Qualifying for an HSA Contribution: Health Accounts and Taxes (2025 IRS Guide)

This guide covers “Qualifying for an HSA Contribution” within health accounts and taxes. The following material presents the IRS treatment of this topic, including the qualifications, exceptions, and examples in the source section. Read the rules alongside the facts of your own situation before deciding what to report, deduct, or document.

Adapted from Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans, published by the Internal Revenue Service. This guide retains the source edition’s years, amounts, deadlines, and examples. It is guidance for that edition, not a statement that the same figures apply to every tax year.

Context for these rules

An HSA is a tax-exempt trust or custodial account you set up with a qualified HSA trustee to pay or reimburse certain medical expenses you incur. You must be an eligible individual to contribute to an HSA.

No permission or authorization from the IRS is necessary to establish an HSA. You set up an HSA with a trustee. A qualified HSA trustee can be a bank, an insurance company, or anyone already approved by the IRS to be a trustee of individual retirement arrangements (IRAs) or Archer MSAs. The HSA can be established through a trustee that is different from your health plan provider.

Your employer may already have some information on HSA trustees in your area.

Qualifying for an HSA Contribution

To be an eligible individual and qualify for an HSA contribution, you must meet the following requirements.

• You are covered under a high deductible health plan (HDHP), described later, on the first day of the month.

• You have no other health coverage except what is permitted under Other health coverage, later.

• You aren’t enrolled in Medicare.

• You can’t be claimed as a dependent on someone else’s 2025 tax return.

Tip:

Under the last-month rule, you are considered to be an eligible individual for the entire year if you are an eligible individual on the first day of the last month of your tax year (December 1 for most taxpayers) and you meet certain other requirements.

If you meet these requirements, you are an eligible individual even if your spouse has non-HDHP family coverage, provided your spouse’s coverage doesn’t cover you.

Also, you may be an eligible individual even if you receive hospital care or medical services under any law administered by the Secretary of Veterans Affairs for a service-connected disability.

Caution:

If another taxpayer is entitled to claim you as a dependent, you can’t claim a deduction for an HSA contribution. This is true even if the other person doesn’t receive an exemption deduction for you because the exemption amount is zero for tax years 2018 through 2025.

Tip:

Each spouse who is an eligible individual who wants an HSA must open a separate HSA. You can’t have a joint HSA.

High deductible health plan (HDHP).

An HDHP has:

• A higher annual deductible than typical health plans, and

• A maximum limit on the sum of the annual deductible and out-of-pocket medical expenses that you must pay for covered expenses. Out-of-pocket expenses include co-payments and other amounts but don’t include premiums.

An HDHP may provide preventive care benefits without a deductible or with a deductible less than the minimum annual deductible. Preventive care includes but isn’t limited to the following.

1. Periodic health evaluations, including tests and diagnostic procedures ordered in connection with routine examinations, such as annual physicals.

2. Routine prenatal and well-child care.

3. Child and adult immunizations.

4. Tobacco cessation programs.

5. Obesity weight-loss programs.

6. Screening services. This includes screening services for the following.

   1. Cancer.

   2. Heart and vascular diseases.

   3. Infectious diseases.

   4. Mental health conditions.

   5. Substance abuse.

   6. Metabolic, nutritional, and endocrine conditions.

   7. Musculoskeletal disorders.

   8. Obstetric and gynecological conditions.

   9. Pediatric conditions.

   10. Vision and hearing disorders.

   For more information on screening services, see Notice 2004-23, 2004-15 I.R.B. 725, available at IRS.gov/irb/2004-15_IRB#NOT-2004-23.

   For additional guidance on preventive care, see Notice 2004-50, 2004-2 C.B. 196, Q&A 26 and 27, available at IRS.gov/irb/2004-33_IRB#NOT-2004-50; Notice 2013-57, 2013-40 I.R.B. 293, available at IRS.gov/pub/irs-drop/n-13-57.pdf; and Notice 2024-75, 2024-44 I.R.B. 1026, available at IRS.gov/irb/2024-44_IRB#NOT-2024-75. Preventive care can also include coverage for treatment of individuals with certain chronic conditions listed in the Appendix of Notice 2019-45, 2019-32 I.R.B. 593, if such services were received or items were incurred on or after July 17, 2019. For information on preventive care for chronic conditions, see Notice 2019-45, 2019-32 I.R.B. 593, available at IRS.gov/pub/irs-drop/n-19-45.pdf.

The following table shows the minimum annual deductible and maximum annual deductible and other out-of-pocket expenses for HDHPs for 2025.

• * This limit doesn’t apply to deductibles and expenses for out-of-network services if the plan uses a network of providers. Instead, only deductibles and out-of-pocket expenses for services within the network should be used to figure whether the limit applies.

Tip:

The following table shows the minimum annual deductible and maximum annual deductible and other out-of-pocket expenses for HDHPs for 2026.

• * This limit doesn’t apply to deductibles and expenses for out-of-network services if the plan uses a network of providers. Instead, only deductibles and out-of-pocket expenses for services within the network should be used to figure whether the limit applies.

Self-only HDHP coverage is HDHP coverage for only an eligible individual. Family HDHP coverage is HDHP coverage for an eligible individual and at least one other individual (whether or not that individual is an eligible individual).

Family plans that don’t meet the high deductible rules.

There are some family plans that have deductibles for both the family as a whole and for individual family members. Under these plans, if you meet the individual deductible for one family member, you don’t have to meet the higher annual deductible amount for the family. If either the deductible for the family as a whole or the deductible for an individual family member is less than the minimum annual deductible for family coverage, the plan doesn’t qualify as an HDHP.

Other health coverage.

If you (and your spouse, if you have family coverage) have HDHP coverage, you can’t generally have any other health coverage. However, you can still be an eligible individual even if your spouse has non-HDHP coverage, provided you aren’t covered by that plan.

You can have additional insurance that provides benefits only for the following items.

• Liabilities incurred under workers’ compensation laws, tort liabilities, or liabilities related to ownership or use of property.

• A specific disease or illness.

• A fixed amount per day (or other period) of hospitalization.

You can also have coverage (whether provided through insurance or otherwise) for the following items.

• Accidents.

• Disability.

• Dental care.

• Vision care.

• Long-term care.

• Telehealth and other remote care.

Caution:

Plans in which substantially all of the coverage is through the items listed earlier aren’t HDHPs. For example, if your plan provides coverage substantially all of which is for a specific disease or illness, the plan isn’t an HDHP for purposes of establishing an HSA.

Prescription drug plans.

You can have a prescription drug plan, either as part of your HDHP or a separate plan (or rider), and qualify as an eligible individual if the plan doesn’t provide benefits until the minimum annual deductible of the HDHP has been met. If you can receive benefits before that deductible is met, you aren’t an eligible individual.

Other employee health plans.

An employee covered by an HDHP and a health FSA or an HRA that pays or reimburses qualified medical expenses can’t generally make contributions to an HSA. FSAs and HRAs are discussed later.

However, an employee can make contributions to an HSA while covered under an HDHP and one or more of the following arrangements.

• Limited-purpose health FSA or HRA. These arrangements can pay or reimburse the items listed earlier under Other health coverage except long-term care. Also, these arrangements can pay or reimburse preventive care expenses because they can be paid without having to satisfy the deductible.

• Suspended HRA. Before the beginning of an HRA coverage period, you can elect to suspend the HRA. The HRA doesn’t pay or reimburse, at any time, the medical expenses incurred during the suspension period except preventive care and items listed under Other health coverage, earlier. When the suspension period ends, you are no longer eligible to make contributions to an HSA.

• Post-deductible health FSA or HRA. These arrangements don’t pay or reimburse any medical expenses incurred before the minimum annual deductible amount is met. The deductible for these arrangements doesn’t have to be the same as the deductible for the HDHP, but benefits may not be provided before the minimum annual deductible amount is met.

• Retiree-only HRA. This arrangement pays or reimburses only those medical expenses incurred after retirement. After retirement with such an HRA, you are no longer eligible to make contributions to an HSA.

Health FSA—grace period.

Coverage during a grace period by a general purpose health FSA is allowed if the balance in the health FSA at the end of its prior-year plan is zero.

Using the guidance

Keep the documents that establish the dates, amounts, and circumstances described above. References to other chapters, forms, worksheets, or earlier and later sections refer to the linked IRS publication. Check the full publication and its updates before relying on a rule for a different tax year or a situation not addressed here.

Sources and further reading

• Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans: Health Savings Accounts (HSAs) — Qualifying for an HSA Contribution — Internal Revenue Service; 2025 edition.

The cited U.S. government text is in the public domain. Source accessed October 28, 2026. Fynoptic has organized this material for educational use and is independent of, and not endorsed by, the IRS.