The Basic Requirements for an HSA

To open a Health Savings Account, you must be enrolled in a High Deductible Health Plan (HDHP) — a specific type of health insurance with a higher annual deductible than standard plans. You cannot have an HSA if you are covered by any other health insurance at the same time, with narrow exceptions for specific plans like dental-only or vision-only coverage. You also cannot be claimed as a dependent on someone else's tax return, and you cannot be enrolled in Medicare.

The HDHP itself must meet IRS standards for what counts as a high deductible. For 2024, that means your plan's deductible is at least $1,600 for individual coverage or $3,200 for family coverage. Your plan's out-of-pocket maximum cannot exceed $8,050 for individual coverage or $16,100 for family coverage. These numbers change each year, so check with your plan administrator or the IRS website to confirm the current year's thresholds.

You do not need to be self-employed or work for a specific type of employer. HSAs are available whether you buy your HDHP through an employer, the marketplace, or directly from an insurance company. The key requirement is the HDHP itself, not where you get it.

Key Takeaways

  • You must be enrolled in an HDHP with a deductible of at least $1,600 (individual) or $3,200 (family) to open an HSA.
  • You cannot have other health insurance at the same time, except for plans that cover only dental, vision, or specific conditions like workers' compensation.
  • You cannot be enrolled in Medicare or claimed as a dependent on someone else's tax return.
  • Your HDHP's out-of-pocket maximum must not exceed $8,050 (individual) or $16,100 (family) in the current year.
  • You can open an HSA through your employer, a bank, an insurance company, or a financial institution — the HDHP enrollment is what matters.

When Your HDHP Qualifies and When It Does Not

Not every plan labeled "high deductible" meets the IRS definition for HSA purposes. Some plans have a high deductible but also have features that disqualify them — for example, if they cover certain services before you meet the deductible, or if they charge a copay instead of requiring you to pay coinsurance. Your plan documents should state whether the plan is HSA-may have access to. If you are unsure, contact your plan's customer service line and ask directly: "Is this plan HSA-may have access to?"

If you are enrolled in an HDHP through your employer, your employer's benefits team can confirm whether the plan qualifies. If you bought your plan on the marketplace, the plan details page will usually indicate HSA may be able to access. Some marketplace plans are HSA-may have access to and some are not, even within the same insurance company.

Certain types of coverage disqualify you from an HSA even if your main plan is an HDHP. These include coverage through a spouse's employer plan (unless that plan is also an HDHP), coverage under a parent's plan (if you are under 26), or coverage through a government program like Medicaid or TRICARE. Dental and vision plans do not disqualify you, nor do plans that cover specific conditions like cancer or diabetes.

Age and Medicare Enrollment

There is no minimum age to open an HSA — children can have one if their parent opens it on their behalf and they are enrolled in an HDHP. However, you must stop contributing to an HSA once you enroll in Medicare, even if you are still working. Many people enroll in Medicare at 65, but some enroll earlier due to disability or end-stage renal disease.

If you turn 65 and enroll in Medicare Part A, you can no longer make new contributions to your HSA. You can still withdraw money from the account for medical expenses without penalty, but contributions stop. If you delay Medicare enrollment past 65, you can continue contributing to an HSA as long as you meet all other requirements.

Dependent Status and Tax Filing

If you are claimed as a dependent on someone else's tax return — typically a parent's — you cannot open or contribute to an HSA, even if you are enrolled in an HDHP. This rule applies regardless of your age or whether you have your own income. Once you are no longer claimed as a dependent, you become may be able to access to open an HSA if you meet the other requirements.

If you are unsure whether you are claimed as a dependent, check your most recent tax return or ask the person who files your taxes. The person who claims you as a dependent must not claim you in order for you to open an HSA.

Coverage Timing and Mid-Year Changes

You can open an HSA only during the months you are actually enrolled in an HDHP. If you enroll in an HDHP on March 1, you can open an HSA starting March 1 — not before. If you drop your HDHP coverage, you can no longer contribute to the HSA, though you can still withdraw money for medical expenses.

If you have a may have access to life event — such as losing employer coverage, getting married, or having a child — you may be able to enroll in an HDHP outside the standard open enrollment period. Once your new HDHP coverage begins, you can open an HSA if you did not already have one. If you switch from a non-HSA plan to an HDHP mid-year, you can open an HSA starting the month your HDHP coverage begins.

Contribution Limits and Who Can Contribute

Once you meet the basic requirements, you can contribute up to an annual limit set by the IRS. For 2024, the limit is $4,150 for individual coverage or $8,300 for family coverage. These limits increase slightly each year. You do not have to contribute the full amount — you can contribute any amount up to the limit, or nothing at all.

Your employer can contribute to your HSA, and that contribution counts toward your annual limit. If both you and your employer contribute, the total cannot exceed the limit. If you have family coverage and both you and your spouse have HSAs, each account has its own limit, and the combined contributions cannot exceed the family limit.

You can contribute to an HSA only during months you are enrolled in an HDHP. If you enroll mid-year, you can contribute a prorated amount for that year, or you can contribute the full annual amount if your plan allows it. Check with your HSA provider about their specific rules for mid-year enrollment.

Self-Employed and Gig Workers

If you are self-employed or work as an independent contractor, you can open an HSA as long as you enroll in an HDHP. You can buy an HDHP through the marketplace or through a professional association or trade group that offers group plans. The requirements are the same as for anyone else — the HDHP must meet the IRS deductible and out-of-pocket maximum thresholds.

Self-employed people can deduct HSA contributions on their tax return, just like they deduct other health insurance premiums. You do not need to be incorporated or have employees to open an HSA.

Frequently Asked Questions

Can I have an HSA if my spouse has a different health plan?

Only if your spouse's plan is also an HDHP or if your spouse is not covered by any health insurance. If your spouse has a non-HDHP plan, you cannot have an HSA. Family coverage on an HDHP is different — both spouses can be covered under the same HDHP and contribute to HSAs.

What happens to my HSA if I leave my job?

Your HSA stays with you — it does not belong to your employer. You can keep the account open and continue to withdraw money for medical expenses. You can only make new contributions if you enroll in another HDHP within 60 days or during the next open enrollment period.

Can I open an HSA if I am on Medicaid?

No. Medicaid coverage disqualifies you from opening an HSA, even if you also have an HDHP. If you lose Medicaid coverage, you can open an HSA the month your HDHP coverage begins, as long as you meet all other requirements.

Do I have to use my HSA every year or lose the money?

No. HSA funds roll over year to year — there is no "use it or lose it" rule. Money you do not spend stays in the account and grows if you invest it. You can withdraw it at any time for medical expenses, or leave it untouched for decades.

Can a teenager with their own income open an HSA?

Only if they are not claimed as a dependent on their parent's tax return. If they are claimed as a dependent, they cannot open an HSA even if they have their own income and are enrolled in an HDHP. Once they are no longer a dependent, they can open one.