Can One Spouse Have an HSA and the Other Medicare? - Understanding Health Savings Accounts

Health Savings Accounts (HSAs) can be a valuable tool for managing healthcare expenses, but many people have questions about how they work, especially when it comes to couples with different insurance situations. One common question is whether one spouse can have an HSA while the other has Medicare.

The short answer is yes, one spouse can have an HSA while the other is on Medicare. However, there are some important things to consider:

  • Eligibility: The spouse with the HSA must be covered by a high-deductible health plan (HDHP) and cannot be enrolled in Medicare.
  • Contribution Limits: If both spouses are eligible to contribute to an HSA, they can each contribute up to the family limit set by the IRS.
  • Qualified Expenses: HSAs can only be used for qualified medical expenses, so it's important to keep track of expenses and ensure they meet the criteria.

Overall, having one spouse with an HSA and the other on Medicare is possible, but it's essential to understand the rules and limitations to make the most of this situation.


It's quite common for couples to navigate different healthcare plans, and understanding how Health Savings Accounts (HSAs) can complement this mix is crucial. One spouse can actively contribute to an HSA while the other utilizes Medicare, provided they follow key eligibility rules.

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