What's Inside
HSAs aren't just savings accounts anymore. In 2025, Lively account holders used their HSAs at Amazon, Hims & Hers, Headway, Warby Parker, and Eli Lilly — not just hospitals and pharmacies.
The 2026 HSA Spend Report breaks down the shift happening in real time, with data on the merchants, categories, and behaviors reshaping how Americans access and pay for care.
Key Findings
Retail is now healthcare. Amazon HSA spend grew 123% year over year, reflecting a consumer expectation that buying healthcare products should feel as easy as any other online purchase.
GLP-1s went mainstream. Spend tied to GLP-1 manufacturers and platforms surged — with Eli Lilly up 5,610% and Hims & Hers up 134% — signaling a structural shift in how consumers manage metabolic health.
Mental health is a recurring line item. Platforms like Headway (up 130% YoY) and BetterHelp reflect a growing norm: therapy is no longer episodic. It's budgeted.
Balances are growing too. The average Lively HSA balance hit $5,457 in 2025 — up 11% from 2024, and 37% above the industry average. Employees are spending smarter and saving more.