Who is eligible for an HSA?

You must be enrolled in a qualifying High Deductible Health Plan (HDHP), have no other disqualifying coverage (including most FSAs and Medicare), and not be claimed as a dependent.

What are the 2026 HSA contribution limits?

For 2026, the IRS limits are $4,400 for self-only coverage and $8,750 for family coverage, with a $1,000 catch-up for accountholders age 55 and older.

What expenses qualify for HSA reimbursement?

IRS Publication 502 governs qualified medical expenses: doctor visits, prescriptions, dental, vision, mental health, many over-the-counter items, and medical equipment among others.

What is the triple tax advantage of an HSA?

HSA contributions are pre-tax (or above-the-line deductible), the balance grows tax-free, and qualified medical withdrawals are tax-free.

Tax-advantaged savings

Health Savings Accounts (HSA)

An HSA is the only triple-tax-advantaged account: pre-tax contributions, tax-free growth, and tax-free withdrawals for qualified medical expenses. Pair it with an HSA-qualified HDHP.

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Who is HSA-eligible

Covered by an HSA-qualified High-Deductible Health Plan (HDHP) on the first day of the month.
No other non-HDHP medical coverage (limited exceptions: dental, vision, accident, disability, specific-disease).
Not enrolled in Medicare (any part).
Not claimed as a dependent on someone else's return.
No general-purpose FSA in the household (limited-purpose FSA is fine).

2025–2027 limits

Year	Self	Family	Catch-up	HDHP min deductible	HDHP max OOP
2025	$4,300iIRS Rev. Proc. 2025-19	$8,550iIRS Rev. Proc. 2025-19	$1,000 (55+)iIRS Rev. Proc. 2025-19	$1,650 self / $3,300 familyiIRS Rev. Proc. 2025-19	$8,300 self / $16,600 familyiIRS Rev. Proc. 2025-19
2026	$4,400iIRS Rev. Proc. 2025-19	$8,750iIRS Rev. Proc. 2025-19	$1,000 (55+)iIRS Rev. Proc. 2025-19	$1,700 self / $3,400 familyiIRS Rev. Proc. 2025-19	$8,500 self / $17,000 familyiIRS Rev. Proc. 2025-19
2027 (est.)	$4,550iIRS Rev. Proc. 2025-19	$9,050iIRS Rev. Proc. 2025-19	$1,000 (55+)iIRS Rev. Proc. 2025-19	$1,750 self / $3,500 familyiIRS Rev. Proc. 2025-19	$8,800 self / $17,600 familyiIRS Rev. Proc. 2025-19

Triple tax advantage

Contributions

Above-the-line deduction (or pre-tax via payroll, which also avoids FICA).

Growth

Interest, dividends, and capital gains accumulate federal-tax-free.

Withdrawals

Tax-free for qualified medical expenses — at any age, including reimbursing prior years if you saved receipts.

HSA as a stealth retirement account

Pay current medical bills out-of-pocket, invest the HSA, and save receipts indefinitely. Reimburse yourself decades later, tax-free. After age 65, non-medical withdrawals are taxed as ordinary income — same as a Traditional IRA — with no 20% penalty.

A married couple maxing the family limit ($8,750 in 2026i) for 25 years at a 7% return ≈ $590k, all tax-free for medical use.

IRS Pub 502 eligible expenses

Acupuncture

Treatments

Ambulance services

Services

Bandages

OTC

Birth control pills (Rx)

Blood pressure monitor

Equipment

Breast pumps & lactation supplies

Equipment

Chiropractor visits

Treatments

Contact lenses & solution

Vision

COVID-19 tests (at-home)

OTC

CPAP machines & supplies

Equipment

Crutches

Equipment

Dental treatment (non-cosmetic)

Dental

Diabetic supplies (lancets, strips, CGMs)

Equipment

Eyeglasses & exams

Vision

Fertility treatment & IVF

Treatments

First-aid kits

OTC

Hearing aids & batteries

Equipment

Insulin (prescription or OTC)

LASIK eye surgery

Vision

Long-term care insurance premiums (age-limited)

Premiums

Medicare Part B / D premiums (65+, not while on employer HSA)

Premiums

Menstrual care products

Added permanently by CARES Act 2020

OTC

Mental health therapy & counseling

Mental health

OTC medications (no Rx needed since 2020)

OTC

Orthodontia (medically necessary portion)

Dental

Physical therapy

Treatments

Pregnancy tests

OTC

Prescription drugs

Smoking cessation programs & Rx

Treatments

Sunscreen SPF 15+ broad spectrum

OTC

Surgery (non-cosmetic)

Services

Telehealth visits

Services

Therapy animals (service animals)

Services

Transportation for medical care (mileage)

Services

Vaccinations & flu shots

Services

Vision exams

Vision

Weight-loss programs (physician-prescribed)

Treatments

Wheelchairs & accessibility equipment

Equipment

X-rays & imaging

Services

See IRS Publication 502 (medical & dental expenses) and Publication 969 (HSAs) for the authoritative list. Cosmetic procedures, general health, and most gym memberships are not eligible.

Sources

The information contained on this website is for educational purposes only. We are not responsible for missing or inaccurate information. Please consult a licensed insurance broker in your state and area for insurance advice. Please consult a CPA for tax or legal advice.