The Basic Requirements for an HSA Account

To open an HSA account, you must be enrolled in a high-deductible health plan (HDHP) — a specific type of health insurance with a higher deductible and lower premiums than traditional plans. You cannot have an HSA if you are covered by any other health insurance that is not an HDHP, with narrow exceptions for specific plans like dental-only or vision-only coverage. You also cannot be claimed as a dependent on someone else's tax return, and you cannot be enrolled in Medicare.

The HDHP itself must meet IRS minimum deductible amounts, which change yearly. For 2024, the minimum deductible is $1,600 for individual coverage and $3,200 for family coverage. Your plan's out-of-pocket maximum (the most you pay before insurance covers everything) also has IRS limits: $4,150 for individual coverage and $8,300 for family coverage in 2024. Your employer, your insurance company, or the healthcare marketplace where you buy your plan can confirm whether your specific plan qualifies as an HDHP.

Key Takeaways

  • You must be enrolled in a high-deductible health plan (HDHP) to open an HSA, and you cannot have other health insurance at the same time except dental or vision coverage.
  • Your HDHP must meet IRS minimum deductible amounts, which are $1,600 for individual coverage and $3,200 for family coverage in 2024.
  • You cannot be enrolled in Medicare, claimed as a dependent, or covered by a spouse's non-HDHP health plan and still contribute to an HSA.
  • If you gain or lose HDHP coverage during the year, you can still open an HSA for that year, but contribution limits are reduced based on the months you were actually covered.

Who Cannot Open an HSA

Medicare enrollment disqualifies you from opening a new HSA, even if you are still working and have an HDHP through your employer. If you are already enrolled in Medicare Part A or Part B, you cannot contribute to an HSA going forward. Some people delay Medicare enrollment specifically to keep contributing to an HSA, but this requires careful planning with a tax professional because Medicare has its own enrollment deadlines and penalties.

If you are claimed as a dependent on someone else's tax return — typically an adult child claimed by a parent — you cannot open an HSA regardless of your health insurance. This rule applies even if you pay for your own insurance and have an HDHP. Once you are no longer claimed as a dependent, you become able to open an account.

Spouses with family HDHP coverage can each open separate HSA accounts and contribute to both. However, if one spouse has an HDHP and the other has traditional insurance, the spouse with the HDHP cannot contribute to an HSA because the family is covered by non-HDHP insurance.

Coverage Changes During the Year

If you enroll in an HDHP partway through the year, you can still open an HSA for that year. However, your contribution limit is reduced based on how many months you were actually covered by an HDHP. The IRS counts each month you were covered as one-twelfth of the annual limit. If you enrolled in July, for example, you could contribute one-twelfth of the annual limit for each of the seven months remaining in the year.

If you lose HDHP coverage during the year — because you changed jobs, lost coverage, or switched to a different plan — you can no longer contribute to your HSA for the remainder of that year. Money already in the account stays there and can be used for may have access to medical expenses anytime, but new contributions are not allowed once coverage ends.

Self-Employed and Gig Workers

Self-employed people and gig workers can open an HSA if they purchase an HDHP through the healthcare marketplace (also called the ACA marketplace or exchange). The plan must still meet the IRS deductible and out-of-pocket maximum limits. You do not need employer sponsorship to open an HSA — the requirement is only that you are enrolled in an HDHP, regardless of who pays for it.

If you are self-employed and have employees, you can offer an HDHP through a group health plan, and both you and your employees can open HSAs. The same rules apply: the plan must meet IRS minimums, and each person must have no other health insurance except dental or vision coverage.

Verification and Documentation

When you open an HSA, the financial institution (usually a bank or investment company) will ask you to confirm that you meet the requirements. You will typically need to provide your health insurance information, including your plan name and policy number, so they can verify it is an HDHP. Some institutions verify this automatically through insurance company databases; others ask you to submit a copy of your insurance card or plan documents.

You are responsible for maintaining your own records showing you met the requirements for each year you contributed. If the IRS ever audits your HSA, you may need to show proof that you were enrolled in an HDHP and had no other disqualifying coverage. Keep copies of your insurance cards, plan documents, and any correspondence from your employer or insurance company about your coverage status.

What Happens If You Lose may be able to access

If you lose HDHP coverage — because you switch to a traditional plan, enroll in Medicare, or lose health insurance entirely — you can no longer contribute to your HSA. However, the money already in your account is yours to keep. You can continue to withdraw it for may have access to medical expenses for the rest of your life, with no time limit.

If you withdraw HSA money for non-medical expenses after you lose HDHP coverage, you will owe income tax on the withdrawal, but you will not owe the additional 20% penalty that applies to non-medical withdrawals while you are still covered by an HDHP. This is one reason some people keep their HSA accounts open even after they stop contributing.

Frequently Asked Questions

Can I have an HSA if my spouse is on Medicare?

Yes, as long as you are not enrolled in Medicare yourself. Your spouse's Medicare enrollment does not affect your ability to open or contribute to an HSA. However, if you are married and file taxes jointly, you cannot claim your spouse as a dependent, so this rule does not apply to you anyway.

What if my employer offers both an HDHP and a traditional plan?

You must choose one or the other. If you enroll in the HDHP, you can open an HSA. If you enroll in the traditional plan, you cannot. You can change plans during your employer's open enrollment period, which usually happens once a year, and your HSA may be able to access changes with your plan choice.

Do I lose my HSA if I change jobs?

No. Your HSA is your personal account, not tied to your employer. If you change jobs and your new employer offers an HDHP, you can continue contributing to your existing HSA or open a new one. If your new job does not offer an HDHP, you can keep the money in your existing HSA but cannot add new contributions until you enroll in an HDHP again.

Can I open an HSA if I have a Health Savings Account through my spouse's employer?

No. If you are married and file taxes jointly, you and your spouse are treated as one household for HSA purposes. Only one HSA can be open per household per year. If your spouse already has an HSA, you cannot open a separate one, even if you both have HDHP coverage.

What if I am unsure whether my plan is an HDHP?

Contact your employer's benefits office or your insurance company directly and ask whether your plan qualifies as an HDHP under IRS rules. They can tell you the deductible and out-of-pocket maximum amounts and confirm may be able to access. You can also check your insurance card or plan documents for the plan name and search the IRS website for a list of may have access to plans.