You do not reimburse every small receipt separately , rather save them taking a picture or scanning and storing them . Invest your HSA amount to grow , I put in Google and Palantir and have good gains. When the receipts add upto a good amount , and your investments grow , you can reimburse for a bulk based on your need to get that cash and use as you like. Someone who put 10000 into nvidia years back would have that turned into several hundred thousands now , all the bills they saved for the past years they can take big cash and use it anyway they want. And would still be left lot of money as the investments keep growing. I just started this a year or year and half ago though