Health Savings Accounts After Medicare

You can continue withdrawing from an HSA after joining Medicare, but you won't be able to make new contributions.

I am about to turn 65, but I am still working. I have a high-deductible health insurance policy and health savings account through work now, but I will be signing up for Medicare soon. Can I keep my HSA account after I am on Medicare?

You can continue to use the money already in the account tax-free for uninsured medical expenses. But you can no longer make new contributions to your health savings account after you sign up for Medicare.

Many out-of-pocket expenses qualify for tax-free HSA withdrawals even after you’re on Medicare. You can use the money to pay premiums for Medicare Part B, Part D prescription-drug coverage or all-in-one private Medicare Advantage plans (but not for medigap premiums). You can also use the money for co-payments and deductibles you pay for medical expenses, out-of-pocket costs for prescription drugs, vision and dental care, and even a portion of qualified long-term-care premiums ($3,500 in 2012 for people ages 61 to 70, for example and more if you’re older). For a full list of eligible expenses, see IRS Publication 502 Medical and Dental Expenses.

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Kimberly Lankford
Contributing Editor, Kiplinger's Personal Finance

As the "Ask Kim" columnist for Kiplinger's Personal Finance, Lankford receives hundreds of personal finance questions from readers every month. She is the author of Rescue Your Financial Life (McGraw-Hill, 2003), The Insurance Maze: How You Can Save Money on Insurance -- and Still Get the Coverage You Need (Kaplan, 2006), Kiplinger's Ask Kim for Money Smart Solutions (Kaplan, 2007) and The Kiplinger/BBB Personal Finance Guide for Military Families. She is frequently featured as a financial expert on television and radio, including NBC's Today Show, CNN, CNBC and National Public Radio.