What are the IRS rules for HSA withdrawals?
Asked by: Fae Walker | Last update: November 14, 2025Score: 4.2/5 (33 votes)
What are the rules for withdrawing from a HSA?
You can withdraw money at any time if it's used for qualified medical expenses. However, if you withdraw money for other purposes, your withdrawal will be subject to income tax (if the contribution was pre-tax) and a 20% penalty.
Does IRS check HSA withdrawals?
Does HSA spending trigger an audit? The IRS doesn't monitor how you spend your HSA funds throughout the year, but that doesn't mean they won't ask for proof that your expenses were eligible. And if your tax return contains unrelated IRS audit red flags, your risk for an HSA audit could increase.
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.
What are the rules for HSA distributions?
HSA distributions
The IRS requires you to prepare Form 8889 and attach it to your tax return when you take a distribution from an HSA. However, if your 1099-SA indicates you did not use the distribution for qualified medical expenses, you will pay income tax on the portion you used for nonqualified expenses.
New HSA Rules in 2025 You Need to Know
How do I withdraw from HSA to avoid tax?
Once you turn 65, you can withdraw money from your HSA for any reason without penalty. But for the distribution to be tax- and penalty-free, it must be used for qualified medical expenses. If you use the funds for other purposes, the amount withdrawn will be subject to regular income taxes.
Can I use HSA money to pay off old medical bills?
No. You cannot reimburse qualified medical expenses incurred before your account was established. As soon as your account is opened and there is money in it, you can use the account for eligible expenses incurred any time after your account opening date.
Are HSA distributions taxable after age 65?
Once you're 65, your HSA is treated like a traditional IRA if you withdraw money for non-medical expenses. A traditional IRA is a retirement account in which the contributions and gains are tax-free, but withdrawals are subject to income tax.
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).
Can I use HSA to pay insurance premiums?
By using untaxed dollars in an HSA to pay for deductibles, copayments, coinsurance, and some other expenses, you may be able to lower your out-of-pocket health care costs. HSA funds generally may not be used to pay premiums.
Do you need receipts for HSA withdrawals?
Essentially, any money that comes out of your HSA must have a receipt showing it was for an eligible medical expense. You may face a 20% penalty on any distribution that you cannot prove was for a qualified medical expense.
Is a gym membership a qualified HSA expense?
Gym memberships. While some companies and private insurers may offer discounts on gym memberships, you generally can't use your FSA or HSA account to pay for gym or health club memberships. An exception to that rule would be if your doctor deems fitness medically necessary for your recovery or treatment.
How does the IRS know what I use my HSA for?
Verification of expenses is not required for HSAs. However, total withdrawals from your HSA are reported to the IRS on Form 1099-SA. You are responsible for reporting qualified and non-qualified withdrawals when completing your taxes.
Does IRS audit HSA withdrawals?
When using an HSA debit card, retain receipts for each transaction as those expenses will be reported to the IRS, and you could be audited.
Can you get in trouble for taking money out of your HSA?
Yes. You can take money out any time tax-free and without penalty as long as it is used to pay for qualified medical expenses. If you take money out for other purposes, however, you will pay income taxes on the withdrawal plus a 20% tax penalty.
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.
Do I ever lose my HSA money?
Myth #2: If I don't spend all my funds this year, I lose it. Reality: HSA funds never expire. When it comes to the HSA, there's no use-it-or-lose-it rule. Unlike Flexible Spending Account (FSA) funds, you keep your HSA dollars forever, even if you change employers, health plans, or retire.
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.
How does HSA affect taxes?
HSA contributions are tax-free.
For example, if your tax rate is 22 percent, and you contribute the maximum amount for 2024, which is $4,150 for an individual or $8,300 for a family, you could save $913 and $1,826 respectively, in tax payments.
At what age can you withdraw from HSA without penalty?
At age 65, you can take penalty-free distributions from the HSA for any reason. However, in order to be both tax-free and penalty-free the distribution must be for a qualified medical expense.
How do I avoid tax on my HSA distributions?
Distributions may be tax free if you pay qualified medical expenses. See Qualified medical expenses, later. An HSA is “portable.” It stays with you if you change employers or leave the work force.
What is the HSA account loophole?
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.
How much should I have in my HSA at retirement?
The amount of money you should have in your HSA during retirement depends on your healthcare needs and circumstances. According to the Fidelity Retiree Health Care Cost Estimate, a single person who is age 65 in 2023 should aim to have about $157,000 saved (after tax) for healthcare expenses during retirement.
How do I cash out my old HSA?
As a practical matter, you are allowed to withdraw funds from your HSA at any time for any reason. But if you aren't using the funds to cover a qualified medical expense, then you'll be stuck paying a penalty tax.
Can I use my HSA for gym membership?
Generally, the IRS doesn't allow pretax dollars in HSAs or FSAs for gym memberships. This is because they see them as expenses for general well-being rather than medical necessity. However, with a Letter of Medical Necessity (LMN), your HSA or FSA could be used to fund those expenses.