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Level 4
posted Mar 22, 2022 9:36:27 AM

HSA pay for Medicare Premiums for spouse?

I will turn 65 in 2022 and currently have an HSA.  My spouse is already on Medicare. 

 

1.  Can I use my HSA funds (prior to turning 65  and/or after turning 65) to pay HIS Medicare premiums Parts A, B, and D ?

 

2. If yes, will the funds be taxed as regular income since he is not the account holder? 

 

3.  If yes, can I use those funds to reimburse myself for the allowed parts of Medicare that has been taken out of his SS for the past few years; i.e., is there a time limit for reimbursement? 

 

Thank you!

 

 

0 9 1545
2 Best answers
Level 15
Mar 22, 2022 1:19:06 PM

Insurance premiums. You can’t treat insurance premiums as qualified medical expenses unless the premiums
are for any of the following. 
4. Medicare and other health care coverage if you were 65 or older (other than premiums for a Medicare supplemental policy, such as Medigap

 

HOWEVER>

For 4 above, if you, the account beneficiary, aren’t 65 or older, Medicare premiums for coverage of your spouse or a dependent (who is 65 or older) aren’t generally qualified medical expenses.

 

so until you turn 65 any medicare premiums you pay for your spouse would be subject to regular income taxes + a 20% penalty.

 

based on your only be able to cover his medicare costs once you turn 65, any medicare premiums before that time would not be a qualified expense.

 

 

Level 4
Mar 23, 2022 7:55:50 AM

Thank you and @PattiF for the quick reply and explanation to my question! 

 

One further question, since he is a beneficiary of a small HSA, can I reimburse him for his Medicare Part A, B, and D in 2022 for those monies that were taken out of his SS in 2020 and 2021?

9 Replies
Level 15
Mar 22, 2022 1:19:06 PM

Insurance premiums. You can’t treat insurance premiums as qualified medical expenses unless the premiums
are for any of the following. 
4. Medicare and other health care coverage if you were 65 or older (other than premiums for a Medicare supplemental policy, such as Medigap

 

HOWEVER>

For 4 above, if you, the account beneficiary, aren’t 65 or older, Medicare premiums for coverage of your spouse or a dependent (who is 65 or older) aren’t generally qualified medical expenses.

 

so until you turn 65 any medicare premiums you pay for your spouse would be subject to regular income taxes + a 20% penalty.

 

based on your only be able to cover his medicare costs once you turn 65, any medicare premiums before that time would not be a qualified expense.

 

 

Expert Alumni
Mar 22, 2022 1:24:58 PM

No, you cannot use your HSA funds to pay the Medicare premiums for your spouse. This paragraph from page 9 of the IRS Publication says that they aren't generally qualified expenses. 

 

Level 4
Mar 23, 2022 7:55:50 AM

Thank you and @PattiF for the quick reply and explanation to my question! 

 

One further question, since he is a beneficiary of a small HSA, can I reimburse him for his Medicare Part A, B, and D in 2022 for those monies that were taken out of his SS in 2020 and 2021?

Expert Alumni
Mar 23, 2022 12:56:18 PM

"can I reimburse him for his Medicare Part A, B, and D in 2022 for those monies that were taken out of his SS in 2020 and 2021?"

 

Yes, on two conditions: 

1. your spouse is 65+ and

2. these expenses for Medicare pre-dated the creation of his HSA (since I suppose these are current Medicare expenses, they must be after the HSA was created).

 

Technically, your spouse is reimbursing himself from his HSA. As noted above, once you turn 65 (whether or not you go on Medicare immediately), you can pay for your spouse's Medicare premiums.

Level 4
Mar 26, 2022 12:36:42 PM

Many thanks for your reply!  Very much appreciate it!

Level 3
Nov 1, 2022 3:56:17 PM

@PattiF I know this is an old thread, but can you please tell me what IRS publication this is quoted from?  I'm interested in the same question and if I look at IRS publication 502 I can't find this quote nor information on the age restriction.  Thanks!

Level 15
Nov 1, 2022 4:08:04 PM


@pigwidgin wrote:

@PattiF I know this is an old thread, but can you please tell me what IRS publication this is quoted from?  I'm interested in the same question and if I look at IRS publication 502 I can't find this quote nor information on the age restriction.  Thanks!


The quote is from IRS Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans on page 9 under Insurance Premiumshttps://www.irs.gov/pub/irs-pdf/p969.pdf#page=9

Level 3
Nov 1, 2022 4:47:08 PM

@DoninGA thank you very much!

Level 15
Nov 1, 2022 4:47:58 PM

You are most welcome!