Medicare Blog

continue to hsa when on medicare?

by Amira Stamm Sr. Published 2 years ago Updated 1 year ago

HSA is only for those enrolled in a high-deductible plan. Since Medicare is not considered an HDHP

High-deductible health plan

In the United States, a high-deductible health plan is a health insurance plan with lower premiums and higher deductibles than a traditional health plan. It is intended to incentivize consumer-driven healthcare. Being covered by an HDHP is also a requirement for having a health savings account. Some HDHP plans also offer additional "wellness" benefits, provided before a deductible is paid. …

, enrolling makes you ineligible to contribute to an HSA. Once you enroll in Medicare, it’s illegal to continue to contribute to a Health Savings Account. The only exception to continue contributing to your HSA is to postpone enrolling in Medicare.

Can I continue to contribute to my HSA once I'm enrolled in Medicare? No. You lose HSA eligibility once you enroll in Medicare, so you can't make additional contributions. You can contribute for months that you were eligible before you enrolled in Medicare.

Full Answer

What is the penalty for having a HSA and Medicare?

Understanding the HSA Withdrawal Penalty and Other Useful Information

  • HSA Basics. In some ways, an HSA is similar to a Flexible Spending Account (FSA). ...
  • Non-qualified expenses and the HSA withdrawal penalty. One significant perk of an HSA is that once you reach age 65, you can withdraw funds for any expense without penalty.
  • Mistake Forgiveness. The IRS does allow some leeway for honest mistakes. ...
  • HSA Facts You Should Know. ...

What happens to HSAs if we get Medicare for all?

  • First, you’ll need to repay all your Social Security payments.
  • Next, you’ll repay anything Medicare spent on your health care.
  • Only then can you disenroll from Part A by calling Social Security at 800-772-1213 (TTY: 800-325-0778).

Can you use HSA with Medicare?

You can use your HSA to pay certain Medicare expenses, including premiums for Part A, Part B, Part C (Medicare Advantage), and Part D prescription drug coverage, but not supplemental (Medigap) policy premiums. Retirees over age 65 who have employer-sponsored health coverage can use their HSA to pay their share of those costs as well. 3.

How your HSA can reimburse you for Medicare premiums paid?

[ANSWER]Even though you have your Medicare premiums paid directly out of your Social Security benefits, you can withdraw money tax-free from your HSA to reimburse yourself for those expenses.

Can I keep my HSA while on Medicare?

Because Medicare is considered another health plan, you're no longer eligible to contribute money to your HSA once you enroll. That doesn't mean you can't use your HSA along with Medicare. You can still use any funds in your HSA to cover expenses like Medicare premiums, copayments, and deductibles.

What happens to my HSA account when I go on Medicare?

Although you can't make any more contributions to your HSA once you're enrolled in Medicare, your HSA will continue to provide tax-free funds to cover medical costs until you use up all the money in your account. You also have the option to use your HSA funds as a regular retirement account after you turn 65.

Can I continue to contribute to my HSA after age 65?

Can I contribute to my HSA if I am age 65 and covered under an HDHP? Yes, you can contribute to your HSA as long as you are an eligible individual and have not enrolled in Medicare Part A, B, or D. Once you enroll in Medicare you may no longer contribute to your HSA.

When should I stop HSA contributions before Medicare?

The takeaway here is that you should delay Social Security benefits and decline Part A if you wish to continue contributing funds to your HSA. Finally, if you decide to delay enrolling in Medicare, make sure to stop contributing to your HSA at least six months before you do plan to enroll in Medicare.

Can my spouse use my HSA if they are on Medicare?

Yes, being eligible to contribute to the HSA is determined by the status of the HSA account holder not the dependents of the account holder. Your spouse being on Medicare does not disqualify you from continuing contributions to the HSA up to the family limit, even if they are also covered by the HDHP.

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What is a health savings account?

A Health Savings Account is a savings account in which money can be set aside for certain medical expenses. As you get close to retiring, it’s essential to understand how Health Savings Accounts work with Medicare.

What is the excise tax on Medicare?

If you continue to contribute, or your Medicare coverage becomes retroactive, you may have to pay a 6% excise tax on those excess contributions. If you happen to have excess contributions, you can withdraw some or all to avoid paying the excise tax.

Can you withdraw money from a health savings account?

Once the money goes into the Health Savings Account account, you can withdraw it for any medical expense, tax-free. Additionally, you can earn interest, your balance carries over each year, and this can become an investment for a retirement fund. Unfortunately, some restrictions come along with having a Health Savings Account with Medicare.

What is an HSA account?

HSA stands for Health Savings Account. This is a tax-favored account that eligible individuals can open to save money for medical expenses. To be eligible, that individual must be enrolled in a qualified high-deductible health plan (HDHP) and must NOT be enrolled in any other insurance, including Medicare.

What is an HSA compatible plan?

Some are enrolled in group health insurance plans which are HSA-compatible. This means that the insurance plan has a high deductible and is a qualified plan for which employees can open health savings accounts to save money toward future medical expenses. These contributions have many benefits for the employee, including tax savings benefits.

How long does it take to get Medicare after 65?

Applying for Medicare After Turning 65. If you apply for Medicare Part A after you turn 65, your Part A will become retroactive for up to 6 months. Therefore, if you plan on applying for Part A after you turn 65, you will want to stop contributing into your HSA up to 6 months prior to enrolling in Medicare. If you don’t, you could end up facing ...

How much can you spend on Medicare Part A in 2021?

Most Medicare beneficiaries who are still working at age 65 choose to enroll in Medicare Part A. That’s because Part A can limit your hospital spending to $1,484 (in 2021) if you ever have a hospital stay.

How much is a deductible for group health insurance?

Let’s say your group health insurance has a $5000 deductible. This is a pretty considerable financial exposure, especially for someone who will retire in a few years. If this person has a hospital stay of even just 1 or 2 days, the likelihood that he would spend that $5K toward his deductible is pretty high.

What if you didn't realize this and have already signed up for Part A and Social Security income benefits?

What if you didn’t realize this and have already signed up for Part A and Social Security income benefits? You would need to stop contributing to the health savings account immediately. However, you can use the funds that are already in your health savings account for qualified medical expenses until you exhaust the account.

Is Medicare a primary or secondary?

If your employer is a small employer, then Medicare is primary. You need to enroll in Medicare A and B and stop contributing in the HSA. If your employer is a large employer and contributing a fair amount of money each year into your HSA for you, then delaying Medicare might be wise.

What happens to my HSA once I enroll in medicare?

When you enroll in Medicare, you can continue to withdraw money from your HSA. The money is yours forever. Your HSA dollars can cover qualified medical expenses — 100% tax-free — if your insurance doesn’t reimburse you.

Are there penalties for having both an HSA and Medicare?

The IRS won’t penalize you if you still have money in your HSA when you enroll in Medicare. You can use your HSA dollars to pay for qualified medical expenses if you want to save money on taxes. Unlike a flexible spending account (FSA), all the unused funds in your HSA will continue to roll over every year.

What costs are not covered by Medicare?

Before you apply for Medicare, you should review your major out-of-pocket costs. This will help you determine the best time to apply for coverage.

What happens when I buy an eligible expense vs. an ineligible expense with HSA funds?

When you turn 65, you will have more flexibility over how you use the funds in your HSA. You can pay for all qualified expenses, free of taxes. You’ll have to pay income tax on money you withdraw to pay for nonqualified expenses. If you’re under 65, you may also owe a 20% tax penalty.

Are my withdrawals for HSA tax-free?

One of the benefits of an HSA is that your withdrawals can be tax-free if used for qualified medical expenses. All nonqualified expenses will be subject to federal and state income taxes.

The bottom line

Enrolling in Medicare can affect your ability to make contributions to a health savings account (HSA). Before you sign up for Medicare, make sure you understand HSA rules to avoid unexpected taxes and penalties. Although Medicare beneficiaries cannot contribute to an HSA, they can still withdraw money from the account.

Is HSA taxed?

Funds contributed to an HSA are not taxed when put into the HSA or when taken out, as long as they are used to pay for qualified medical expenses. Your employer may oversee your HSA, or you may have an individual HSA that is overseen by a bank, credit union, or insurance company.

Can you use HSA for qualified medical expenses?

If you use the account for qualified medical expenses, its funds will continue to be tax-free. Whether you should delay enrollment in Medicare so you can continue contributing to your HSA depends on your circumstances.

Does HDHP have a deductible?

HDHPs have large deductibles that members must meet before receiving coverage. This means HDHP members pay in full for most health care services until they reach their deductible for the year. Afterwards, the HDHP covers all the member’s costs for the remainder of the year.

How long do you have to stop HSA before enrolling in Medicare?

There is a six - month lookback period (but not before the month of reaching age 65) when enrolling in Medicare after age 65, so a best practice is for workers to stop contributing to their HSA six months before enrolling in Medicare to avoid penalties. See the examples below for more on this.

What happens if you miss the deadline for Medicare?

In other words, getting the Medicare Special Enrollment Period wrong risks a gap in coverage plus a lifetime of penalties.

When did HSA start?

Image by Roy Scott/IKON Images. Before the tax - savings wonder that is the health savings account (HSA) was introduced in 2003, it was a generally accepted best practice for any worker who wasn't already collecting Social Security at the age of 65 to go ahead and sign up for Medicare Part A (hospital insurance), regardless of other coverage.

Can HSA funds be used for medical expenses?

See the examples below for more on this. Funds already in the HSA can still be used for qualified medical expenses upon enrollment in Medicare, including to reimburse taxpayers for Medicare premiums (but not premiums for Medicare supplemental insurance) as well as to pay for long - term - care costs and insurance.

How long can you keep HSA contributions?

In some cases, you may want to stop contributing six months prior to when you plan to enroll in Medicare. Once you sign up for Part A, you’re entitled to up to six months of retroactive coverage ...

Why not sign up for Part A?

The main reason not to sign up for Part A when you’re still covered by a group health plan is if you’d like to continue funding an HSA, since you can’t do so once enrolled. HSAs offer immediate tax savings, since contributions exclude a portion of your income from taxation the year they’re made.

Can a 65 year old get Medicare?

That said, many 65-year-olds who have group health coverage sign up for Medicare Part A only, since there’s generally no premium attached to it. This way, Medicare serves as secondary insurance for hospital care. The main reason not to sign up for Part A when you’re still covered by a group health plan is if you’d like to continue funding an HSA, ...

Does Medicare apply to a 65 year old?

That penalty, however, doesn’t apply if you have group health coverage in place when you turn 65. Rather, you get a special enrollment period for Medicare that begins once you separate from your employer or once your group coverage ends – whichever comes first.

Do HSAs require you to use up your plan balance?

Often confused with flexible spending accounts, HSAs do not require you to use up your plan balance year after year. In fact, the value of the HSA lies in your ability to invest your contributions and grow them into a larger sum over time.

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