Who Can Open and Use an HSA Account

The basic rule: you need a high-deductible health plan

To open an HSA, you must be enrolled in a high-deductible health plan (HDHP) — a specific type of health insurance with a higher yearly deductible than standard plans. Your employer may offer one, you may buy one on the individual market, or you may find one through your state's health insurance marketplace. The plan itself must meet IRS requirements for what counts as an HDHP, which your insurance company or employer can confirm.

You cannot have an HSA if you are covered by any other health insurance at the same time, with a few exceptions. Medicare, TRICARE (military health coverage), the Veterans Administration, and certain limited plans do not block you from having an HSA. But if you have a spouse with a standard health plan and you are on that plan too, you cannot open an HSA.

You also cannot claim an HSA if someone else — usually a parent — claims you as a dependent on their tax return. This rule applies even if you pay for your own health insurance.

Key Takeaways

You must be enrolled in a high-deductible health plan (HDHP) to open an HSA, and you cannot have other health coverage at the same time except Medicare, TRICARE, or VA benefits.
You cannot open an HSA if someone claims you as a dependent on their tax return, regardless of who pays for your insurance.
You must be a U.S. citizen or resident alien with a valid Social Security number or Individual Taxpayer Identification Number (ITIN).
You can open an HSA through your employer's plan, a bank, credit union, or insurance company — the HDHP and the HSA account are separate things.
Age does not disqualify you, but once you turn 65 and enroll in Medicare, you can no longer contribute new money to an HSA.

Citizenship and tax filing requirements

You must be a U.S. citizen or resident alien to open an HSA. You will need either a Social Security number (SSN) or an Individual Taxpayer Identification Number (ITIN). If you are a resident alien, you must have lived in the United States for at least part of the tax year in which you open the account.

You do not need to be employed to open an HSA. Self-employed people, part-time workers, and people with no income can all open one as long as they are enrolled in an HDHP. However, you can only contribute money to an HSA in years when you have earned income or your spouse has earned income (if you file taxes jointly).

The dependent rule and family coverage

If you are claimed as a dependent on someone else's tax return — usually a parent's — you cannot open an HSA, even if you have your own HDHP and pay for it yourself. This is a strict rule with no exceptions. Once you are no longer claimed as a dependent (typically when you turn 24 or move out and become financially independent), you can open an account.

If you are married and file taxes jointly, both spouses can have HSAs if you both have individual HDHP coverage. If you have family coverage under one HDHP, only one of you can open an HSA, and that person can contribute on behalf of the whole family. The rules are different for married couples than for dependent children, so check with your plan administrator if you are unsure.

Medicare and age limits

There is no minimum age to open an HSA. A teenager with a job and an HDHP can open one. However, once you turn 65 and enroll in Medicare, you can no longer contribute new money to an HSA. You can still withdraw money from an existing HSA for any reason, but non-medical withdrawals will be taxed as income.

If you turn 65 and are still working, you have a choice: you can delay enrolling in Medicare and keep contributing to your HSA, or you can enroll in Medicare and stop contributing. Many people delay Medicare enrollment specifically to keep their HSA active, though this decision depends on your individual situation and whether your employer's plan allows it.

Where to open an HSA account

Your HDHP and your HSA are separate things. Your insurance company does not have to offer the HSA account itself. You can open an HSA through your employer's plan (if they offer one), through a bank, credit union, or online financial institution, or through an insurance company that specializes in HSAs. Some employers automatically set up an HSA for you when you enroll in their HDHP; others require you to open one yourself.

When you open an account, you will need to show proof of HDHP enrollment. This is usually a copy of your insurance card or a letter from your employer confirming your plan type. The financial institution holding your HSA will verify that your plan qualifies as an HDHP before opening the account.

What disqualifies you from an HSA

You cannot have an HSA if you are enrolled in a standard health plan, a Health Maintenance Organization (HMO) with a low deductible, or a Preferred Provider Organization (PPO) with a low deductible. You also cannot have an HSA if you are covered by your spouse's non-HDHP plan, even if you are not actually using that coverage.

Certain other coverage also blocks HSA may be able to access: if you have coverage through TRICARE (military), the Veterans Administration, or a health plan from a Native American tribe, you may still be able to have an HSA, but the rules are complex. If you have Medicaid or are claimed as a dependent, you cannot have an HSA. If you are enrolled in a health plan through your school or employer that is not an HDHP, you are not may be able to access.

Frequently Asked Questions

Can I open an HSA if my employer does not offer one?

Yes. You can open an HSA through a bank, credit union, or insurance company as long as you are enrolled in an HDHP. Your employer does not have to sponsor it. You will need to show proof of your HDHP enrollment when you open the account.

What if I lose my HDHP coverage during the year?

You can no longer contribute to your HSA once you switch to a different type of health plan. However, you can keep the account open and withdraw money from it. If you switch back to an HDHP later, you can resume contributions.

Can I have an HSA if I am on my parent's health insurance?

Only if your parent does not claim you as a dependent on their tax return. If they do claim you as a dependent, you cannot open an HSA, even if you have your own HDHP. Once you are no longer claimed as a dependent, you become may be able to access.

Do I need to be employed to open an HSA?

No, but you do need earned income in the year you contribute. Self-employed people, part-time workers, and people with side income can all open and contribute to an HSA. If you have no income in a given year, you cannot contribute that year, though you can keep an existing account open.

What happens to my HSA when I turn 65?

You can keep your HSA and withdraw money from it for any reason. However, once you enroll in Medicare, you cannot contribute new money. Non-medical withdrawals after 65 are taxed as income but not penalized, unlike withdrawals before 65.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.