- quote -

My HSA is at http://www.hsatrusteeservices.com/ where there are no
recurring fees.


- quote -

Actually, if I'm not mistaken, it's the taxpayer's job to keep records to
show valid medical costs. The administrator has no way to check this. All
they see is a credit card transaction or a check transaction. For all they
know, I could've bought used furniture from my doctor's office. I keep the
bills that document the services provided and the amounts.

The administrator does have work to do, though. There are yearly forms to
file, and there are rules like contribution limits, account transfers, etc.

I have noticed administration fees have dropped on such accounts.
Last year several places want about $100 a year. This year its half
of that.
I presume the main reason for fees is the adminstrator much check
the receipts to see if its a valid medical cost.

(taken from the bogleheads discussion forum with minor edits)

Quote:

Almost seems like it makes sense to leave the funds in for a while, pay medical
expenses out of after tax money (never pay or write a check from HSA to oneself) and
let the account build up. Seems like worst case is you remain really healthy and risk
having some funds revert to regular IRA tax status when/after you are 65. I can't
imagine not having some out-of-pocket medical expenses forever though. Am I missing
anything here?


Answer:

You are missing a lot.

You don't have to revert to regular IRA tax status at 65. You can keep the HSA till
beyond the grave. You can use it for long-term care premiums (up to a limit) and
Medical B and D premiums, and a long list of medical and dental expenses after 65 even
if you are not still in an HDHP. But you can't contribute more after you go into
Medicare.

The account can be transferred to a surviving spouse.

Note that you can withdraw tax free from your HSA for anything that you paid out of
pocket in the past since the date you started your HDHP. After you die, your executor
can pay those old bills. If you don't have a surviving spouse, the executor probably
should pay the old bills since I believe that has the effect of transferring the HSA
to
your estate. That is, it converts from income taxes for the inheritors to typically
lower estate taxes.

The only drawback to this is that you have to keep the records on all your past bills
for a long time in case the IRA audits.