(FORTUNE Small Business) – Small-business owners have often felt like second-class citizens when it comes to their own health insurance. With U.S. premiums up 13.9% last year, a common strategy for entrepreneurs is to buy "catastrophic" insurance, which covers big expenses but leaves you on the hook for routine doctor visits and drugs until a high deductible is met and the coverage kicks in. But with the recent introduction of health savings accounts (HSAs), help is here.

HSAs (formerly called medical savings accounts, or MSAs) grew out of a seven-year pilot program available only to business owners and the self-employed. The new accounts are free of many restrictions that limited MSAs and are open to anyone under 65 who is covered by a catastrophic insurance policy--that is, one with a deductible of $1,000 or more ($2,000 for families). The main companies offering HSAs so far are Fortis Health of Milwaukee and Golden Rule of Lawrenceville, Ill., but more are expected to enter the market soon.

You might face a complex decision over whether to set up catastrophic insurance for your employees: One worker with a chronic condition such as diabetes will bump up the premiums for everyone. But if you purchase catastrophic insurance for your personal health care, HSA accounts are a slam dunk. As with an IRA, you contribute pretax money to an account that bears interest or can be invested in stocks. You can contribute as much as the deductible on your catastrophic policy, up to $2,600 a year for one person or $5,150 for a family. The money in the HSA is designated for health-related expenses such as doctor's visits, dental care, and even alternative therapies like acupuncture. At the end of the year, any leftover money rolls to the next year--eliminating one headache of today's use-it-or-lose-it flexible spending accounts.

Unlike an IRA, you don't pay any tax on withdrawals, as long as the money is used to cover qualified medical expenses. "Nothing else allows you a deduction today and tax-free withdrawal tomorrow," says Pam Dumonceau, a financial planner in Boulder. If you withdraw money for non-health-care expenses, you pay tax on the withdrawal, plus a 10% penalty. But after age 65 that penalty is waived, meaning any extra HSA money is yours in retirement.

Fran Molinari, 47, a partner at accountants Molinari Oswald in Bethlehem, Pa., set up an HSA in January. The cost of his Blue Cross family plan was set to go up by 30%, to $818 a month. He instead bought a family plan from Fortis Health with a $4,000 deductible that costs $470 a month. The premium savings works out to $4,173 a year--more than enough to cover the higher deductible. Plus, Molinari gets tax advantages--advantages that might grow if, as President Bush proposed in his State of the Union address, not only HSA contributions but also catastrophic-insurance premiums could be deductible from taxable income.

One factor to consider: HSAs require thinking about health care in a different way--a market-oriented way that many entrepreneurs no doubt will welcome. Says Tim Bireley, a spokesman for Fortis Health: "It was an easy decision to go to the doctor for a $10 co-pay, but if you're paying the full $150, you'll think twice about whether you really need to go"--and to whom you go and how many follow-up visits you need. On the other hand, the accounts give you a tax break--as well as a financial incentive to get in shape, stop smoking, and take better care of yourself.