FAQ: HSA in retirement and Medicare

If you want to understand more about Health Savings Accounts (HSA) in retirement and Medicare, here are answers to some of the most frequently asked questions:

What are the potential tax advantages of using a Health Savings Account (HSA)?
What health care expenses can I pay for using my HSA?
Can my HSA be used for anything other than qualified health care expenses?
Is there a limit to how much I can contribute to an HSA? If so, what is the maximum contribution per year?
How does the HSA catch-up contribution work?
Is it a good idea to pay for medical expenses out of pocket now, and save my HSA to help pay for health care expenses after I retire?
Is it better to contribute to both my 401(k) account and HSA, instead of putting all of my retirement money in a 401(k)?
If I retire early at age 62, can I still contribute pre-tax dollars to my HSA until I turn 65?
I’d like to keep contributing to my HSA as long as I’m working. If I continue working and have health insurance through my employer, do I have to sign up for Medicare Part A or Part B?
Once I enroll in Medicare, can I continue to use my HSA?
What are the HSA contribution considerations in the year that I plan to start Medicare?
My spouse is younger than I am. Can my spouse open and contribute to an HSA after I start Medicare so we can save more dollars for future health care costs?
Can I use my HSA to pay for Medicare premiums for myself or my spouse?
If my spouse is on Medicare but still covered by my high-deductible health plan at work, can I still contribute to my HSA?
If I’m still working and have coverage with my employer, how do I decide whether it’s best to start Medicare when I turn 65 or wait until I retire?
Can I name a beneficiary to my HSA account? If not, what happens to the HSA upon my death?
Can my HSA pay for burial expenses?
Is it possible to transfer money from my 401(k) to my HSA?

1Potential Tax Advantages: You can receive federal income tax-free distributions from your HSA to pay or be reimbursed for qualified medical expenses you incur after you establish the HSA. If you receive distributions for other reasons, the amount you withdraw will be subject to income tax and may be subject to an additional 20% tax, unless an exception applies. Any interest or earnings on the assets in the account are federal income tax-free. You may be able to claim a tax deduction for contributions you, or someone other than your employer, make to your HSA directly (not through payroll deductions). In addition, HSA contributions may reduce your state income taxes in certain states. Certain limits may apply to employees who are considered highly compensated key employees. Bank of America [and Merrill] recommends you contact qualified tax or legal counsel before establishing an HSA.