@msf - thank you for your insight on the questions, but also the real time examples.
I used the ACA as I needed to purchase health insurance. You are correct in that ACA plans tend to be high deductible plans and the total out-of-pocket costs are at very high points (in my case, for a family).
What I saw with the non-HSA plan was that PCP visits were $40. With the HSA plans, the deductibles were high, then the co-insurance allocation begins until you reach the maximum out-of-pocket expense limit for the calendar year.
Knowing that my child could see the doctor for $40 versus having to pay for each visit in full (even at the negotiated insurance cost) until I reached the deductible was an important aspect for me to manage my personal cash flow situation. Whether non-HSA or HSA, once you reach the deductible, you then start the co-insurance process until you reach the maximum out-of-pocket costs for the plan. In the ACA plans, the deductibles and maximum out-of-pocket costs are very high to anything I have experienced when I was employed.

So long as you have income, whether it is considered compensation or not, you get to deduct your HSA contribution. It reduces your AGI.
You are correct that you can only make HSA contributions for the months in which you have an HDHP plan (and no other coverage).
As to whether HSA-eligible HDHP plans come out better, it depends on where you live.
Where I live, there are only three HSA-eligible plans offered. Comparing each with the "most popular" non-HSA plans from the same insurer, I would come out better with the HSA-eligible plan each time.
Insurer 1: Bronze vs. HSA-Bronze
- HSA plan costs $48/year more
- HSA plan has $400 higher deductible. (All services subject to deductible in both plans)
Worst case, HSA plan costs $448 more, but allows deduction of $4350 in HSA contributions.
Insurer 2: Bronze vs. HSA-Bronze
- HSA plan costs $276/year more
- HSA plan has $3K lower deductible
- All services on both plans are subject to deductible, except first two PCP visits ($45 co-pay) with non-HSA plan.
Worst case, HSA plan costs about $600 more (assuming PCP visit negotiated charge is around $200), but allows $4350 deduction.
Insurer 2: Silver vs. HSA-Silver
- HSA plan costs $120/year less
- HSA deductible is $200 more
- All services on both plans are subject to deductible, except for PCP visits with non-HSA plan.
Unless most of your services are PCP, the HSA is going to cost at worst a few hundred dollars more. Again, the HSA tax deduction will more than compensate for that.
A real problem with ACA plans is that even if they're not HSA-eligible, they still tend to be high deductible (albeit not HSA-eligible, because of the way they're structured). So if you're seeing ACA plans with much lower deductibles, consider yourself fortunate.

From my specific example, in 2014, I was in an employer HSA (HDHP) eligible plan and made the HSA contribution.
In 2015, I went to the ACA and chose a non-HSA eligible plan (I did not want the high deductible for my medical costs as no Earned Income, and because I have no Earned Income, the HSA contribution could be wasted as no real effect to reduce Adjusted Gross Income).
Edit - Therefore, in 2015 with no HDHP plan, I can not make an HSA contribution for the 2015 tax year, is that a correct statement?
And I have found that at least in the ACA versions, even with the high deductibles, the HSA plans were more expensive, higher deductible but offer the HSA contributions, which therefore are great for high income earners and business owners that can deduct all premiums and HSA contributions.

1. Generally, you need to have an eligible HDHP (high deductible health plan) in order to open an HSA. However, if you have an existing HSA, you're allowed to open another one (even without having an eligible HDHP), and transfer/roll over the existing HSA to the new one.
For example, here's Alliant CU's page:

To open an Alliant HSA you must be:
- 18 years of age or older
- Must be enrolled in a qualified High Deductible Health Plan (HDHP) to make contributions.
- If not enrolled in a HDHP you are still qualified to roll over or transfer funds from your current HSA

2. As others have stated, you don't need compensation income in order to contribute to an HSA. AFAIK (this is speculation), you don't need income at all (though you'll waste the deduction that way).
In order to fund (not open) an HSA, you must have had an eligible HDHP. However, since funding can be retroactive (like an IRA, you can fund it early the next year), you can fund the HSA because you were in an HDHP, even if you aren't currently.

I have a general question about the HSA (which is different than the Flexible Savings Accounts, which generally expire in that year). When I was previously employed, my employer switched the health insurance plan offerings to HSA eligible insurance plans that allowed for an HSA account, and that was how I funded the account.
The previous plans were not HSA eligible.
Now that I purchase under the Affordable Care Act (ACA) plans, it says which plans are eligible for an opening an HSA account as the contribution can be deducted against Income.
So two questions: 1. the health insurance plan has to be eligible to open an HSA account (as specified in the ACA plans - I was told the answer for this is Yes, ie, can only fund an HSA with specific IRS approved health insurance plans.
2. do you need Earned Income (employer or business income) to fund or add funds to an HSA account?
For those that have an HSA account, did all you have an HSA eligible health insurance plan when it was opened and funded?

Thanks for the info. It bothered me enough that I had no idea what "interesting" meant that I tried searching for Archipelago. Got one hit, on boggleheads:

If I do not want to invest in those 10 funds, looks like I can open a Saturna Brokerage account and buy mutual funds there. It has access to Vanguard funds via "Saturna Brokerage Archipelago", with some stiff conditions to avoid transaction fee:

I think NTF Vanguard funds qualifies as "interesting". Seems to be a thing of the past, though.
(Health Savings Administrators does offer Vanguard funds NTF, but they tack on a 32 basis point ER, and like a 12b-1 in excess of 25 basis points, I regard that surcharge as a load.)
Regardless, Saturna seems to be one of the least expensive ways of owning an HSA without being restricted to a small list of funds provided by Devenir.
(Devenir's HSA bank fund list, Devenir's Select Account HSA fund list, etc.)

Bee, I did not know about the roll over from IRA to HSA. Thank you for that great information. Unless I'm mistaken, this is nothing like a shell game. Money into an IRA is taxed when you take it out, but in an HSA, there is no tax in and no tax out. What could be better then that?
I have been maxing out my HSA contributions for the last few years and not using the money. I pay for medical expenses with taxed money. But, I have been very lucky that I have had good health, limited expenses. I plan to use the accumulating money in the HSA account as a bridge to pay health insurance when I retire - until medicare kicks in.
Thanks again. You are a gem to this discussion board.

Hi, msf....I am also using my HSA for saving and investing. It's been a few years since I made the switch to Saturna, but I remember that originally I was in one "arm" of the firm, which didn't have a large list of funds, so I switched my HSA to the brokerage "arm". They still do not have the selection of funds that Schwab or TD have, but they offer TRP funds NTF, so that's what I focused on. Again, there are positives and negatives with them, just like with any brokerage. When I start withdrawing cash....who knows...I may decide to switch again.

Regarding complexities - each HSA administrator handles things differently - checks, debit cards, ACH transfers. Some will do the medical expense bookkeeping for you. (Similar to mutual fund companies keeping track of cost basis for you - pre-2012 - as a service, but not reporting it to the IRS.)
Whatever works best for you. Since I view HSAs as savings vehicles, I don't care about the withdrawal mechanism. I just keep track of all my eligible expenses since I opened the account. At some time in the future I'll withdraw a lump sum. I'll be able to justify the withdrawal with those medical expenses, so long as I keep good records.
Fidelity does offer an HSA account, but only to employer-sponsored plans. I've spoken with them for years about this. They tell me that they've gotten lots of requests, and they keep looking into it. My guess is that these are not especially profitable accounts, so they're not too interested.
- Accounts tend not to be large (limited contributions, people take withdrawals for expenses)
- Servicing costs are high (lots of small withdrawals)
- Regulatory costs are high
Question about Saturna - they mention Archipelago, but don't provide detail. Last time I checked (a couple of years ago?), this was a smaller list of funds (but more "interesting" as I recall), and required a $10K min. Did Archipelago vanish from Saturna?

@ msf said:
If you need to pull money out of a traditional IRA and you're under 59.5, then "laundering" it through the HSA gives you a way to do that (if you've got matching medical expenses). That's the only reason I can see for doing a rollover to an HSA.

For those that may have retired early or are retired and under age 65 with little or no earned income this rollover feature provides a way to fully fund an hsa in the form of a rollover without impacting present income. This perfectly legal rollover might help the newly retired "coupon clipper" who also has to do their own "laundry" and may not have the resources to budget for hsa contributions.
At 59.5 I plan on taking IRA distributions equal to my hsa contributions there by offsetting the taxes on the IRA with an equal hsa tax deductible contribution. I will do this until I am 65. I mention age 65 because that is the age at which one can no longer add to their hsa (because medicare kicks in).
Bottom line, without earned income you can't make Roth contributions. Not true with hsa contributions. hsa contributions are tax deductible even without earned income. In my case these hsa contributions will reduce any other taxable income I have (pension, annuities, SS, interest and dividends) and IRA distributions.

As an additional funding source have you considered a rollover into your hsa?
If you haven't already done so and have a tax deferred IRA you can make a one time rollover from your IRA to you hsa. The amount cannot exceed your maximum allowable hsa contribution. For an individual that would be $4350 for 2015 and a but more if you have a family hsa plan.
Its a nice way to move what would be taxable IRA dollars into tax free hsa. This is not a distribution...its a one time rollover.

Generally, I don't see this as an advantage, assuming you have outside money with which to fund your HSA. It's basically a shell game. You're taking money out of an IRA and thus losing the deduction you could have had by making a regular HSA contribution. So effectively, you are paying taxes on that IRA rollover.
If I'm going to pay taxes when I move money from a traditional IRA to another tax-advantaged account, I'd rather pay the taxes (directly) and move it to a Roth, rather than pay the taxes indirectly (by losing a deduction) and move it to an HSA.
With the Roth, after five years, I can take the money out tax free, no questions asked. With the HSA, questions are asked - what were the medical expenses that this withdrawal is covering?
On the other hand, with the rollover to the HSA, there's no five year waiting period.
If you need to pull money out of a traditional IRA and you're under 59.5, then "laundering" it through the HSA gives you a way to do that (if you've got matching medical expenses). That's the only reason I can see for doing a rollover to an HSA.

Hi, Maurice -- I would definitely check again at Fidelity, since HSAs have become more popular. The issue I had was that the maintenance fees were quite steep, and with a small account, it really ate into my return. That's basically why I switched to Saturna...but sometimes I wish I were with my prior firm, because I could "trade" the Rydex funds daily. I really did well with that strategy in 2011.

Yes, I agree...it can be confusing. I had my HSA at another firm before I moved it to Saturna and it was run very differently. I also manage an HSA for my son at TD Ameritrade...also run differently. Like I said, I have not made any withdrawals, but Saturna said if I needed cash for medical expenses, to just let them know and they would send a check (?!?)...no documentation necessary. I guess they are using the honor system there...my prior firm had an actual debit card.

I have been given a debit card and a bank account has been set up through BNY Mellon. I am having bi-weekly payroll deductions to begin funding the HSA. You have to have a minimum amount in the account before you can branch off into investments for the funds.

Yes, I agree...it can be confusing. I had my HSA at another firm before I moved it to Saturna and it was run very differently. I also manage an HSA for my son at TD Ameritrade...also run differently. Like I said, I have not made any withdrawals, but Saturna said if I needed cash for medical expenses, to just let them know and they would send a check (?!?)...no documentation necessary. I guess they are using the honor system there...my prior firm had an actual debit card.

I'm trying the HSA through my employer for a family this year. It's a little bit confusing to start with, especially if you have prescriptions through mail order, but I'm curious to see how it goes for the year.

As an additional funding source have you considered a rollover into your hsa?
If you haven't already done so and have a tax deferred IRA you can make a one time rollover from your IRA to you hsa. The amount cannot exceed your maximum allowable hsa contribution. For an individual that would be $4350 for 2015 and a but more if you have a family hsa plan.
Its a nice way to move what would be taxable IRA dollars into tax free hsa. This is not a distribution...its a one time rollover.
Article on topic:
rules-for-ira-to-hsa-rollovers
IRA to hsa worksheet:
IRA_to_HSA_Worksheet.pdf

Just reached a certain $$ level. Yes, thankfully, I am healthy and using the HSA as a supercharged savings account for future healthcare expenses. I set up the HSA at Saturna Capital...no maintenance fees there. They have a limited selection of fund families available, so I went with TRP funds, based on MFO recommendations. The downside of Saturna is that you must hold the funds for 180 days, so I have been very careful in my selection and stagger my investments and redemptions accordingly. It is a comparatively small account, so it has been challenging at times.

I just wanted to thank the MFO community....I reached a big milestone in my HSA, thanks to all of you and the T Rowe Price funds you have recommended over the years. It is greatly appreciated!

Hi l5b,
What's the milestone? Hopefully the Health Savings Account finds you healthy, wealthy and wise. Were you able to set an hsa with TRP funds at TRP or through an intermediary?

I just wanted to thank the MFO community....I reached a big milestone in my HSA, thanks to all of you and the T Rowe Price funds you have recommended over the years. It is greatly appreciated!

Ameritrade is a delightful 180 day holding period.... used to be 90.

Depends what kind of account you have with them. 180 days seems "right" for a taxable brokerage account, but their terms are different for IRAs and for HSAs (which seem to be considered IRAs there for most purposes).
For example, here's the fee schedule for a relative's account (90 days):
http://www.tdameritraderetirement.com/forms/ACS1009.pdf