To qualify for a Health Savings Account in 2024, your health plan must meet specific IRS thresholds for its deductible and out-of-pocket maximum. The IRS calls these plans “high deductible health plans” (HDHPs), and the numbers change each year with inflation. For 2024, the minimum annual deductible is $1,600 for individual coverage or $3,200 for family coverage. But hitting the deductible threshold alone isn’t enough. Your plan also has to stay within out-of-pocket spending caps, and you personally have to meet several eligibility rules beyond just having the right insurance.
The 2024 Deductible and Out-of-Pocket Rules
The IRS sets two requirements your health plan must satisfy. First, the annual deductible must be at least $1,600 for self-only coverage or $3,200 for family coverage. Second, total out-of-pocket expenses (including deductibles, copays, and coinsurance, but not premiums) cannot exceed $8,050 for an individual or $16,100 for a family. A plan that meets the deductible minimum but blows past the out-of-pocket ceiling doesn’t qualify.
These numbers apply to in-network care. Out-of-network costs don’t have to fall within the same limits. If your employer offers multiple plan options during open enrollment, look for the one explicitly labeled “HDHP” or “HSA-eligible.” Marketplace plans sometimes qualify too, but you’ll need to check the specific deductible and out-of-pocket figures against the IRS thresholds.
What the Plan Can Cover Before the Deductible
A common misconception is that an HDHP can’t pay for anything until you’ve met your full deductible. That’s not quite right. The IRS allows HDHPs to cover preventive care at no cost to you before the deductible kicks in, without disqualifying the plan. This includes things like annual physicals, immunizations, cancer screenings, and prenatal care.
The IRS also expanded what counts as “preventive care” for people managing certain chronic conditions. If you have diabetes, your plan can cover insulin, glucose monitors, and hemoglobin A1c testing before the deductible. Blood pressure monitors are covered pre-deductible for people with hypertension. Inhalers and peak flow meters qualify for those with asthma. Cholesterol-lowering medications and LDL testing count for heart disease. Even certain antidepressants qualify as preventive care for people diagnosed with depression. These exceptions mean an HDHP doesn’t have to leave chronically ill enrollees completely on their own until they hit a high deductible.
Telehealth Changed in 2025
During the pandemic, a special rule let HDHPs offer free or reduced-cost telehealth visits before the deductible without jeopardizing HSA eligibility. That safe harbor expired on December 31, 2024. Starting in 2025, if your HDHP covers telehealth visits before you meet the minimum deductible (and those visits go beyond standard preventive care), that coverage could make you ineligible to contribute to an HSA. For non-calendar-year plans, the relief extends through the end of the plan year that started in 2024.
Personal Eligibility Beyond the Plan Itself
Having an HSA-eligible plan is necessary but not sufficient. You also need to meet several personal requirements. You cannot be enrolled in any other health coverage that isn’t an HDHP, with limited exceptions for dental, vision, and certain supplemental plans. You can’t be claimed as a dependent on someone else’s tax return. And you cannot be enrolled in Medicare.
The Medicare rule trips up many people approaching 65. Once you enroll in any part of Medicare, you lose eligibility to make or receive tax-free HSA contributions as of the date your Medicare coverage begins. This applies even to Medicare Part A, which many people sign up for automatically when they start receiving Social Security benefits. If you’re still working past 65 and want to keep contributing to your HSA, you should delay both Medicare enrollment and Social Security benefits.
There’s a timing wrinkle worth knowing about. If you apply for Medicare or Social Security after age 65, your Part A coverage gets backdated up to six months from your application date, or to the month you turned 65, whichever is closer. Any HSA contributions you made during that retroactive coverage period could exceed your allowed limit and trigger a 6% excise tax. Your spouse’s Medicare enrollment, however, has no effect on your own HSA eligibility.
2024 HSA Contribution Limits
Once you confirm your plan qualifies and you’re personally eligible, the IRS caps how much you can put into your HSA each year. For 2024, the limits are $4,150 for self-only coverage and $8,300 for family coverage. If you’re 55 or older by the end of the tax year, you can add an extra $1,000 as a catch-up contribution on top of those limits.
When your eligibility changes mid-year (because you enroll in Medicare, switch to a non-HDHP plan, or gain other disqualifying coverage), your contribution limit is prorated. The IRS calculates it based on how many months you were eligible, checking your coverage status on the first day of each month. So if you enrolled in Medicare on July 1, you’d be eligible for roughly six months’ worth of contributions.
How to Verify Your Plan Qualifies
If you get insurance through an employer, your benefits materials should clearly state whether the plan is HSA-eligible. Look for the HDHP label or check the Summary of Benefits and Coverage document for the deductible and out-of-pocket maximum. Compare those numbers against the 2024 thresholds: at least $1,600/$3,200 for the deductible and no more than $8,050/$16,100 for out-of-pocket costs.
If you’re shopping on the ACA marketplace or buying an individual plan, the insurer isn’t required to flag HSA eligibility for you. You’ll need to verify the numbers yourself. Bronze and Silver plans sometimes qualify, but not always. The key is matching both the deductible floor and the out-of-pocket ceiling, since a plan can have a high enough deductible but still fail the out-of-pocket test. When in doubt, call the insurer directly and ask whether the plan meets IRS Section 223 requirements for HSA eligibility.