How to Fill Out HSA Eligibility Questionnaire: A Comprehensive Guide

When it comes to opening a Health Savings Account (HSA), one of the key steps is determining your eligibility. The HSA eligibility questionnaire plays a crucial role in this process as it helps you confirm whether you meet the requirements to contribute to an HSA. Here is a step-by-step guide on how to fill out the HSA eligibility questionnaire:

  1. Understand the basic eligibility criteria: To contribute to an HSA, you must meet certain requirements, including being covered by a high-deductible health plan (HDHP) and not being claimed as a dependent on someone else's tax return.
  2. Gather necessary information: Before filling out the questionnaire, make sure you have relevant details such as your health insurance coverage, tax filing status, and any other pertinent financial information.
  3. Access the HSA eligibility questionnaire: Your HSA provider or employer will typically provide you with the questionnaire either in a physical or digital format.
  4. Complete the questionnaire accurately: Take your time to carefully read and answer all the questions on the form. Provide truthful and up-to-date information to ensure your eligibility assessment is accurate.
  5. Submit the questionnaire: Once you have filled out the questionnaire, submit it to the designated party for review. This could be your employer, HSA provider, or a third-party administrator.
  6. Wait for confirmation: After submitting the questionnaire, wait for confirmation on whether you are eligible to contribute to an HSA. If you meet the requirements, you can proceed with setting up your HSA and making contributions.

By following these steps and completing the HSA eligibility questionnaire accurately, you can ensure a smooth process in opening and contributing to your HSA.


Filling out the HSA eligibility questionnaire is an important step for anyone considering opening a Health Savings Account (HSA). This process helps you establish whether you're eligible to contribute, based on your health coverage and financial standing. By understanding the basic eligibility criteria, including being enrolled in a high-deductible health plan (HDHP) and not being claimed as a dependent, you can navigate this process smoothly.

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