You need three things: a high-deductible health plan, U.S. citizenship or residency, and no other coverage that disqualifies you

A Health Savings Account (HSA) is not something you request from a government agency. You open one through a bank, credit union, or financial institution—the same way you'd open a regular savings account. But the IRS has strict rules about who can have one, and they centre on your health insurance.

The core requirement is that you must be enrolled in a high-deductible health plan (HDHP). For 2024, that means your plan's deductible is at least $1,600 for individual coverage or $3,200 for family coverage. Your out-of-pocket maximum cannot exceed $4,000 for individual coverage or $8,000 for family coverage. These numbers change yearly, so check your plan documents or call your insurer to confirm your plan qualifies.

You also cannot be covered by any other health insurance that would disqualify you—Medicare, Medicaid, TRICARE, the Veterans Administration, or a spouse's non-HDHP plan. If you have coverage through any of those, you cannot open or contribute to an HSA, even if you also have an HDHP.

Key Takeaways

  • Your health insurance plan must be a high-deductible plan with a deductible of at least $1,600 (individual) or $3,200 (family) in 2024, and you can verify this by calling your insurer or checking your plan documents.
  • You cannot have Medicare, Medicaid, TRICARE, VA coverage, or a spouse's non-HDHP plan at the same time you hold an HSA.
  • You must be a U.S. citizen or resident alien with a valid Social Security number, and you cannot be claimed as a dependent on someone else's tax return.
  • You open an HSA directly with a financial institution—not through your employer or the government—though your employer may offer one as a payroll option.
  • You can open an HSA at any point during the year, but contributions for a given tax year must be made by the tax filing important date (usually April 15) to count toward that year.

Verify your health plan meets the HDHP definition

Before you do anything else, confirm that your plan actually qualifies. Call your health insurance company directly and ask: "Does my plan meet the IRS definition of a high-deductible health plan for HSA purposes?" They will tell you yes or no. Do not assume based on the plan name or what your employer told you—some plans that sound like they should may have access to do not.

If your employer offers an HSA option during open enrollment, they have already vetted the plan. If you are shopping for coverage on your own through the health insurance marketplace or a broker, look for plans labeled as HSA-may be able to access or HSA-compatible. The marketplace website will flag them.

Your deductible and out-of-pocket limits are in your plan documents or on your insurer's website. If you cannot find them, call and ask for your Summary of Benefits and Coverage (SBC)—that document lists both figures clearly.

Check that you have no disqualifying coverage

Even if your plan is an HDHP, you cannot contribute to an HSA if you have other health coverage running at the same time. The most common disqualifiers are Medicare (even Part A alone), Medicaid, TRICARE, VA health benefits, or a spouse's health plan that is not an HDHP.

If you are turning 65 and enrolling in Medicare, you can no longer contribute to an HSA starting the month you enroll, even if you keep your HDHP. If you are on Medicaid and also have an HDHP, you cannot use the HSA. If your spouse has a PPO or HMO plan through their job, you cannot open a family HSA—you could only open an individual one if you are also on an HDHP.

The exception: if your spouse has an HDHP and you are both covered under it as a family plan, you can open a family HSA together. You would each contribute to the same account, and the combined contributions cannot exceed the family limit for that year.

Confirm your tax status and residency

You must be a U.S. citizen or a resident alien with a valid Social Security number. If you are a non-resident alien, you cannot open an HSA. You also cannot be claimed as a dependent on someone else's tax return—if a parent or other person claims you as a dependent, you are ineligible, even if you have an HDHP.

If you are unsure whether you are a resident alien for tax purposes, check your most recent tax return or contact the IRS directly. The definition is specific and depends on how long you have been in the United States and your immigration status.

Open an HSA with a financial institution

Once you confirm you meet the requirements, you open an HSA the same way you open any savings account. You can go to a bank, credit union, or online financial institution. Many large banks offer HSAs—Chase, Bank of America, Wells Fargo, and others. Credit unions often offer them too. You can also use HSA-specific custodians like HealthEquity, Lively, or Fidelity.

You will need your Social Security number, proof of identity, and proof of your HDHP enrollment. Some institutions ask for a copy of your insurance card or plan documents. The process usually takes 10 to 15 minutes online or in person.

If your employer offers an HSA through payroll, you can set it up through your benefits portal. This is often simpler because your employer has already done the HDHP verification. But you are not required to use your employer's HSA—you can open one anywhere and contribute on your own.

Understand the contribution important date and timing

You can open an HSA at any time during the year. However, contributions for a specific tax year must be made by the tax filing important date for that year—usually April 15 of the following year. If you open an HSA in November 2024, you can still make contributions that count toward your 2024 tax year, as long as you deposit the money by April 15, 2025.

If you enroll in an HDHP mid-year, you can still open an HSA and contribute for the remainder of that year. The contribution limit is prorated based on the number of months you were may be able to access. For example, if you enroll in an HDHP in July, you can contribute one-half of the annual limit for that year.

There is one exception: if you enroll in an HDHP in December, you can contribute the full annual amount for that year, even though you were only covered for one month. This is called the "testing period" rule, but it comes with a catch—you must remain on an HDHP for the entire following year or you will owe back taxes and penalties.

Know what happens if your circumstances change

If you lose your HDHP coverage or gain disqualifying coverage (like Medicare or Medicaid), you can no longer contribute to your HSA. However, the money already in the account stays there and grows tax-free. You can withdraw it for may have access to medical expenses at any time, tax-free. You just cannot add new money.

If you move to a state with different Medicaid rules or your employer changes your health plan, review your coverage when ready. Some life changes—like turning 65, getting married, or losing a job—can affect your HSA may be able to access. When in doubt, call your insurer and ask whether your new plan is HDHP-may be able to access.

Frequently Asked Questions

Can I open an HSA if my employer does not offer one?

Yes. You can open an HSA at any bank or financial institution that offers them, regardless of whether your employer has a plan. You will need to show proof of your HDHP enrollment, usually a copy of your insurance card or plan documents.

What if I have an HDHP but I am also on my spouse's non-HDHP plan?

You cannot contribute to an HSA. Even though you have an HDHP, the non-HDHP coverage disqualifies you. You would need to drop the spouse's plan or switch to an HDHP family plan together.

Can I open an HSA if I am self-employed?

Yes, as long as you have an HDHP and meet all other requirements. Self-employed people often use HSAs because they can contribute to them and deduct the contributions on their tax return, just like an employee would.

What if I turned 65 and enrolled in Medicare?

You cannot contribute to an HSA once you enroll in Medicare, even if you keep your HDHP. The money already in your account remains available for may have access to medical expenses, but you cannot add new contributions.

Do I need my employer's permission to open an HSA?

No. You can open an HSA on your own at any financial institution. If your employer offers one through payroll, that is a convenience option, but it is not required. You are free to open an account elsewhere and contribute independently.