How does high deductible plan affect taxes?

Asked by: Kailey Zboncak  |  Last update: January 10, 2026
Score: 4.9/5 (67 votes)

High-Deductible Health Plan Tax Benefits You don't pay federal taxes on the money you put into it. Your total annual contribution is tax deductible. Your money can earn interest, which is also tax-free. Any money you don't spend rolls over into the next year.

Does having an HSA affect my taxes?

Health Savings Accounts offer a triple-tax advantage* – deposits are tax-deductible, growth is tax-deferred, and spending is tax-free. All contributions to your HSA are tax-deducible, or if made through payroll deductions, are pre-tax which lowers your overall taxable income.

What is the downside to having a high deductible?

Cons. Higher deductible: If your deductible is higher, it means you are required to pay for your medical care out of pocket up to that amount before your health plan begins to help pay for covered costs. The exception is for preventive care, which is covered at 100% under most health plans when you stay in-network.

How does the IRS know if you have a HDHP?

How does the IRS know you have a high deductible health plan? Because your employer reports to the IRS and then gives you proof of insurance attached to your W-2. It used to be a provision of the Obamacare law that you paid a penalty for not having insurance so companies now give you proof of insurance.

Do I need to report HSA contributions on my tax return?

Form 8889 is submitted with your tax return via Form 1040 or Form 1040-SR to report a distribution from the account, even if it's not taxable. If you took a taxable distribution from your HSA, this is where you report that. You also report contributions and any deductions related to your HSA on this form.

New HSA Rules in 2025 You Need to Know

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Why does my HSA lower my tax refund?

When you contribute money to an HSA, it decreases your adjusted gross income (AGI) which determines your taxable income. Since the U.S. runs on a tax rate system based on your income, the lower your AGI, the lower your tax bill.

What is the downside of an HSA?

Drawbacks of HSAs include tax penalties for nonmedical expenses before age 65, and contributions made to the HSA within six months of applying for Social Security benefits may be subject to penalties. HSAs have fewer limitations and more tax advantages than flexible spending accounts (FSAs).

Do you get a tax break for having a high-deductible health plan?

Leverage the tax breaks.

The HSA that comes with an HDHP offers a potential triple tax advantage2, that helps you save on taxes: Your HSA contributions are made pre-tax. Interest and any investment earnings in the account are tax-free. Your payments for qualified medical expenses are tax-free.

What are the problems with HDHP?

High-deductible health plans (HDHPs) are characterized by higher deductibles and lower monthly premiums compared with a typical health plan. HDHPs may reduce, or delay, needed care, which will ultimately lead to poorer access to care for chronically affected participants.

What is the 12 month rule for HSA?

It means you must remain eligible for the HSA until December 31 of the following year. The only exceptions are death or disability. If you violate the testing period requirement, your ineligible contributions become taxable income.

Why is it not a great idea to have a high deductible?

Large medical expenses: Since HDHPs generally only cover preventive care, an accident or emergency could result in very high out-of-pocket costs. Future health risks: Because of the costs, you may refrain from visiting a physician, getting treatments, or purchasing prescriptions when they're not covered by your HDHP.

Is it better to have HDHP or PPO?

HDHPs can be a good form of insurance for the young and healthy — especially if your employer offers you HSA contributions. But for anyone with significant medical expenses, an upcoming surgery, or a serious health condition, a PPO could be a better fit because of the lower deductible.

Can you use GoodRx with HSA?

You can use the funds from your HSA on qualified medical expenses, including prescriptions purchased using a GoodRx discount card.

What is the tax loophole for HSA?

The ultimate loophole available to almost everyone under the age of 65 in our tax code is the Health Savings Account (HSA). It is the only account you can contribute to and deduct the contribution and then withdraw the money tax free. Think about that, a tax deduction going in and no taxes going out.

What decreases your taxable income?

There are a few methods recommended by experts that you can use to reduce your taxable income. These include contributing to an employee contribution plan such as a 401(k), contributing to a health savings account (HSA) or a flexible spending account (FSA), and contributing to a traditional IRA.

Can I cash out my HSA when I leave my job?

Yes, you can cash out your HSA at any time. However, any funds withdrawn for costs other than qualified medical expenses will result in the IRS imposing a 20% tax penalty. If you leave your job, you don't have to cash out your 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.

What is one disadvantage to a high deductible health plan?

While High Deductible Health Plans (HDHPs) offer low monthly premiums, they come with several cons that individuals need to consider before enrolling. One major disadvantage is the high out-of-pocket expenses that a person may face before their coverage kicks in.

What is the upside to having a high deductible?

This means you'll pay less each month for insurance and more out-of-pocket when you receive care. The upside? Preventive care is still covered at 100 percent on these plans. Once you hit your deductible, your health plan will start to cover the cost of your other care.

Is it worth it to have a high deductible health plan?

HDHPs have higher out-of-pocket costs than LDHPs. So, this type of plan is best for healthy people who expect little to no healthcare expenses. If this outlines your scenario, the HDHP's lower premium will likely save you more money than you would spend on medical care.

Do HSA contributions reduce your taxable income?

HSA Contributions Are Tax-Deductible

Deductions reduce your taxable income, which can potentially push you into a lower tax bracket. With an HSA, you're allowed to write-off the money you contribute for the year.

What does the IRS consider a high deductible health plan?

HDHP deductible and out-of-pocket maximum

For 2025, the Internal Revenue Service (IRS) defines a high-deductible health plan as any plan with an annual deductible of at least $1,650 for an individual or $3,300 for a family.

When should you not use an HSA?

HSAs might not make sense if you have some type of chronic medical condition. In that case, you're probably better served by traditional health plans. HSAs might also not be a good idea if you know you will be needing expensive medical care in the near future.

Can I use HSA for dental?

Your HSA also covers expenses for standard dental cleanings and dental check-ups. One thing to keep in mind is that some of these procedures may have a co-payment, so it's important that you check with your dental insurance provider to find out exactly what you'll have to pay out of pocket.

Does HSA lower my paycheck?

Contributing to the HSA will both reduce your taxes and your paycheck because the amount of the contribution is greater than the tax savings.