HSA Frequently Asked Questions (FAQ)
B. Eligibility
1. Who is eligible for an HSA?
To be an eligible individual and qualify for tax-free contributions to an HSA, you must meet the following requirements:
- You must be covered under a high deductible health plan (HDHP),
- You must have no other medical coverage (see next section for details).
- You must not be enrolled in Medicare.
- You must not be claimed as a dependent on someone else’s tax return.
- You must have a valid Social Security Number.
2. What is the "No Other Medical Coverage" requirement?
To be eligible for tax-free HSA contributions, the IRS requires that you have no other medical coverage other than an IRS-qualified high deductible health plan.
You are disqualified for tax-free contributions if:
- You are enrolled in a federal government plan like Medicare A, B, or D, or Tricare (if you have VA benefits, receiving preventive care services or treatment for a service-related disability from the VA does not disqualify an individual from participating in an HSA);
- Your spouse covers you on an IU plan or another employer’s medical plan unless it is also a high deductible health plan;
- Your spouse has a Health Reimbursement Account (HRA) or flexible spending account (FSA) that is unrestricted, and the account could be used to cover your HDHP deductible.
You are still eligible for tax-free HSA contributions if your spouse has other medical coverage. However, you cannot be covered on their non-HDHP medical plan or their HRA/FSA plan and still be eligible for tax-free HSA contributions.
If you are ineligible for tax-free HSA contributions, you can waive the HSA and still enroll in an HDHP.
If you are ineligible for tax-free HSA contributions and still elect the HSA, you are responsible for reporting the ineligible HSA contributions on your annual tax return as taxable income. Consulting a tax advisor about reporting ineligible contributions is advised.
3. Am I eligible for these plans if I am here on a J-1 Visa?
No. According to the U.S. Department of State, all J-1 Visa holders must have health insurance; however, the insurance policy cannot have a deductible that exceeds $500. J-1 Visa holders are eligible for the Anthem PPO $500 Deductible plan.
4. Can I enroll in an HSA if I have other insurance that pays medical expenses?
Yes and no. You cannot be covered as an employee or as a dependent under any other plans that can cover the expenses you incur to meet your HDHP deductible and still be eligible for tax-free HSA contributions.
You are disqualified for tax-free contributions if:
- You are enrolled in a federal government plan like Medicare A, B, or D, or Tricare (if you have VA benefits, receiving preventive care services or treatment for a service-related disability from the VA does not disqualify an individual from participating in an HSA);
- Your spouse covers you on an IU plan or another employer’s medical plan unless it is also a high deductible health plan;
- Your spouse has a Health Reimbursement Account (HRA) or flexible spending account (FSA) that is unrestricted and can be used to cover your HDHP deductible.
However, you may have automobile, dental, vision, disability, or long-term care insurance at the same time as an HDHP, and coverage for a specific disease (e.g., a cancer policy) or illness, as long as it pays a specific dollar amount when the policy is triggered.
5. My spouse has an FSA or HRA through their employer. Can I enroll in the HSA?
You can enroll in an HDHP, however, according to the IRS, you cannot contribute or receive tax-free dollars to an HSA if your spouse’s FSA or HRA can pay for any of your medical expenses before your HDHP deductible is met. Please note that unless your spouse’s FSA agreement specifically states it does not cover you, you are not eligible for tax-free HSA contributions.
6. If both spouses are enrolled in an HDHP, can they each have an HSA? How much can each spouse contribute?
Be sure to consider the following if you and your spouse each have an HSA:
- If you and your spouse are each enrolled in employee-only HDHP coverage, each of you are subject to the employee-only HSA limit ($4,150 each).
- If either you or your spouse has ‘family’ HDHP coverage (employee with children or Family coverage), then you will be subject to the family contribution limit ($8,300) as a couple. In other words, if you or your spouse cover family members on your HDHP, your combined HSA contributions cannot exceed $8,300.
- If you are age 55 or older by the end of the tax year, you can contribute up to an additional $1,000 each year to your HSA (make a "catch-up contribution"). If you and your spouse are both eligible to make a catch-up contribution (i.e. enrolled in an HDHP, either together or separately, and age 55+), you can each make a $1,000 catch-up contribution, but each of you must deposit the funds into your own individual HSA.
The following examples describe how much can be contributed under varying circumstances. Assume that neither spouse qualifies for "catch-up contributions."
If your spouse has an HDHP with another employer or enrolls separately from you, the university will not be able to assist you in limiting your contributions to stay within the IRS-defined maximums. That said, if you or your spouse exceeds the statutory maximums, you are responsible for taking corrective action and for any tax consequences.
Example 1: Jan, an IU employee, is enrolled in the Anthem PPO HDHP. She covers her spouse, Mike, on her plan.
- Jan has no other coverage.
- Mike has additional self-only coverage through his employer which has a deductible less than $1,600. Since he has coverage that does not qualify as an HDHP, he is not eligible to contribute to an HSA in his name.
- Jan may contribute $8,300 to an HSA in her name because she covers one or more individuals on her plan, therefore qualifies for the family maximum.
Example 2: Dave, an IU employee, is enrolled in the Anthem PPO HDHP. He covers his spouse, Ellen, on his plan.
- Dave has no other coverage.
- Ellen has additional self-only HDHP coverage through her employer which has a deductible greater than $1,600.
- Both Dave and Ellen are eligible to have and to contribute to their own HSA. However, because they are married, they are only eligible to contribute up to the combined family maximum of $8,300 between both accounts.
Example 3: John, an IU employee, is enrolled in the Anthem PPO HDHP. He covers his spouse, Charlie, on his plan.
- John has no other coverage.
- Charlie has additional employee & child(ren) HDHP coverage with a deductible greater than $3,800.
- Both John and Charlie are eligible to have and to contribute to their own HSA. However, because they are married, they are only eligible to contribute up to the combined family maximum of $8,300 between both accounts.
Example 4: Sam, an IU employee, is enrolled in the Anthem PPO HDHP. He covers his spouse, Anne, on his plan.
- Sam and Anne also have family coverage with a $200 deductible through Anne’s employer plan.
- Sam and Anne are treated as having family coverage with the lower annual deductible ($200). The $200 deductible does not meet the IRS minimum requirements of an HDHP, thus neither Sam nor Anne are eligible for and neither may contribute to an HSA.
Example 5: Mary, an IU employee, is enrolled in the Anthem PPO HDHP. She covers her spouse, Julie, on her plan.
- Mary has no other coverage. Mary may contribute $8,300 to an HSA in her name because she covers one or more individuals on her plan, therefore qualifies for the family maximum.
- Julie is also enrolled in Medicare. Julie is not eligible and cannot contribute to an HSA.
Example 6: Martin and Jean are married and both work for IU. They are each enrolled in employee-only Anthem PPO HDHP coverage.
- Martin has no other coverage. Martin can contribute $4,150 (the individual maximum) to his HSA.
- Jean has no other coverage. Jean can also contribute $4,150 (the individual maximum) to her HSA.
- Each is only eligible to contribute up to the individual lRS limit because they each only cover themselves.
Example 7: Samantha and Gary are married and both work for IU. Samantha is enrolled in employee & child(ren) Anthem PPO HDHP coverage. Gary is enrolled in employee-only Anthem PPO HDHP coverage.
- Samantha has no other coverage.
- Gary has no other coverage.
- Both Samantha and Gary are eligible to have and contribute to their own HSA. However, because they are married, they are only eligible to contribute up to the combined family maximum of $8,300 between both accounts.
Remember, HSA maximums are the combined total of IU’s contributions, your contributions to your HSA, your spouse’s contributions to their own HSA (if applicable), and contributions made to an Archer MSA (if applicable).
These maximums can further be affected by the number of months you are covered under an HDHP if you enroll or make plan changes mid-year. Details on the calculation of the IRS prorated maximum can be found in IRS publication 969.
7. What are the contribution limits for participants age 55 or older?
If you and your spouse are each enrolled in employee-only HDHP coverage, each of you are subject to the employee-only HSA limit ($4,150 each). If either you or your spouse has ‘family’ HDHP coverage (employee with children or family coverage), then you will be subject to the family contribution limit ($8,300) as a couple. This means that if either you or your spouse cover family members on your HDHP, your combined HSA contribution limit is the annual maximum for family coverage ($8,300).
Those turning age 55 or older during the year may contribute up to an additional $1,000 each year to the HSA (make a "catch-up contribution"). You and your spouse can each make the $1,000 catch-up contribution, but you must deposit the funds into separate accounts. This means that in order for both you and your spouse to elect the catch-up, you must enroll in separate medical plans.
When a spouse has an HDHP with another employer or spouses enroll separately from one another, the university will not be able to assist in limiting contributions to statutory maximums. If an employee or their spouse exceeds statutory maximums, they are responsible for taking corrective action and are responsible for any tax consequences.
Example 1: Joan, age 56, and Michael, age 60, are married. Both are enrolled in the Anthem PPO HDHP with employee-only coverage, and each has their own HSA.
- Joan and Michael are each eligible to contribute the individual IRS limit of $4,150 to their individual HSA.
- Joan can also contribute an additional $1,000 to her HSA.
- Michael can also contribute an additional $1,000 to his HSA.
Example 2: Jeremiah, age 60, and Michelle, age 52, are married IU employees. Jeremiah has Anthem PPO HDHP employee and child(ren) coverage. Michelle has Anthem PPO HDHP employee-only coverage. Each has their own HSA.
- Because Jeremiah covers one or more individuals, they are both treated as having family coverage for purposes of determining the annual IRS maximum contribution limit.
- Jeremiah and Michelle can contribute up to the combined family maximum of $8,300 between both accounts.
- Because Jeremiah is over age 55, he can contribute an additional $1,000 to his HSA.
Example 3: Thomas, age 60, and Isabel, age 55, are married IU employees. Thomas covers them under Anthem PPO HDHP employee/spouse coverage. Thomas has an HSA. Isabel has no other coverage, therefore is not eligible for a separate HSA through IU.
- Thomas can contribute up to the family maximum of $8,300 to his HSA because he covers one or more family members on his plan.
- Because Thomas is over age 55, he can also contribute an additional $1,000 to his HSA.
- Even though Isabel is over age 55, Thomas cannot contribute an additional $1,000 to his HSA on her behalf because Isabel does not own the account.
Remember, HSA maximums are the combined total of IU’s contributions, your contributions to your HSA, your spouse’s contributions to their own HSA (if applicable), and contributions made to an Archer MSA (if applicable).
These maximums can further be affected by the number of months you are covered under an HDHP if you enroll or make plan changes mid-year. Details on the calculation of the IRS prorated maximum can be found in IRS publication 969.
8. What if I am only eligible part of the year?
If this is your first year of coverage under a HDHP and you start mid-year, you can contribute up to the full applicable federal limit; including a full catch-up amount if age 55 or greater, so long as you start your HDHP coverage no later than December 1 of that year. In this case; however, you will be subject to a testing period. The testing period requires that you maintain HSA eligibility for a period beginning on December 1 of the year you started and ending on December 31 of the next year.
If this is not your first year of the HSA and you stop your HSA eligibility mid-year, you are only allowed to contribute 1/12 of the applicable federal limit times the number of months you were eligible.
9. I am currently enrolled in the Anthem PPO HDHP & HSA, but plan to leave the university. Can I continue my coverage after I have separated from the university?
Yes, you may retain enrollment in the plan for up to 18 months through COBRA continuation coverage. The university will no longer make contributions to your Health Savings Account via pre-tax payroll deductions, but as long as you are enrolled in a HDHP, you are still allowed to put contributions into your Health Savings Account up to the IRS allowed maximum. Any contributions put in your account on an after-tax basis are eligible to be deducted from your gross taxable income on your tax return.
You are responsible for tracking your contributions to ensure you don't exceed the IRS annual contribution limits.
10. Can I use the money in my HSA to pay for health care for a family member?
Yes, you can use your HSA funds to pay for qualified health expenses for you, your spouse, and your IRS-defined tax dependent relatives without tax penalty, even if they aren’t covered on your medical plan.
11. Who qualifies as a dependent?
A person generally qualifies as your dependent for HSA purposes if you claim them as an exemption on your Federal tax return. Please see IRS Publication 502 for exceptions.