If you want to start a health savings account you'll need to apply for a HSA qualified high deductible health plan (or HDHP). Next, you open your HSA at a bank or credit union. Then all you need to do is make contributions to your account, up to the preset annual maximum set by the government. If you make contributions as an employee, contributions are tax deductible on your next tax return. If you make the contributions as an employer, on the other hand, contributions are exempt from federal employement taxes. When you have medical expenses, such as hospital or doctor visits, you withdraw money from your HSA to cover the amount. If you ever decide to stop your HDHP coverage you will still have access to your health savings account funds for medical costs.