Who Can Contribute to an HSA: HDHP, Medicare, and Dependent Rules

You can contribute to a Health Savings Account if three things are true at once: you’re enrolled in a qualifying high deductible health plan, you have no other disqualifying health coverage, you’re not enrolled in any part of Medicare, and no one else can claim you as a dependent on their tax return.¹ For 2026, eligible individuals can put in up to $4,400 with self-only coverage or $8,750 with family coverage, plus an extra $1,000 if they’re 55 or older. The IRS checks eligibility on the first day of each month, so your status can shift mid-year as your coverage changes. The One, Big, Beautiful Bill Act broadened this list of qualifying coverage starting in 2026, pulling in bronze and catastrophic marketplace plans, direct primary care arrangements, and permanent pre-deductible telehealth.

What Counts as a Qualifying High Deductible Health Plan

The foundation of HSA eligibility is enrollment in an HDHP. For 2026, the plan must carry a minimum annual deductible of $1,700 for self-only coverage or $3,400 for family coverage. Out-of-pocket costs (deductibles, copays, and coinsurance, but not premiums) cannot exceed $8,500 for an individual or $17,000 for a family.²

A high deductible alone isn’t enough. The plan has to be formally designated as HSA-qualified by the insurer, and it cannot pay for non-preventive services before the deductible is met. If your plan covers specialist visits with a flat copay before you’ve hit the deductible, it fails the test regardless of how high the deductible is. Preventive care is the sole carve-out. Screenings, immunizations, and similar services can be covered at no cost before the deductible without breaking eligibility.³

New Paths to Eligibility in 2026

Starting January 1, 2026, three new categories of coverage let you contribute:

ACA marketplace bronze and catastrophic plans are automatically treated as HSA-compatible HDHPs, even when they don’t meet the standard deductible and out-of-pocket thresholds. The IRS has said this applies whether or not the plan is purchased through an exchange.
Enrollment in a direct primary care arrangement (a periodic fee for primary care services) no longer knocks out HSA eligibility, and you can use HSA funds tax-free to pay those periodic fees.
HDHPs can cover telehealth and other remote care services before the deductible without jeopardizing your eligibility. Congress made this permanent, retroactive to plan years beginning after December 31, 2024.

These are among the largest expansions of HSA access since the accounts were created in 2003.⁴

Other Coverage That Disqualifies You

Even with the right HDHP, other health coverage can cancel your eligibility. The rule: you cannot have additional coverage that pays for benefits your HDHP covers before you’ve met your deductible.³

The most common trip-ups are a spouse’s non-HDHP plan that also covers you, and a general-purpose Flexible Spending Account. A general-purpose FSA can reimburse medical expenses before you hit your HDHP deductible, which is exactly what the rules prohibit. If your spouse has a general-purpose FSA through their employer that covers you as a family member, your HSA eligibility disappears even though you never signed up for it yourself.

A Health Reimbursement Arrangement causes the same problem unless it’s structured as a limited-purpose or post-deductible HRA. Employer plan design controls the outcome here, and it’s worth reading the summary plan description before assuming your household is safe.

Some supplemental coverage is specifically carved out and won’t affect eligibility: standalone accident and disability insurance, dental and vision coverage, long-term care insurance, a limited-purpose FSA (dental and vision only), and now permanent telehealth. These either don’t overlap with what your HDHP covers or are exempted by statute.³

Medicare Ends HSA Contributions

Once you enroll in any part of Medicare (Part A, B, C, or D), your HSA contribution limit drops to zero for that month and every month after.³ This holds even if you’re still working and still covered by an employer HDHP. The restriction applies only to new deposits. Your existing HSA stays yours: you can invest it, let it grow, and spend it tax-free on qualified medical expenses for the rest of your life.

There’s a timing trap. If you’re still working past 65 and want to keep contributing, you have to delay Medicare enrollment. But filing for Social Security benefits automatically enrolls most people in Medicare Part A at 65. Anyone who claimed Social Security before turning 65 is essentially auto-enrolled in Part A when they hit that birthday, and contribution eligibility ends whether they wanted it to or not.

One consolation after 65: the 20% additional tax on non-medical HSA withdrawals no longer applies. You’ll owe ordinary income tax on non-medical distributions, like a traditional IRA, but no penalty. HSA funds also pay Medicare premiums for Parts A, B, C, and D tax-free.¹

Dependents Cannot Contribute

If someone else can claim you as a dependent on their tax return, your contribution limit is zero. Whether they actually claim you doesn’t matter; the mere ability to do so is disqualifying.¹ This most often catches young adults on a parent’s family HDHP: the child may be covered under the plan and even have their own HSA, but if the parent can claim them, no one can put money into that child’s account.

Unlike IRAs and Roth IRAs, HSAs have no income limits. Whether you earn $30,000 or $300,000, you qualify for the same contribution ceiling as long as your coverage and tax status check out.³

How Much You Can Contribute in 2026

The 2026 annual contribution limits are:

Self-only HDHP coverage: $4,400
Family HDHP coverage: $8,750
Catch-up contribution at age 55 or older: additional $1,000

These figures include every dollar going into the account from every source. If your employer puts $1,500 into your self-only HSA, you can add up to $2,900 more yourself.²

The catch-up is available to anyone who is 55 or older by the end of the tax year. You don’t need to have been 55 for the full year. If you turn 55 in December 2026, you can still make the full $1,000 catch-up for that year.¹

Who Can Fund Your HSA

The account has to be in your name, but the deposits can come from you, your employer, or a family member. Every dollar counts against the single annual cap.¹

Employer contributions come with an extra tax benefit: they’re excluded from your gross income and aren’t subject to Social Security or Medicare taxes. Many employers contribute a flat amount or match employee contributions up to a certain level. When employers contribute outside of a cafeteria plan, they must follow comparability rules requiring comparable contributions for employees with similar coverage. Contributions routed through a Section 125 cafeteria plan are exempt from comparability rules but must satisfy the cafeteria plan’s own nondiscrimination requirements.⁵

Whoever writes the check, the tax deduction belongs to the account holder. If a parent deposits money into an adult child’s HSA, the child (not the parent) claims the deduction.

Rules for Married Couples

When both spouses are HSA-eligible, the specifics matter. If either spouse has family HDHP coverage, the IRS treats both as having family coverage. The family limit ($8,750 for 2026) is then divided between the spouses by agreement, or split equally if they can’t agree.⁶

If both spouses are 55 or older, each gets their own $1,000 catch-up, but each catch-up must go into that spouse’s own HSA. You cannot deposit both catch-ups into a single account, so couples in this position need at least two HSAs between them.

If only one spouse has HDHP coverage, only that spouse is eligible. The other cannot contribute to an HSA at all, even when covered as a dependent under the HDHP. Being the named enrollee or covered individual under a qualifying plan is required.

Partial-Year Eligibility and the Last-Month Rule

Because the IRS checks eligibility monthly, someone who becomes eligible partway through the year would normally get 1/12 of the annual limit for each qualifying month. The last-month rule offers an alternative: if you’re eligible on December 1, the IRS treats you as eligible for the entire year and lets you contribute the full annual amount.¹

The condition is a testing period. If you use the rule, you must stay HSA-eligible for the entire following calendar year. Based on December 1, 2026 eligibility, the testing period runs through December 31, 2027. Lose eligibility during that window for any reason other than death or disability, and the contributions the pro-rata calculation wouldn’t have allowed get added back to your taxable income, plus a 10% additional tax.⁷

The rule rewards someone who switches to an HDHP late in the year and plans to keep it. It’s risky for someone whose coverage might change, such as anyone eyeing a job move or approaching Medicare enrollment.

1
Internal Revenue Service. Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans
2
Internal Revenue Service. Revenue Procedure 2025-19 – 2026 Inflation Adjusted Items for Health Savings Accounts
3
Office of the Law Revision Counsel. 26 USC 223 – Health Savings Accounts
4
Internal Revenue Service. Treasury, IRS Provide Guidance on New Tax Benefits for Health Savings Account Participants Under the One, Big, Beautiful Bill
5
eCFR. 26 CFR 54.4980G-5 – HSA Comparability Rules and Cafeteria Plans and Waiver of Excise Tax
6
Internal Revenue Service. Rules for Married People – IRS Courseware
7
Internal Revenue Service. Instructions for Form 8889 (2025)