You are confused. The FSA (Flex Spending Account) has serious limitations on how the money is spent. With an HSA (Health Savings Account) YOU decide how the money is spent on "qualifying purchases". HSA's have unlimited carryover and are portable (i.e. you don't lose any $$$ if you don't spend it annually and you keep the money if you change employers). HSA and FSA program have pro's and con's. I've had a HDHP for several years and I have a very nice HSA. The IRS has publications on this to the point of ad nauseam. Regardless, you can only have $3500/$7000 (single/family) deposited into the HSA annually; this includes whatever your employee "gives you". My employer deposits $150/mo ($1800/yr) into my HSA and I put in $5200 pre-taxed income. I can use the HSA money to pay for virtually anything medically necessary such as my Rx eyeware, FAA medical exams, OSA supplies, etc. I pay for the stuff with my credit card and reimburse myself. I even pay myself the IRS mileage rate to drive to the doctor.