17 Apr Can I use an HSA for my husband’s Medicare premiums?

Q. I’m losing my employee health insurance because of a reduction in hours, and I’ve decided to get insurance through GetCoveredNJ. (I was offered COBRA, but it’s much more expensive.) I have a Health Savings Account and plan to enroll in a GetCovered plan that’s also HSA eligible. My husband, who has been on my employee insurance, will go on Medicare B. Can we use HSA account funds to cover his Medicare B premiums, or can HSA funds be used to pay only for the premiums of the primary insurance holder? (I understand that I can’t use HSA funds for the premiums of my GetCovered insurance.)
— Looking for savings

A. Figuring out health care costs can be confusing.

Let’s dive in.

Health Savings Accounts, or HSAs, are tax-advantaged accounts that allow individuals with high-deductible health plans (HDHPs) to set aside pre-tax money to pay for qualified medical expenses, said Claudia Mott, a certified financial planner with Epona Financial Solutions in Basking Ridge.

The benefits of HSAs include tax-deductible contributions (often through payroll deduction), tax-free interest, and tax-free withdrawals for many medical needs, Mott said. Unlike a flexible spending account (FSA), remaining funds in an HSA can be rolled over for future use, she said.

You are correct that the premium for your GetCovered plan can’t be paid from the account but other expenses can be, Mott said.

Included in the expenses that are payable from HSA fund are: deductibles, co-payments, coinsurance, dental care, vision care (contacts/eyeglasses), prescriptions and some medical supplies, she said. These out-of-pocket costs could be for your or your spouse regardless of age, she said.

“When it comes to paying the premium for your spouse’s Medicare, there is a restriction based on the account owner’s age,” Mott said. “The owner must be age 65 or older in order for a spouse’s Medicare premiums to be paid tax-free.”

If you are under age 65 and were to pay his Medicare premiums from your HSA, the withdrawals will be subject to both income tax and a 20% penalty, she said.

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This story was originally published in April 2026. 

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