Medicare and Health Savings Accounts (HSAs)

The basic rule

Once you are enrolled in any part of Medicare, you can no longer contribute to a Health Savings Account. You can still spend the money already in your HSA.

The 6-month look-back

If you sign up for Part A after you turn 65, your Part A coverage can start up to 6 months earlier (but not before the month you turned 65). To avoid a tax penalty, many people stop HSA contributions 6 months before they apply for Medicare.

Social Security and Part A

If you start Social Security benefits at 65 or later, you are automatically enrolled in Part A and cannot opt out of Part A without giving up Social Security. Plan HSA contributions with that in mind.

Using HSA money on Medicare

HSA funds can generally be used tax-free for Part B, Part D and Medicare Advantage premiums, plus deductibles, copays and coinsurance. Medigap premiums generally are not a qualified expense. Check with a tax professional for your situation.

Frequently asked questions

Can I contribute to my HSA after I enroll in Medicare?

No. Once you have any part of Medicare, you cannot make new HSA contributions, but you can still use the money in the account.

When should I stop HSA contributions before Medicare?

Many people stop 6 months before they apply, because Part A coverage can be backdated up to 6 months.

Can I use HSA money to pay Medicare premiums?

Generally yes for Part B, Part D and Medicare Advantage premiums. Medigap premiums are generally not eligible.

Can I keep my HSA if I am still working at 65?

Yes, if you have not enrolled in any part of Medicare or started Social Security benefits.

Talk with a licensed agent

Questions about your Medicare options? Call 1-844-438-6284 (TTY 711) or request a free, no-obligation quote. We do not offer every plan available in your area.

Sources for 2026 figures: CMS 2026 Medicare Parts A & B Premiums and Deductibles; Medicare.gov: Medicare costs; Medicare.gov: Part D costs. For information on all of your options, contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048).