Can you have a high-deductible plan and Medicare?

Asked by: Roberto Prohaska V  |  Last update: October 27, 2025
Score: 4.7/5 (19 votes)

Retirees older than age 65. These retirees must be enrolled in Medicare Part A and B, and that coverage disqualifies them from participating in the HSA/HDHP. If the Medicare enrolled retiree is on a family contract, no member on the family contract may have an HDHP plan.

Can I be on Medicare and a HDHP?

Some people opt to wait to enroll in Medicare and keep their HDHP and their HSA. This is allowed, providing a person has healthcare coverage.

What is the penalty for having an HSA and Medicare?

What are the consequences of contributing funds to my HSA while enrolled in Medicare? Medicare beneficiaries who continue to contribute funds to a HSA may face IRS penalties including payment of back taxes on their tax-free contributions and account interest, excise taxes and additional income taxes.

Do I have to stop HSA contributions 6 months before Medicare?

Because your enrollment date for Medicare (ie, when your coverage starts will generally be 6 months before your application date, you must stop contributing to your HSA 6 months before applying for Medicare.

Can you have a deductible with Medicare?

You pay this deductible once each year. You'll usually pay 20% of the cost for each Medicare-covered service or item after you've paid your deductible. If you have limited income and resources, you may be able to get help from your state to pay your premiums and other costs, like deductibles, coinsurance, and copays.

Medicare High Deductible Plan

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Does everyone have to pay $170 a month for Medicare?

Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.

Why are people leaving Medicare Advantage plans?

Key takeaways: People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.

What is the 6 month rule for Medicare?

You can sign up for Part A any time after you turn 65. Your Part A coverage starts 6 months back from when you sign up or when you apply for benefits from Social Security (or the Railroad Retirement Board). Coverage can't start earlier than the month you turned 65.

What happens to my HSA balance when I go on Medicare?

The month your Medicare begins, your account overseer should change your contribution to your HSA to zero dollars per month. However, you may continue to withdraw money from your HSA after you enroll in Medicare to help pay for medical expenses, such as deductibles, premiums, copayments, and coinsurances.

What is considered a high deductible health plan in 2024?

For calendar year 2024, a “high deductible health plan” is defined under § 223(c)(2)(A) as a health plan with an annual deductible that is not less than $1,600 for self-only coverage or $3,200 for family coverage, and for which the annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not ...

Why can't Medicare recipients have an HSA?

Yes. Because Medicare doesn't offer an HSA-qualifying option, you can no longer make contributions to an HSA — even if you have another health plan.

What happens to your HSA when you turn 65?

Once you turn 65, you can use the money in your HSA for anything you want. If you don't use it for qualified medical expenses, it counts as income when you file your taxes.

Can I reimburse myself from HSA for Medicare premiums?

Yes. You can withdraw money from your HSA to reimburse yourself for Medicare premiums that are automatically deducted from your Social Security benefits check. You can withdraw HSA funds at any time to reimburse yourself for eligible expenses you have incurred since you opened the HSA.

Who should avoid a high deductible health plan?

While these types of plans can be beneficial to those who are relatively healthy, they can be very expensive for those who have chronic conditions or who experience a medical crisis. It's important to carefully consider your expected medical expenses before choosing to participate in a high deductible health care plan.

Can my wife have an HSA if I am on Medicare?

Yes, being eligible to contribute to the HSA is determined by the status of the HSA account holder not the dependents of the account holder. Your spouse being on Medicare does not disqualify you from continuing contributions to the HSA up to the family limit, even if they are also covered by the HDHP.

Is a HDHP considered creditable coverage for Medicare?

The $3,200 Deductible and $5,000 High Deductible Health Plans (HDHP) do not provide Creditable Coverage. The HDHPs provide no prescription drug coverage until the deductible is satisfied and therefore, do not provide Creditable Coverage.

Is there a penalty for HSA with Medicare?

There's no penalty for having an already established HSA when you're enrolled in Medicare, although you can no longer set up a new HSA. However, if you save to an HSA while you're enrolled in Medicare, you may be hit with IRS penalties on what are considered “excess contributions,” including a 6% excise tax charge.

What is the 6 month rule for Medicare and HSA?

If you have a Health Savings Account (HSA), you and your employer should stop contributing to your HSA 6 months before you retire or apply for benefits from Social Security (or the Railroad Retirement Board). This will ensure you avoid a tax penalty.

Do you have to stop HSA before Medicare?

To avoid a tax penalty, many advisors recommend you stop contributing to your HSA at least 6 months before you apply for Medicare. NOTE: It may take several weeks to process a request to stop any automatic contributions.

What is the 2 2 2 rule in Medicare?

Introduced in the Fiscal Year 2014 Inpatient Prospective Payment System (IPPS) Final Rule, the two-midnight rule specifies that Medicare will pay for inpatient hospital admissions when a physician reasonably expects the patient's care to require a stay that crosses two midnights, and the medical record supports this ...

What is the best supplemental insurance for Medicare?

The best Medicare supplement plan providers
  • Best for extra plan benefits: Humana.
  • Best for straightforward coverage: State Farm.
  • Best for extensive medical care coverage: AARP by UnitedHealthcare.
  • Best for a range of Medigap plans: Blue Cross Blue Shield.

What is the 100 day rule for Medicare?

Medicare covers up to 100 days of care in a skilled nursing facility (SNF) each benefit period. If you need more than 100 days of SNF care in a benefit period, you will need to pay out of pocket. If your care is ending because you are running out of days, the facility is not required to provide written notice.

Why do doctors not like Medicare Advantage?

Many doctors and healthcare physicians don't like Medicare Advantage plans due to coverage restrictions, limited networking, and overpayment rates, which cause increasing difficulties for patients. Since pre-authorization and referral requirements often impede patients' needs, doctors refuse to accept these plans.

What happens if you can't afford a Medicare Supplement plan?

If you are still finding yourself squeezed, look into a Medicare Savings Progam. There are four different programs with different asset and income criteria. These programs can help you to pay for Part A and Part B. They can also enroll you in the Extra Help program to assist with Part D costs.

Why are seniors losing Medicare Advantage plans?

Medicare vs Privatized Medicare Advantage

Beneficiaries are tossed aside because they live in an unprofitable market for their insurer or because they are actually using the insurance they signed up for to access services.