Dean Austin, CEO of Austin Benefits Group in Bloomfield Hills, Michigan, is noticing a change in how people treat their health savings accounts.

"I see them paying more attention to HSAs as part of their overall financial strategy," Austin says. "If people have the financial means — a group with incomes of $80,000 a year and more — we are certainly seeing that they are putting in the maximum contributions and taking the tax benefits."

That's a change from years past, when consumers contributed about the same amount that they spent in any given year. It's a possible reflection of consumers' growing awareness that they will incur substantial medical costs as they age. In 20 years of retirement, from ages 65 to 85, the average couple will spend about $491,000 out-of-pocket on health care, says Peter Stahl, president of Bedrock Business Results near Philadelphia and an expert on health care challenges during retirement.