Read our study for HSA trends, statistics, and more information to aid in understanding potential gender differences in the financial behavior and actions of plan participants.4

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1Society of Actuaries Research Institute., 2021 Retirement Risk Survey Brief Report: Identifying Retirement Risks and Trends, October 2022.

2EBRI “Projected Savings Medicare Beneficiaries Need for Health Expenses Spike in 2021”, January 20, 2022. Note: These costs include deductibles, copays and premiums for Medicare Part A, Part B and Part D, as well as Medigap insurance costs. They do not include services not covered by Medicare, such as over-the-counter medications and most dental services.

32022 Year-End Devenir Health Savings Account Research Report

4Our first study focused on the behavior of 401(K) plan participants “2022: Gender Lens in Defined Contribution (DC) Plans”, Bank of America and Chief Investment Office, October 2022. Our second study provides a gender perspective on financial wellness of plan participants: “Employee Financial Wellness in America” Bank of America and Chief Investment Office, December 2022.

5HealthView Services, “Addressing the Women’s Longevity Gap,” September 2020 (most current data available).

6According to the Social Security Administration: www.ssa.gov/planners/lifeexpectancy, at age 65, women can expect to live an average of 21.8 more years and men an average of 19.1 more years.