How does this health savings account work with Medicare?


Q. My husband is 52 and I am 63 and disabled. I am currently covered under his medical plan and have Medicare Parts A and B. My husband is contributing to a health savings account (HSA) plan for both of us. His employer says I may use the HSA since I am not contributing. Is that okay or do I need to open a medical savings account (MSA)?
— Unsure

A. The main advantage of the savings accounts you’re talking about is tax savings.

As you know, a person covered by a high-deductible health insurance plan (HDHP) may contribute pre-tax money to a Health Savings Account (HSA).

These pre-tax dollars can be used to pay for eligible health care, dental, and vision expenses for the account holder, their spouse and any eligible dependents, said J. David Principe, a certified financial planner with SAGEbroadview Wealth Management in Morristown.

This means that you do not need to open your own account, he said. Your husband can use his HSA to pay for your qualified medical expenses.

For 2022, your husband’s HSA can accept contributions up to the family maximum of $7,300. Once he turns 55, he’ll also be eligible to make annual “catch-up” contributions, which is currently set at $1,000 per year, Principe said.

A covered spouse over the age of 55 may similarly make catch-up contributions to their own HSA, which would require setting up a separate account, but a enrolled in Medicare may not make HSA contributions, he said.

You should note that a Medicare medical savings account (MSA) is a feature of a specific type of Medicare Advantage — Medicare Part C — plan, he said.

“Like your husband’s HSA, a MSA is a savings account that provides a source of funds for qualified medical expenses, however, enrolling in Medicare Advantage is unnecessary for you at this time since you have your husband’s group health insurance to supplement your Medicare A/B coverage,” he said.

When that group insurance eventually ends, you will want to evaluate your options.

Will he have an option to continue under some sort of group retiree coverage? Will you want to enroll in Medicare Advantage? Will you want to rely on original Medicare plus a supplemental Medigap policy?

“This decision will be based on your individual circumstances at that time, and you may find it helpful to speak to a reputable financial advisor or Medicare insurance broker in order to evaluate your choices,” Principe said.

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This story was originally published on Jan. 19, 2022. presents certain general financial planning principles and advice, but should never be viewed as a substitute for obtaining advice from a personal professional advisor who understands your unique individual circumstances.