You need a high-deductible health plan to open an HSA

The first requirement is straightforward: you must be enrolled in a high-deductible health plan (HDHP) to open or contribute to an HSA. Your health insurance plan has to meet the IRS definition of an HDHP, which means it has a minimum deductible and a maximum out-of-pocket limit. For 2024, that means a deductible of at least $1,600 for individual coverage or $3,200 for family coverage. Your plan documents will tell you whether it qualifies.

You cannot have an HSA if you are covered by a non-HDHP plan at the same time — not even a spouse's plan or a parent's plan if you are a dependent. If you switch to a regular health plan mid-year, you can no longer contribute to your HSA for the rest of that year, though you keep the money already in the account.

Some employers offer both HDHP and traditional plans. If your employer offers an HDHP, you can choose it during open enrollment. If your employer does not offer one, you can buy an HDHP on the individual market through your state's health insurance marketplace or directly from an insurer.

Key Takeaways

  • You must be enrolled in a high-deductible health plan with a deductible of at least $1,600 (individual) or $3,200 (family) to open an HSA.
  • You cannot be claimed as a dependent on someone else's tax return and cannot have Medicare, Medicaid, TRICARE, or Veterans Affairs coverage at the same time.
  • You must be a U.S. citizen or resident alien with a valid Social Security number or Individual Taxpayer Identification Number.
  • You can open an HSA through your employer's plan, a bank, a credit union, or an investment firm — the HDHP and the HSA account are separate.

Age and tax filing status do not matter

Unlike some savings accounts, there is no age limit for opening an HSA. You can open one at 25 or at 65. You do not have to be working full-time or part-time — self-employed people, gig workers, and people with multiple jobs can all open HSAs as long as they have an HDHP.

Your tax filing status does not affect whether you can open an account. Single, married filing jointly, married filing separately, head of household — all can open HSAs. If you are married and both spouses have individual HDHP coverage, each spouse can open a separate HSA and contribute up to the individual limit.

You cannot have Medicare or Medicaid at the same time

If you are enrolled in Medicare, you cannot contribute to an HSA, even if you also have an HDHP. Once you turn 65 and enroll in Medicare Part A or Part B, your HSA contributions stop. You can still withdraw money from an existing HSA without penalty, but new contributions are not allowed.

The same rule applies to Medicaid. If your state's Medicaid program covers you, you cannot contribute to an HSA during that time. Some people move between Medicaid and marketplace coverage — if you lose Medicaid and enroll in an HDHP, you can start contributing again.

TRICARE (military health coverage) and Veterans Affairs coverage also disqualify you from HSA contributions. If you are a veteran with VA coverage, you would need to drop that coverage and switch to an HDHP through the marketplace or an employer to open an HSA.

You cannot be claimed as a dependent

If someone else claims you as a dependent on their tax return, you cannot open or contribute to an HSA, even if you have your own HDHP. This rule applies most often to adult children living with parents, but it can affect anyone claimed as a dependent.

If you are no longer a dependent — because you moved out, started paying your own expenses, or your parents stopped claiming you — you can open an HSA starting in the tax year you are no longer claimed. You will need to verify this on your own tax return.

You need a Social Security number or ITIN

To open an HSA, you must have either a Social Security number (SSN) or an Individual Taxpayer Identification Number (ITIN). The financial institution holding your HSA needs this to report contributions and withdrawals to the IRS.

U.S. citizens and permanent residents have SSNs. Resident aliens and some non-citizens can obtain an ITIN from the IRS. If you do not have either, you cannot open an HSA until you do.

Self-employed people and gig workers can open HSAs

You do not need to be employed by a company to open an HSA. If you are self-employed, a freelancer, or a gig worker, you can buy an HDHP on the individual market and open an HSA. You can contribute up to the individual or family limit depending on your coverage type.

Self-employed people can also deduct HSA contributions from their taxable income on Schedule C, just as they do with health insurance premiums. This is one of the tax advantages of an HSA for people without employer coverage.

Spouses can each have their own HSA

If you are married and both you and your spouse have individual HDHP coverage (not family coverage), you can each open a separate HSA. Each of you contributes up to the individual limit, and each account is yours alone.

If you have family HDHP coverage that covers both of you, you can open one HSA and contribute up to the family limit. Only one of you needs to be the account owner, but both can use the money for may have access to medical expenses. Some couples open one account for simplicity; others prefer separate accounts for tracking.

Where to open an HSA

Your employer may offer an HSA through a specific bank or financial firm, but you are not required to use it. You can open an HSA at a different bank, credit union, or investment firm as long as you have an HDHP. Some people open an HSA with their regular bank for convenience; others use investment firms to grow the money over time.

When you open an account, the institution will ask for your SSN or ITIN, proof of HDHP coverage (usually your insurance card or plan documents), and basic identifying information. The process typically takes a few days to a week.

Frequently Asked Questions

Can I open an HSA if I have a spouse with regular health insurance?

Yes. Your spouse's coverage does not affect your ability to open an HSA as long as you have your own HDHP. You cannot be covered by their plan at the same time, but if you have separate coverage, you can each have your own HSA.

What if I turn 65 and enroll in Medicare?

You cannot make new contributions to an HSA once you enroll in Medicare Part A or Part B. You can withdraw money from your existing HSA for any reason without penalty after age 65, though non-medical withdrawals are taxed as income. The money does not disappear — it stays in your account.

Can I open an HSA if I am self-employed with no employees?

Yes. Self-employed people can open an HSA as long as they have an HDHP. You buy the HDHP on the individual market, then open an HSA at a bank or financial firm. You can deduct your HSA contributions from your self-employment income.

Do I need to open an HSA through my employer?

No. Your employer may offer an HSA, but you can open one anywhere — at a different bank, credit union, or investment firm. Some employers contribute to their HSA plans, so check whether yours does before you switch, as you would lose that employer contribution.

Can I have an HSA if I am on Medicaid?

No. You cannot contribute to an HSA while you are enrolled in Medicaid. If you lose Medicaid coverage and enroll in an HDHP, you can open an HSA starting in that tax year.