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Small Business Employee Benefits and HR Blog

Using HSAs with Social Security and Medicare for Individual Health Insurance

Health savings accounts (HSAs) have been around since 2003; however, many Coordinating HSAs with Social Security and Medicare
people remain unfamiliar with them. Similar to a personal savings account, an HSA allows an individual to use untaxed savings to pay their own individual health insurance costs—and to receive employer contributions up to a certain amount.

HSAs offer many advantages, but they don’t mix with certain types of federal programs and benefits. For example, if you are enrolled in Medicare Parts A or B, or if you file for Social Security benefits after age 65, you can’t make contributions to an HSA.

Medicare and HSAs

Medicare is health insurance provided by the federal government. Although there are several ways to qualify for Medicare, the program is most closely associated with people over age 65. The different types of Medicare coverage are as follows:

  • Part A. Hospital insurance
  • Part B. Medical insurance
  • Part C. Medicare advantage plus, which allows Medicare recipients to receive health benefits through a private health insurance company
  • Part D. Prescription drug coverage

For a more detailed breakdown on Medicare coverage, visit Medicare.gov.

IRS rules prohibit people enrolled in Medicare Parts A or B from contributing to an HSA. The reason is that a person with an HSA must also have individual health insurance through a high-deductible health plan (HDHP) and can receive no other health coverage apart from that provided by the HDHP. The IRS counts Medicare Parts A and B as health coverage, but not as an HDHP. Thus, individuals who continue making contributions to an HSA after Medicare coverage begins risk IRS penalties.

The good news is that you can continue to make withdrawals from an HSA after you begin receiving Medicare benefits—you just can’t put more money into your account.

Social Security and HSAs

Social security retirement benefits can also impact your ability to make contributions to an HSA.

Under federal law, individuals age 65 and older are automatically enrolled in Medicare Part A upon filing for retirement benefits through the Social Security Administration. The only way to opt out of Medicare Part A is to stop your Social Security payments.

This automatic enrollment is also triggered even if you delay your Social Security benefits past age 65 for purposes of increasing your monthly retirement benefit. Furthermore, because the Social Security Administration makes retirement benefits retroactive for six months prior to an individual’s application, it’s important to stop making contributions to your HSA at least six months before you apply for Social Security.

Conclusion

With more Americans staying in the workforce past age 65, the issue of balancing federal benefits against individual health insurance options like HSAs is likely to feature prominently in employees’ health concerns. It’s important for workers and businesses alike to educate themselves about how HSAs interact with various types of federal benefits. 

The Comprehensive Guide to the Small Business HRA

Want to know more about how Medicare and Social Security impact HSAs? Let us know in the comments.

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