Can you use a HSA for premiums?

Learn all about using a Health Savings Account (HSA) for premiums in 2024.

In recent years, health savings accounts (HSAs) have become increasingly popular among individuals seeking to save for medical expenses. This tax-advantaged account allows individuals with high-deductible health plans (HDHPs) to save money for qualified medical expenses. However, many people are still unclear about whether HSAs can be used to pay for premiums. In this article, we will explore the ins and outs of using an HSA for premiums and provide updated information for the year 2024.

Can you use an HSA for premiums?

One of the most common questions about Health Savings Accounts (HSAs) is whether they can be used to pay for health insurance premiums. The answer is generally no, with a few exceptions. According to the Internal Revenue Service (IRS), HSA funds cannot be used to pay for premiums for any type of health insurance, including employer-sponsored plans, individual plans, or Medicare premiums.

However, it's important to note that there are certain circumstances where HSA funds can be used to pay for specific types of premiums. These exceptions provide some flexibility for HSA account holders. Let's explore these exceptions in more detail:

1. Long-Term Care Insurance Premiums: One exception to the general rule is that HSA funds can be used to pay for premiums for long-term care insurance. Long-term care insurance provides coverage for individuals who require assistance with daily activities such as bathing, dressing, and eating due to chronic illness, disability, or cognitive impairment. By allowing HSA funds to be used for long-term care insurance premiums, the IRS recognizes the importance of planning for future healthcare needs.

2. Health Coverage While Receiving Unemployment Benefits: Another exception is that HSA funds can be used to pay for health coverage while an individual is receiving unemployment benefits. Losing a job can be a stressful time, and maintaining health insurance coverage is crucial. By allowing HSA funds to be used for health insurance premiums during periods of unemployment, individuals have the opportunity to continue their coverage and protect their health.

3. Continuation Coverage (COBRA): COBRA stands for the Consolidated Omnibus Budget Reconciliation Act, which allows individuals to continue their employer-sponsored health insurance coverage for a limited period of time after certain qualifying events, such as job loss or divorce. HSA funds can be used to pay for COBRA premiums, ensuring that individuals have access to the same level of coverage they had while employed.

While these exceptions provide some flexibility, it's important to stay informed about any changes in IRS guidelines regarding the use of HSA funds for premiums. The IRS may update its rules and regulations, so it's always best to consult the latest guidelines or seek professional advice to ensure compliance.

Now that we have explored the exceptions, let's take a closer look at the benefits of using an HSA for premiums. Although HSA funds cannot be used for most health insurance premiums, HSAs offer numerous advantages that make them a valuable tool for managing healthcare expenses.

1. Tax Advantages: Contributions to an HSA are tax-deductible, meaning that individuals can reduce their taxable income by the amount contributed to the account. Additionally, any interest or investment earnings on HSA funds are tax-free. When used for qualified medical expenses, withdrawals from the HSA are also tax-free. These tax advantages can result in significant savings for individuals and families.

2. Flexibility and Control: Unlike other healthcare accounts, such as Flexible Spending Accounts (FSAs), HSA funds roll over from year to year. This means that any unused funds remain in the account and can be used for future medical expenses. HSAs also provide individuals with greater control over their healthcare dollars, allowing them to choose how and when to spend their funds.

3. Investment Opportunities: Another unique feature of HSAs is the ability to invest the funds in various investment options, such as stocks, bonds, and mutual funds. By investing HSA funds, individuals have the potential to grow their savings over time, further enhancing the long-term benefits of an HSA.

4. Portability: HSAs are portable, meaning that individuals can take their HSA with them if they change jobs or retire. This ensures that individuals can continue to use their HSA funds for qualified medical expenses, regardless of their employment status.

5. Financial Security: By contributing to an HSA, individuals can build a financial safety net for future healthcare expenses. With rising healthcare costs, having a dedicated account specifically for medical expenses can provide peace of mind and help individuals better manage their healthcare finances.

In conclusion, while HSAs cannot be used to pay for most health insurance premiums, there are exceptions for certain types of premiums, such as long-term care insurance, health coverage while receiving unemployment benefits, and continuation coverage (COBRA). It's important to stay informed about the latest IRS guidelines and seek professional advice to ensure compliance. Despite the restrictions on premium payments, HSAs offer numerous benefits, including tax advantages, flexibility, investment opportunities, portability, and financial security. Consider utilizing an HSA to maximize your healthcare savings and take control of your healthcare expenses.

What are the benefits of using an HSA for premiums?

While HSAs cannot be used to pay for most health insurance premiums, there are still many benefits to having an HSA. HSAs offer individuals a tax-advantaged way to save for medical expenses, providing valuable financial flexibility when it comes to healthcare costs.

One significant advantage of using an HSA is that contributions are tax-deductible, allowing individuals to reduce their taxable income. Additionally, any earnings or growth within the account are tax-free. This means that individuals can save money on both the front end (contributions) and the back end (withdrawals).

Another benefit of an HSA is the ability to carry over unused funds from year to year. Unlike a flexible spending account (FSA), which typically has a "use it or lose it" policy, HSA funds can be rolled over and accumulated over time, allowing for long-term savings and financial security.

Furthermore, HSA funds can be invested in a variety of options, such as mutual funds or stocks, giving individuals the opportunity to grow their savings over time. The ability to invest provides a chance for individuals to further maximize their HSA savings and potentially increase their overall financial well-being.

What are the downsides of using an HSA for premiums?

While the benefits of having an HSA are undeniable, there are also some downsides to consider. One of the main drawbacks is the limitation on using HSA funds for premiums, as previously discussed. This can be a disappointment for individuals hoping to use their HSA savings towards their insurance costs.

Additionally, HDHPs, which are a requirement for opening an HSA, often come with higher deductibles and out-of-pocket expenses. This means that individuals may need to pay a significant amount of money upfront before their insurance coverage kicks in. This financial burden can be a barrier for some individuals who may not have the necessary funds readily available.

Another potential drawback of HSAs is the lack of accessibility for certain individuals. In order to be eligible for an HSA, individuals must have a high-deductible health plan. This may not be an ideal option for individuals with chronic health conditions or those who anticipate higher medical expenses.

HSA vs FSA for premiums

When it comes to using funds for premiums, it's important to understand the difference between an HSA and a flexible spending account (FSA). While HSAs cannot be used for most premiums, FSAs do allow individuals to pay for health insurance premiums with pre-tax dollars.

Unlike HSAs, FSAs are available to individuals regardless of whether they have a high-deductible health plan. However, it's important to note that FSAs have a "use it or lose it" policy, meaning that any unused funds at the end of the year are forfeited.

Ultimately, the decision between an HSA and an FSA depends on individual circumstances, including financial goals, medical expenses, and eligibility criteria. It's advisable to carefully consider these factors before selecting the most suitable option.

Where can you find more information about HSA eligibility for premiums?

If you are looking for more information about HSA eligibility for premiums or have specific questions regarding your situation, it is recommended to consult the official IRS guidelines. The IRS provides detailed information on HSA rules and regulations, including what expenses can be paid with HSA funds.

In addition to the IRS, various reputable financial institutions, healthcare providers, and insurance companies offer resources and expert advice on HSAs. These sources can help individuals better understand the intricacies of using an HSA and make informed decisions about their healthcare and financial well-being.


In conclusion, while HSAs cannot be used for most health insurance premiums, they still offer valuable benefits when it comes to saving for medical expenses. The tax advantages, rollover feature, and investment options make HSAs an attractive option for individuals seeking long-term financial security.

It's important to remember that HSA rules and regulations can change, so it's always a good idea to stay updated on the latest guidelines. By understanding the limitations and benefits of using an HSA for premiums, individuals can make informed decisions about their healthcare savings strategies and overall financial health.

What do you do if you're unsure?

If you’re unsure, it’s best to consult your HSA provider or a tax professional to confirm expense eligibility. 

What are HSA benefits for employers?

If you’re an employer, there are multiple benefits to offering HSA to your employees, including:

  • Attracting and retaining talent
  • It’s a cost-effective healthcare option
  • Enhances employee satisfaction and productivity
  • Increases the utilization of employee benefits
  • Has tax advantages for both you and your employees

Want to learn more? Check out our blog on what is an HSA

Get started with Forma today

Looking to offer an HSA as part of your employee benefits package? At Forma, we provide Pre-tax Accounts - including HSAs - to companies worldwide. 

If you want your business to profit from the employee and employer benefits of HSAs, fill out the form below, and one of our experts will be in touch.