Consider a Health Savings Account

Nearly a quarter of large employers plan to offer an HSA to workers in 2012.

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Alongside your tax-free accounts for retirement and college savings, you might want to establish a health savings account to cover any medical bills tax-free. Nearly a quarter of large employers plan to offer an HSA to workers in 2012, according to the consulting firm Mercer.

Pre-tax money goes into the HSA, grows on a tax-free basis, and is not taxed even at withdrawal when it is used to cover healthcare expenses. "It essentially never gets taxed," says Michael Thompson, a principal at PricewaterhouseCoopers in New York City. And retirees who are healthy can tap their HSAs for other reasons, too.

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To qualify for an HSA, individuals and families must first buy a high-deductible health plan with a minimum annual deductible of $1,200 or $2,400, respectively. Insurance coverage doesn't kick in until deductibles are met, except that preventive care is covered regardless. This design puts more of the onus on consumers to manage their medical costs and decision-making. Individuals and employers can contribute up to $3,100 per person or $6,250 per family a year, and people 55 and older can contribute an extra $1,000 each year.

[See Working Into Your 70s: A Smart Retirement Move.]

Money from the HSA can be applied tax-free toward the deductible, copayments, and most other health-related costs, or the funds can simply accrue as savings. You'll owe income taxes and a 20 percent penalty if you withdraw funds for purposes other than healthcare before age 65. But at that point, money that pays for non-medical expenses is simply taxed as income.

While the figures vary widely, Thompson says, out-of-pocket costs associated with high-deductible health plans not uncommonly run $6,000 per individual or $12,000 per family per year. If you expect to face high healthcare costs going forward, you may want to think twice—assuming you have a choice. Increasingly, notes William Applegate, vice president of HSA products at Fidelity Investments, employers are choosing to make these plans the only option.

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