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HSAs: Who Qualifies and Doesn't?

Who Qualifies for an HSA?

You, if you’re:

  • under the age of 65,
  • not listed as someone else’s dependent for income tax purposes,
  • not receiving Medicare or Social Security benefits,
  • covered by a high-deductible health plan, and
  • not covered by any other type of health insurance plan, except for:
    • Separate dental and/or vision care insurance, or flexible spending accounts (FSAs) covering only dental and/or vision care
    • Discount cards for health care services or products (for example, prescription drugs)
    • Disease management and wellness programs, as long as they do not “provide significant benefits in the nature of medical care”
    • Employee assistance plans, again if they do not “provide significant benefits” (short-term counseling is okay)
    • FSAs or HRAs that pay or reimburse for medical expenses after a high deductible has been met*
    • Separate long-term care insurance
    • Worker’s compensation insurance (through employers)
    • Disability insurance (individual or through unions or employment)
    • Automobile insurance (including coverage for medical care in accidents and emergencies)
    • Business liability insurance
    • Insurance that pays for fixed amount of hospitalization
    • Freestanding health insurance for travel (such as flight insurance or automatic travel coverage when transport is booked on a credit card).

*  Employers may offer HSAs or FSAs that pay or reimburse additional fees for coinsurance or out-of-pocket costs, provided that you have already satisfied your in-network deductible.  Retirement HRAs funded by employers, accounts that will only pay for or reimburse medical expenses incurred after retirement, are permitted. 

If your spouse or dependents are covered by other insurance, they may not be able to participate. However, you may still be able to use your HSA to pay for their qualifying medical expenses tax-free.

Who Will Not Qualify?

HSAs are not available to persons who are both eligible for and enrolled in Medicare. Most Americans qualify for Medicare at age 65; however, if an individual continues to work past that age, remains enrolled in a high-deductible health plan, and does not apply for Medicare benefits, he or she may qualify to contribute to an HSA.

If you’re claimed as a dependent on someone else’s tax forms — regardless of whether that someone is a spouse, a domestic partner, or a parent — you cannot open your own HSA.

Children not of working age cannot open their own HSAs with money given by their parents. Children who work but are claimed as dependents on their parents’ tax return cannot open their own HSAs.

Similarly, a non-working spouse or any other relative who is claimed as a dependent on another person’s tax return cannot open his or her own HSA either.

Individuals and families covered under traditional, full-coverage insurance plans (including Health Maintenance Organizations, Preferred Provider Options, Point-of-Service plans, Medicare and Medicaid) that do not meet the deductible minimum are not eligible for HSAs.

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