Navigating Open Enrollment: Essential Reads for Expats in the US
Navigate US open enrollment with confidence—I've curated essential guides on HSAs, HDHPs, and FSAs to help expats decode America's complex benefits system.
Updated for 2026: This post was originally published in 2023. For the latest IRS figures and a comprehensive guide, see Expat Healthcare Benefits in the US: HSA, FSA & HDHP Guide (2026).
If you work for a company in the US, there is a good chance you are getting bombarded with emails right now about open enrollment. I remember my first open enrollment season after moving here — I stared at the benefits portal for about an hour, completely lost. HSA? FSA? HDHP? PPO? It felt like alphabet soup designed to confuse anyone who did not grow up in this system T.T
The thing is, nobody teaches you this. Your HR department assumes you understand the basics, and Google returns a thousand conflicting articles. So over the past couple of years, I have written several posts breaking down the key concepts that tripped me up. Here they are in one place, with a quick summary so you can decide which ones are relevant to you:
- Health Saving Accounts (HSA) — Explains how HSAs work as a triple-tax-advantaged savings account, why they are one of the best wealth-building tools in the US, and who qualifies.
- High Deductible Health Plan (HDHP) — Breaks down the trade-off between lower premiums and higher out-of-pocket costs, and helps you decide if an HDHP makes sense for your family's health situation.
- FSA 101 — Covers the basics of Flexible Spending Accounts, including the "use it or lose it" rule that catches most newcomers off guard and how to estimate the right contribution amount.
And if you are wondering why healthcare in the US costs so much in the first place (spoiler: it is complicated and frustrating), these might help:
- Never Pay the First Bill — A book review that changed how I handle medical bills — the core insight is that US hospital pricing is often negotiable and the first number you see is rarely the final number.
- Medical Insurance in the US — A broader overview of how the US insurance system works, what the different plan types mean, and what to watch out for as an expat.
Standard disclaimer: I am not a financial planner — always verify with your own research and HR department.
How are you handling open enrollment this year? Any tips or horror stories to share?
Cheers,
Chandler
