HSA Reimbursement

Health Savings Account (HSA) reimbursement is a benefit in the United States that allows employees to save and use pre-tax dollars for qualified medical expenses. This financial tool is highly valued for its tax advantages and the flexibility it offers in managing healthcare costs. While the HSA is unique to the U.S., various countries have their own systems that serve similar purposes. 

What is HSA Reimbursement?

HSA reimbursement involves using funds from a Health Savings Account to pay for out-of-pocket qualified medical expenses. An HSA is a tax-advantaged account, considering the: 

  • Contributions to an HSA are made pre-tax
  • Funds grow tax-free, and 
  • Withdrawals for eligible healthcare expenses are also tax-free. 

This triple tax benefit makes HSAs a popular choice for managing out-of-pocket medical costs.

Does HSA Reimbursement Have Equivalents in Other Countries?

While HSAs are specific to the United States, other countries have developed their own mechanisms to help individuals manage and reimburse healthcare expenses. 

These systems vary in structure and benefits but serve the same fundamental purpose: to alleviate the financial burden of medical costs for employees. Below, we explore similar schemes in the UK, Singapore, the Philippines, and New Zealand.

In the UK

In the UK, there is no direct equivalent to the HSA reimbursement, but there are several health-related financial products that provide some of the same benefits:

Health Cash Plans

Health cash plans are insurance policies that allow employees to claim back the cost of everyday health expenses. These plans cover a range of services such as dental care, optical care, physiotherapy, and health screenings. 

Employees pay a weekly or monthly premium and can then claim reimbursements up to a specified limit for each type of expense.

For example, an employee might receive £100 per year towards dental check-ups and treatments, or £200 for prescription glasses. This helps spread the cost of routine health expenses and provides a safety net for smaller, more predictable medical costs.

Private Medical Insurance (PMI)

Private Medical Insurance (PMI) in the UK covers the cost of private healthcare, offering faster access to treatments and a broader choice of healthcare providers. Employers often provide PMI as part of their employee benefits package. PMI policies typically cover consultations, diagnostics, surgeries, and inpatient care. Unlike health cash plans, PMI is designed for more significant, less frequent health expenses.

Employees with PMI can access private hospitals and specialists. While PMI doesn't offer the same tax benefits as an HSA reimbursement, it provides substantial financial and service-level benefits for healthcare needs.


Singapore's healthcare financing system is multi-layered, combining individual savings, insurance, and government funding to cover various healthcare expenses. Key components include MediSave, MediShield Life, and Medifund.


MediSave is a compulsory national savings scheme where employees contribute a portion of their income to a personal healthcare savings account. These funds can be withdrawn to pay for a wide range of medical expenses, including hospitalizations, surgeries, and certain outpatient treatments, working similarly with HSA reimbursement. MediSave offers a level of personal control similar to an HSA, allowing individuals to manage their healthcare spending.

MediShield Life

MediShield Life is a basic health insurance plan that provides coverage for large hospital bills and expensive outpatient treatments. It works alongside MediSave by covering the cost of significant medical expenses that exceed an individual's MediSave balance. Premiums for MediShield Life can be paid using MediSave funds, ensuring that essential healthcare remains affordable.


Medifund is a government endowment fund designed to assist low-income individuals who cannot afford their medical bills despite other schemes like MediSave and MediShield Life. It acts as a safety net, ensuring that no Singaporean is denied essential healthcare due to financial constraints. While Medifund is not a savings or reimbursement account, it complements the other schemes to provide comprehensive healthcare support.


The Philippines has several healthcare financing mechanisms that offer reimbursement for medical expenses, albeit with different structures compared to an HSA.

Social Security System (SSS)

The SSS provides various benefits to its members, including sickness and maternity benefits, which offer financial support during periods of illness or pregnancy. Members contribute a portion of their salary to the SSS, which then provides cash allowances during periods of incapacity. Generally, employees pay out of pocket for their medical needs, then make claims to SSS to get the amount of money they are entitled to. 


PhilHealth is the national health insurance program that provides financial assistance for medical expenses. Members pay premiums based on their income, and in return, they receive coverage for a wide range of healthcare services, including inpatient and outpatient care, surgeries, and preventive services. In most cases, PhilHealth reduces the out-of-pocket expenses for employees, but employees can claim refunds, which works similarly with HSA reimbursement. 

Private Insurance

Many employers in the Philippines also offer private health insurance as part of their benefits package. Usually, the goal of private health insurance is to eliminate out-of-pocket expenses, but some also have a system similar to HSA reimbursement where employees pay first and then claim a refund. 

Benefits of Making Sure Employees Have Access to Healthcare Services

Ensuring employees have access to healthcare through systems like HSA reimbursement and private medical insurance can significantly benefit your organisation. It can:

  • Attract and retain top talent, as comprehensive healthcare coverage is a priority for employees.
  • Increase productivity and reduce absenteeism rates, leading to lower operational costs.
  • Foster a positive workplace culture, enhancing employee satisfaction and loyalty.
  • Potentially gain tax advantages from offering HSAs, resulting in financial savings.
  • Improve the company's reputation, making it more appealing to prospective employees and clients.
  • Demonstrate a commitment to employee well-being, which can enhance overall business performance.


While the HSA reimbursement system is unique to the United States, other countries have developed their own system to manage and reimburse healthcare expenses. From health cash plans and private medical insurance in the UK to Singapore's MediSave and MediShield Life, each system offers distinct benefits tailored to the healthcare needs of its population. Understanding these alternatives can help employers and employees navigate their healthcare options and make informed decisions about their health benefits.

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