Health Savings Account (HSA) Application - Optum Bank 2026

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The document is an application form for opening a Health Savings Account (HSA) with OptumHealth Bank. It outlines the necessary personal information required, instructions for submission, and details about optional features such as requesting additional debit cards. The form also includes sections for beneficiary designation and a required signature to certify the accuracy of the provided information. A processing fee for paper applications is mentioned, along with options to avoid it by enrolling online.

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Click ‘Get Form’ to open the Health Savings Account (HSA) Application in the editor.
Begin with Part 1: Personal Information. Fill in your Social Security Number, Date of Birth, First Name, Last Name, and Street Address. Ensure all starred fields (*) are completed to avoid processing delays.
In Part 2, if you wish to request an additional debit card for an authorized user, provide their First Name, Date of Birth, and Social Security Number.
Proceed to Part 3: High Deductible Health Plan Information. Enter your Medical Insurance Plan or Group Number and Carrier. Indicate who is covered and the HDHP Effective Date.
Complete Part 4 by designating a beneficiary if desired. If not specified, your estate will be the default beneficiary.
In Part 5, read the required statements carefully before signing. Your signature is essential for processing the application.
Finally, if applicable, check whether you are enclosing an opening deposit in Part 6 and indicate the amount.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can I use my Optum HSA card internationally?

So rest assured, you can use your HSA when traveling abroad.

Who is eligible for HSA Optum Bank?

To be an eligible individual and qualify for an HSA, you must meet the following requirements, as defined by the IRS: You must be covered under a high deductible health plan (HDHP) on the first day of the month. You have no other health coverage except what is permitted by the IRS. You are not enrolled in Medicare.

How to open an HSA with Optum Bank?

Open your HSA Register your account to access online banking. Designate a beneficiary for your account. Sign up for payroll deduction into your HSA, if this is an option provided by your employer. Start saving so you can pay for, or be reimbursed for, qualified medical expenses.

Is Optum Bank good for HSA?

Optum Financial is a leader in HSAs, with tools that help you pay for health care now and save for the future. With tax advantages and investment options, our HSAs are built to help you get more from your money and your benefits.

What is the minimum HSA account amount for Optum Bank?

The minimum amount that can be transferred at one time is $100. So you will need to have a balance of $2,100 before you are eligible to invest (assuming $2,000 investment threshold). To make things easier, you can choose to set up recurring transfers/sweeps.

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Is Optum Bank a good HSA?

Comments Section Optum is a parasite on your HSA. All Optum HSA investment options are costly and limited. Their all-cash balances earn 0.01% - like a crappy checking account. They also charge a lot of fees. Optums integration with Betterment and the mutual funds is slow and, in my case, utterly broken.

Can I withdraw money from Optum Bank HSA?

Once you are 65, you can withdraw funds for any reason without paying a penalty, but they will be subject to ordinary income tax. If you are under age 65 and use your HSA funds for nonqualified expenses, you will need to pay taxes on the money you withdraw, as well as an additional 20 percent penalty.