No, not necessarily. Just turning 65 alone does not make you ineligible for a HSA. You can still contribute to an HSA as long as you are meeting all of the HSA eligibility requirements. These requirements are:

  • Enrolled and covered on a HSA-qualified medical plan.
  • Don’t have any other disqualifying health coverage (includes Medicare, Medicaid, TRICARE)
  • Are not covered by a full coverage FSA or HRA (you may be covered by a limited purpose or post-deductible FSA or HRA as well as a retirement or suspended HRA)
  • Not claimed as a dependent on anyone else’s tax return

Yes. Medicare does not offer a HSA-qualified medical plan; therefor enrolling in either Medicare Part A or Part B would make you ineligible to open and/or contribute to an HSA as you are not meeting the HSA eligibility requirements.

No. You are only automatically enrolled in Medicare if you are receiving Social Security benefits or Railroad Retirement benefits. Receiving Social Security benefits will automatically enroll you in Medicare Part A.

Yes. If you decide to enroll in Medicare mid-year, you can continue enrollment in your High Deductible Health Plan (HDHP) and contribute to your HSA up until the month in which you turn age 65 and enroll. Your contributions in the HSA must be pro-rated based on a monthly calculation.

If you decide to delay Medicare enrollment during the Initial Enrollment Period and later enroll in Medicare during a Special Enrollment Period, your Medicare enrollment effective date is retroactive 6 months (but will never extend prior to turning age 65). Assuming you remain in your employer’s HDHP, you will be able to contribute to your HSA until your Medicare enrollment retroactive date on a pro-rata basis. If you prefund your HSA, you may have to withdraw funds to avoid exceeding the pro-rated contribution limit imposed by the retroactive Medicare enrollment date.

Yes. You can use your HSA dollars to pay for your own qualified expenses, your spouse’s or any of your tax dependent’s expenses; even if they are not HSA eligible or covered on your HSA-qualified medical plan.

Yes! You can still use the money in your HSA to pay for eligible expenses tax free; you just can no longer contribute to the HSA. You can withdraw funds at any time to pay for your eligible expenses.

In addition to the eligible expenses that you have been using your HSA dollars for prior to enrolling in Medicare, once you are over age 65 you will be able to use your HSA dollars for additional expenses, including premiums for: Medicare Parts A and B, Medicare Part D plans (e.g., PDPs), Medicare Advantage plans, and employer sponsored retiree health plans. It is important to note that premium payments for Medicare Supplement (or “Medigap”) policies are not qualified HSA expenses. All of the expenses that are HSA-eligible prior to age 65 continue to be qualified medical expenses after age 65, including: deductibles, copays, coinsurance, dental, vision, COBRA premium, long term care services and even long-term care insurance premium (up to IRS limits).

No. Your spouse cannot use their HSA dollars to pay for your Medicare premiums until they turn 65. Once they turn 65 then they can use their HSA dollars to pay for their own Medicare premiums as well as yours.

Yes, but you will still have to pay income taxes on any non-qualified expenses that you pay for with your HSA dollars. However, when you turn 65 and use your HSA dollars for a non-qualified expense, the 20% penalty no longer applies.

Yes, as long as your spouse is the HSA account owner, is enrolled in an HSA qualified medical plan and meets all of the other HSA eligibility requirements. If you stay enrolled as a family under the HSA-qualified plan, both you and your spouse can make contributions to the spouse’s HSA up to the family maximum contribution limit. Because your spouse is still HSA eligible and is the account owner, they can still accept contributions into their account from you as long as they are post-tax. Your spouse will then deduct these contributions on their tax return (or joint tax return).