How HSA Account Holders Navigated Rising Healthcare Costs in 2021

Lively’s 2021 HSA Spend Report analyzes HSA account holders’ spending in 2021 and its implications for national healthcare trends.

In 2021, uncertainty continued to be the only certainty, an unwelcome carryover from the rollercoaster of 2020. Despite widespread vaccination and availability of vaccines, the COVID-19 pandemic has persisted, and new variants like Delta and Omicron caused infections to rise and fueled an uneven economic recovery.

HSA Spend Overview

In addition, consumers had to contend with rising inflation, prescription drug costs, and health insurance premiums. Inflation in the United States hit 6.2% in October, the highest level in 30 years and one of the highest rates in the world.

Total HSA Spending

These, among other factors, influenced how Americans spend their healthcare dollars. In our new fourth annual HSA Spend Report Lively takes a look at the numbers, and spending patterns, of Lively HSA account holders in 2021 and offers insight into what these spending habits can show us about national healthcare trends.


The report examines:

  • How HSA account holders spend, especially on routine expenses versus major healthcare emergencies such as hospital visits.
  • HSA consumer spending habits, including year-over-year changes since 2019, and highlights important patterns around mental health and dental spending.
  • Trends in consumer behavior, including shopping at pharmacies versus online, and Amazon’s increasing dominance in the healthcare space.
  • How HSA spending compares to overall healthcare spending in the United States.

Spending changes since 2020

Insurance brokers, consultants, and employers can use this report to understand how account holders are using their HSAs, and how they can support their clients and employees in navigating the rising costs of healthcare in the United States. They can also understand areas where additional HSA education may be needed, especially around eligibility and spending on mental healthcare. Download the report today for essential industry data and insights from Lively.

Disclaimer: the content presented in this article are for informational purposes only, and is not, and must not be considered tax, investment, legal, accounting or financial planning advice, nor a recommendation as to a specific course of action. Investors should consult all available information, including fund prospectuses, and consult with appropriate tax, investment, accounting, legal, and accounting professionals, as appropriate, before making any investment or utilizing any financial planning strategy.

Sign up for our newsletter

Stay up to date on the latest news delivered straight to your inbox

You're subscribed!

Expect a friendly hello in your inbox.