What the New HSA Rules Mean for Healthcare and Retirement Planning

 

Health Savings Accounts have quietly become one of the most powerful tools in financial planning. They offer tax efficiency that rivals retirement accounts while addressing one of the largest unknowns most households face: healthcare costs.

The One Big Beautiful Bill Act builds on that foundation. Rather than reinventing HSAs, the legislation removes friction points that previously limited who could use them and how they could be applied. The result is a more flexible, more accessible and more strategic planning tool for individuals and families who want greater control over both taxes and healthcare spending.

If you have asked yourself how HSAs fit into your long-term plan under the new tax law, you are asking the right question.

What Changed for Health Savings Accounts Under the One Big Beautiful Bill?

The most important HSA changes fall into three categories: eligibility, qualified expenses and planning certainty. Together, they expand the usefulness of HSAs across income levels and coverage types.

At a high level, the law:

  • Expands who can contribute to an HSA
  • Permanently protects telehealth access without jeopardizing eligibility
  • Allows HSAs to work alongside Direct Primary Care arrangements

These are not abstract policy updates. They directly affect how people structure insurance coverage, manage cash flow and plan for retirement healthcare costs.

Who is Now Eligible to Contribute to an HSA?

Historically, HSA eligibility depended on strict IRS definitions of high-deductible health plans. That framework excluded many individuals who carried meaningful out-of-pocket risk but did not meet the technical thresholds.

Beginning in 2026, the One Big Beautiful Bill expands eligibility to individuals enrolled in Bronze and Catastrophic health plans offered through ACA marketplaces. These plans often feature lower premiums paired with higher deductibles, making them a natural fit for HSA planning.

From a planning standpoint, this change matters because it:

This is a structural expansion, not a temporary exception. It opens the door for more consistent, long-term HSA funding strategies.

Can you Still Use Telehealth and Keep your HSA?

Yes — and now you can do so with confidence.

Prior to the legislation, pre-deductible telehealth services created uncertainty around HSA eligibility. Temporary relief existed, but it required ongoing extensions and careful monitoring.

The One Big Beautiful Bill permanently allows telehealth and remote care services without disqualifying HSA contributions. This provides clarity for individuals, employers and insurers who have embraced virtual care as a standard part of healthcare delivery.

From a wealth management perspective, this change removes an unnecessary compliance concern and allows clients to prioritize convenience and access without sacrificing tax efficiency.

How Do Direct Primary Care and HSAs Work Together Now?

One of the most practical changes in the new law involves Direct Primary Care (DPC).

DPC arrangements typically involve a flat monthly fee for primary care services. Under prior IRS interpretations, these arrangements were treated as disqualifying coverage for HSA purposes.

Starting in 2026, that changes.

Under the new rules:

  • Participation in a DPC arrangement no longer disqualifies HSA eligibility
  • Monthly DPC fees qualify as eligible medical expenses, subject to statutory caps
  • HSA funds may be used to reimburse those fees tax-free

This integration allows individuals to pair lower-premium insurance coverage with consistent primary care access while still leveraging HSA tax advantages. It also supports a more proactive approach to healthcare, which often translates into better outcomes and more predictable costs over time.

What are the Current HSA Contribution Limits?

For tax year 2026, the IRS has increased the Health Savings Account (HSA) contribution limits as part of its annual inflation adjustments:

  • $4,400 maximum contribution for self-only coverage
  • $8,750 maximum contribution for family coverage
  • $1,000 catch-up contribution remains available for individuals age 55 and older who are eligible but not enrolled in Medicare

These limits apply to the total contributions made by you and your employer combined and are tied to eligibility in an HSA-qualified high-deductible health plan (HDHP) for the year. If you’re contributing through payroll deductions, it’s important to coordinate with your plan sponsor to avoid exceeding these thresholds.

Individuals age 55 and older may also make catch-up contributions.

The planning opportunity lies not just in the limits themselves, but in expanded eligibility. More people can now access these limits and compound tax-free growth over longer periods.

Why HSAs Matter More Than Ever for Retirement Planning

Healthcare remains one of the largest and most unpredictable expenses in retirement. HSAs are uniquely positioned to address that risk.

They offer:

  • Pre-tax contributions
  • Tax-deferred investment growth
  • Tax-free withdrawals for qualified medical expenses

After age 65, non-medical withdrawals are taxed like traditional retirement income, removing penalty risk while preserving flexibility.

The changes under the One Big Beautiful Bill strengthen this value proposition by making HSAs easier to use alongside modern healthcare models and coverage options. For many households, HSAs now function as a hybrid account that supports both current healthcare needs and long-term retirement strategy.

What Should you Do Next?

The value of these changes depends on how they are implemented. For individuals and families, next steps may include:

  • Reviewing current health plan eligibility under the new rules
  • Re-evaluating contribution strategies in light of expanded access
  • Coordinating HSAs with retirement and cash-flow planning

For business owners and high-income earners, HSAs can serve as a complementary tax-management tool alongside retirement plans, charitable strategies and investment planning.

The rules have changed. The opportunity lies in responding intentionally.

Questions?

For those who want to manage taxes, healthcare costs and long-term financial security with more precision, HSAs deserve renewed attention.

The smartest strategies rarely come from reacting to change. They come from understanding it early and putting it to work. To make the most of your HSA, consult an Adams Brown wealth advisor.

 

About Adams Brown Wealth Consultants

Adams Brown Wealth Consultants is a nationally recognized financial advisory firm delivering holistic wealth management solutions for individuals, families and business owners. As a division of Adams Brown, a top CPA firm, the team integrates tax strategy, financial planning, estate planning, insurance and risk management and retirement plans into a seamless experience. As a fiduciary, the firm operates under a fee-based model and is committed to providing objective, client-first advice. At Adams Brown Wealth we go above+beyond® for our clients, acting as true strategic allies dedicated to supporting their growth at every stage of their journey.