What is the 6 month rule for HSA and Medicare?

Asked by: Nedra Schimmel  |  Last update: July 9, 2025
Score: 4.1/5 (74 votes)

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 6 months before Medicare?

What to do with your HSA if you get Medicare Part A. If you have to (or choose to) enroll in Medicare Part A, the coverage is retroactive for up to 6 months, but no earlier than your eligibility date. Because of this, you should plan to stop HSA contributions around 6 months before enrolling in Medicare.

What is the 6 month look back for Medicare HSA?

If you enroll in Medicare after turning 65, your coverage can become effective up to 6 months earlier. You and your employer will need to end your HSA contributions up to 6 months before enrolling in Medicare since Medicare back dates your Part A coverage from the date you enroll.

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.

Can you have an HSA and Medicare at the same time?

Can I enroll in an HSA if I am enrolled in Medicare? No. Once you enroll in Medicare Part A and/or B, you can no longer setup or contribute pre-tax dollars to an existing HSA.

6-Month Lookback on HSA Contributions Before Medicare

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What is the penalty for having an HSA and 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.

Can I contribute to an HSA if I am over 65 and still working?

If you are not enrolled in Medicare and are otherwise HSA eligible, you can continue to contribute to an HSA after age 65. You are also allowed to contribute the $1,000 catch-up. If you signed up for Medicare Part A and now want to decline it, you can do so by contacting the Social Security Administration.

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 ...

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.

Can I drop my employer health insurance and go on Medicare Part B?

Once you stop working (or lose your health insurance, if that happens first) you have an 8-month Special Enrollment Period (SEP) when you can sign up for Medicare (or add Part B to existing Part A coverage).

Why does Medicare Part A go back 6 months?

Beginning in 1983, the Department of Health and Human Services (HHS) started backdating Medicare coverage retroactively for six months to ensure that people coming off employer-sponsored health coverage would not inadvertently find themselves uninsured while transitioning to Medicare.

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.

Can I close my HSA account after age 65?

Remember, you have to stop contributing to your HSA once you enroll in Medicare Part A and/or Part B, which happens at age 65 for most people. But your HSA can continue to provide benefits long after you enroll in Medicare!

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.

Is there a penalty for Cobra and Medicare Part B?

If you have COBRA before signing up for Medicare, your COBRA will probably end once you sign up. You have up to 8 months after you stop working (or lose your health insurance, if that happens first) to sign up for Part B without a penalty, whether or not you choose COBRA.

Is HSA worth it for seniors?

Knowing that Medicare will only pay approximately 66%* of your health care costs in retirement, it may be a good idea to set aside money in your HSA for your retirement years.

How do you qualify for $144 back from Medicare?

To be eligible for the Medicare Part B Giveback Benefit, you must:
  1. Be enrolled Original Medicare (Parts A and B)
  2. Pay your own Part B premium.
  3. Live in the service area of a plan that offers a Part B giveback.

Why is Social Security no longer paying Medicare Part B?

There could be several reasons why Social Security stopped withholding your Medicare Part B premium. One common reason is that your income has exceeded the threshold for premium assistance. Another reason could be that there was a mistake or error in your records.

How much money can you have in the bank if you're on Medicare?

eligibility for Medi-Cal. For new Medi-Cal applications only, current asset limits are $130,000 for one person and $65,000 for each additional household member, up to 10. Starting on January 1, 2024, Medi-Cal applications will no longer ask for asset information.

What is the Medicare 85% rule?

Medicare pays for medical and surgical services provided by PAs at 85 percent of the physician fee schedule. This rate applies to all practice settings, including hospitals (inpatient, outpatient and emergency departments), nursing facilities, homes, offices and clinics. It also applies to first assisting at surgery.

What is the 80/20 Medicare rule?

The 80/20 Rule generally requires insurance companies to spend at least 80% of the money they take in from premiums on health care costs and quality improvement activities. The other 20% can go to administrative, overhead, and marketing costs. The 80/20 rule is sometimes known as Medical Loss Ratio, or MLR.

What is the Medicare 72 hour rule?

This rule, officially called the three-day payment window and sometimes referred to as the 72-hour rule, applies to diagnostic tests and other related services provided by the admitting hospital on the three calendar days prior to the patient's admission.

When should I stop contributing to HSA before Medicare?

If you do not stop HSA contributions at least six months before Medicare enrollment, you may incur a tax penalty.

At what age can you no longer have an HSA?

When you turn 65 and begin Medicare coverage, you lose HSA eligibility on the first day of that month. For example, if your birthday is April 19, you are no longer eligible to contribute to an HSA as of April 1.

Can HSA be used for dental?

Yes, you can use a health savings account (HSA) or flexible spending account (FSA) for dental expenses.