For 2025 tax year, I may request an HSA reimbursement for long term care premium up to $4,810 (I'm 68). Can I exceed that limit if I get reimbursed for prior years?

[BarneyB]

I would like to get reimbursed (in 2025) for long term care insurance premiums from years 2021-2025 (5 years).

[Mike9241]

The premiums for long-term care insurance that you can treat as qualified medical expenses are subject to limits based on age and are adjusted annually. Any excess over the 2025 limit would be a non-qualified distribution.

For HSA purposes, expenses incurred before you establish your HSA aren’t qualified medical expenses. State
law determines when an HSA is established.

[dmertz · Accepted solution]

"Any excess over the 2025 limit would be a non-qualified distribution."

That's with respect to a 2025 qualified medical expense and is the amount that you already had distributed from the the HSA in 2025.  For 2021, 2022, 2023 and 2024, long-term care expenses that the you can reimburse yourself for with distributions from the HSA, provided that they were incurred after the establishment of the HSA and not already claimed on Schedule A for those years, are limited to $4,520, $4,510, $4,770 and $4,710, respectively.

If you reimburse yourself with a distribution from the HSA for the permissible amounts for 2021 through 2024 in addition to the distribution for 2025 and you itemize medical deductions on Schedule A, be sure to enter the entire amount of these 2025 HSA distributions as insurance expenses when completing the medical-expense section of TurboTax.  TurboTax automatically subtracts from the amount that it puts on Schedule A line 1 the amount of the HSA distributions that you claim as applied to qualified medical expenses.

[Opus 17]

Also remember, if you previously took a schedule A deduction for those premiums in past years, the HSA reimbursement may be considered a taxable recovery (taxable reimbursement of a previous deduction) even though HSA payments are usually tax-free.

And lastly, remember you can only reimburse yourself for expenses that occurred after the HSA was established.  

[BarneyB]

Thank you DMertz. My HSA dates back to 2016 and my annual premium is only about a quarter of those yearly limits. So it looks like I'm in good shape taking reimbursements for 4 or 5 prior years this year. I just have to ensure I didn't already take a distribution for any of those years, so appreciate the tip re looking at prior year Schedule A's.