Once you own an HSA, you can use the money to pay for out-of-pocket medical expenses for yourself, a spouse, and your dependents, without regard to the kind of insurance coverage you have. Insurance coverage only determines whether or not you may make new contributions.
Additionally, if you are age 65 or older, you can withdraw money from an HSA for any reason and pay regular income tax but no penalty, much like an IRA. If you withdraw it for medical expenses, it is still tax free and penalty free.
