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Print this checklist, answer each question, and bring it to your tax preparer or to our meeting.
Download the PDF (large print)The short version. A Health Savings Account (HSA) lets you put money in tax-free, grow it tax-free, and take it out tax-free for medical costs. You qualify only while covered by a high-deductible health plan, and you cannot contribute once Medicare starts.
2026 limits
| Self-only coverage | Family coverage | |
|---|---|---|
| Maximum HSA contribution | $4,400 | $8,750 |
| Extra if you are 55 or older | $1,000 | $1,000 (each spouse in their own HSA) |
| High-deductible plan: minimum deductible | $1,700 | $3,400 |
| High-deductible plan: maximum deductible plus out-of-pocket | $8,500 | $17,000 |
Employer contributions count toward your limit. [1, 2]
Who qualifies
- You are covered by a qualifying high-deductible health plan on the first day of the month.
- You have no other disqualifying coverage. A general-purpose health flexible spending account usually blocks contributions, though limited-purpose versions do not.
- You are not enrolled in Medicare and no one else can claim you as a dependent. [3]
Beginning in 2026, bronze and catastrophic plans sold on the health insurance Exchange can count as high-deductible plans, and certain direct primary care arrangements no longer disqualify you. Telehealth before the deductible is also permanently allowed. [4]
How the tax benefit works
| Stage | Tax treatment |
|---|---|
| Contributions | Deductible on your return, or pre-tax through payroll. Employer contributions are excluded from your income. |
| Growth | Tax-free while in the account. |
| Withdrawals for qualified medical expenses | Tax-free. |
| Other withdrawals before 65 | Taxed as income, plus a 20% additional tax. |
| Other withdrawals at 65 or later | Taxed as ordinary income, with no 20% additional tax. |
The deadline to contribute for 2026 is your tax filing due date, which is April 15, 2027 for most people. You file Form 8889 with your return. [3, 5]
The Medicare catch
Your contribution limit drops to zero from the first month you are enrolled in Medicare. Part A coverage can begin retroactively, up to six months back, when you sign up after 65. Because contributions in those months become excess contributions, many people stop contributing about six months before applying for Medicare or Social Security. [3, 6]
Other rules worth knowing
- Testing period. If you become eligible late in the year, the last-month rule can let you contribute for the full year, but you must stay eligible through the end of the following year or part of it becomes taxable with a 10% additional tax. [3]
- No required withdrawals. Balances carry over year to year. [3]
- Keep records. Keep receipts showing each withdrawal paid a qualified expense. You do not file them, but you may need them. [3]
- At death. A spouse can treat the HSA as their own. Anyone else receives the balance as taxable income, and the account stops being an HSA. [3]
Questions worth asking
- Does my health plan meet the high-deductible rules for 2026?
- Am I (or my spouse) covered by a flexible spending account that blocks contributions?
- Do I want to invest my HSA balance and pay current medical bills from other money?
- When should I stop contributing so Medicare does not create an excess?
Frequently asked questions
What is the 2026 HSA contribution limit?
$4,400 for self-only coverage and $8,750 for family coverage, plus $1,000 if you are 55 or older.
Who can contribute to an HSA?
You must be covered by a qualifying high-deductible health plan, have no other disqualifying coverage, not be enrolled in Medicare, and not be claimable as a dependent.
What changed for HSAs in 2026?
Bronze and catastrophic Exchange plans can count as high-deductible plans, and certain direct primary care arrangements no longer disqualify you.
Sources and review notes
General education, not individualized investment, tax, or legal advice. Discuss tax decisions with your tax professional, and recheck annual limits before using this page for another tax year.