and it was a real game changer for our budget.
It capped our total exposure each year. When we had a family of 6 at home, we were constantly dealing with random illnesses and accidents. Setting the max out of pocket and saving it each year with the carryover really helped.
It allowed us to save for the total exposure each year - as long as the max was under the federal allowable contribution.
It allowed us to save for orthodontics.
You don't have to use it all every year like an fsa.
It's tax free when it goes in, it' tax free when used on medical expenses. Make sure you max out your contributions every year.
If you're healthy, it creates a good savings tool that can be used in retirement.

The biggest fear I hear is, "What if I have a major event at the beginning of the year?" My response is that it's not likely payment will be due for 90 days. You can often negotiate the bill. You can also negotiate payment terms if necessary. With all of our medical expenses, and we've had many, we've never been in this situation.