Devenir: invested HSA balances top $100 billion, 52% of assets

Invested health savings account balances reached $100 billion at June 30, 52% of the $192 billion held across 42.6 million accounts, according to Devenir's 2026 Midyear HSA Research Report. The report, released Oct. 13, put invested balances up 37% from a year earlier, when investments made up 46% of the market. Devenir said it was the first time invested balances made up a majority of HSA assets, attributing the shift to favorable markets and account holders using the HSA as a long-term savings vehicle.

Only 4.7 million accounts, or 11% of all HSAs, held investments, yet they account for 59% of HSA assets. Devenir put their average combined balance at $23,837, nearly nine times that of a funded deposit-only account. Account age explains part of the gap: HSAs opened in 2004 averaged $36,870 at midyear, while those opened in 2026 averaged $1,963. Balances of $25,000 or more grew nearly 50% to almost 1.9 million, about 14 times the 134,000 at midyear 2016.

The $23,837 average combined balance in an investing HSA equals about 13% of Fidelity's $185,500 lifetime health care cost estimate for a 65-year-old retiree, a figure Fidelity put 7.5% above last year's projection. The 2004 cohort's $36,870 covers about 20%.

Fidelity also found 40% of Americans with HSAs have not invested their balances; Steve Betts, head of Fidelity Health, said Medicare “does not eliminate every health care expense.” Employer-affiliated accounts made up 61% of HSAs and 65% of assets, and 12% of them were unfunded against 33% of non-employer accounts.