What is the HSA high deductible rule?
Asked by: Domenico Rau | Last update: October 6, 2025Score: 4.1/5 (32 votes)
Is it worth it to have a high deductible health plan with HSA?
HDHP is great for young, healthy, and single people who are able to funnel excess cash into an HSA for its tax advantages. The high deductible means that you'll be basically uncovered for most ``standard'' health care outside of a yearly physical, but theoretically you have money in the HSA to cover such expenses.
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 isn't my high deductible plan HSA-eligible?
The most common reason for high deductible plans to fail the HSA test is that they have an associated pharmaceutical plan that is not subject to the same deductible. The pharmaceutical plan might just have co-pays from the first dollar of spending, making the entire plan ineligible for HSA.
What qualifies as 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 ...
When is a High Deductible Health Plan with an HSA a Good Choice?
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).
How do I know if my HSA is a high deductible plan?
Per IRS guidelines in 2025, an HDHP is a health insurance plan with a deductible of at least $1,650 if you have an individual plan or a deductible of at least $3,300 if you have a family plan. The deductible is the amount you'll pay out of pocket for medical expenses before your insurance pays anything.
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.
What happens if you contribute to HSA without HDHP?
There is no 20% penalty on excess contributions. If you no longer are enrolled in an HDHP you are not eligible to make contributions to your HSA, but you may request withdrawals for qualified medical expenses.
Can you 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.
When should you stop contributing to HSA?
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. Six months before you retire or get Medicare benefits, you must stop contributing to your HSA.
What qualifies as a high-deductible health plan?
An HDHP is health coverage with a: Higher annual deductible than typical health plans and. Maximum limit on the sum of the annual deductible and out-of-pocket medical expenses that the taxpayer must pay for covered expenses. Out-of-pocket expenses include copayments and cost sharing but do not include premiums.
What is a downside of a HDHP?
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.
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.
Should I use my HSA or pay out-of-pocket?
Use HSA funds to pay for emergency medical costs.
A better option is to pay with other funds and keep track of expenses. Medical claims never expire, so money can be withdrawn tax-free in retirement in order to reimburse medical expenses that were paid out-of-pocket years before.
Can HSA pay for gym membership?
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 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.
Can I use HSA for glasses?
Yes! You can definitely use funds from your flexible spending account (FSA) or health savings account (HSA) to purchase prescription glasses. (FSAs and HSAs can be used for many other vision- and eye health-related expenses, too, but we'll discuss that more in a bit.)
Can I use my HSA to pay health insurance premiums if I retire early?
If you pay for your medical expenses out of pocket now, you'll have more saved in your HSA account to help pay for medical expenses once you retire. If you retire before age 65 and you aren't yet eligible for Medicare, you can use money in your HSA to pay your medical coverage premiums.
What can I use my HSA for Blue Cross Blue Shield?
- Doctor and hospital visits.
- Copays and coinsurance.
- Prescriptions.
- Some over-the-counter medications like pain relievers, allergy relief, cough suppressants, etc.
- Feminine hygiene products.
- Dental and vision care, including prescription eyeglasses.
- Health insurance or medical expenses if unemployed.
Is an HSA or FSA better?
Bottom line: Both HSAs and FSAs provide financial benefits for managing health care expenses. HSAs offer more flexibility and long-term growth potential, making them a valuable tool for future financial planning. Learn about HSA options from Aetna.
What happens to my HSA if I no longer have a high deductible plan?
16. What happens to my HSA if I change health plans, terminate employment, or retire? The money in the HSA belongs to you. You can continue to use the money in your HSA to pay for qualified medical expenses but you can no longer make contributions to the account unless you are enrolled in another HSA-eligible HDHP.
Are vitamins HSA-eligible?
In general, vitamins are not considered an HSA eligible expense unless they are prescribed by a doctor for a specific medical condition. For example, if your doctor prescribes prenatal vitamins during pregnancy or recommends vitamin D supplements to treat a deficiency, those could be eligible expenses under your HSA.
What insurance premiums can be paid with HSA funds?
You can use your HSA to pay for premiums on long term care insurance, COBRA (health insurance you might use if you become unemployed), and even Medicare if you are age 65 or older.