Understanding Tax Penalties When You Have an HSA and Medicare

Having both a Health Savings Account (HSA) and Medicare can provide great benefits for your healthcare needs. However, it's important to be aware of the tax implications that may arise when you have both accounts.

One key consideration is that you can still contribute to your HSA while enrolled in Medicare Part A or Part B. However, there are certain rules you need to follow to avoid tax penalties:

  • If you are enrolled in any part of Medicare, you cannot contribute to your HSA on a pre-tax basis.
  • If you contribute to your HSA after enrolling in Medicare, those contributions are considered excess and subject to a 6% excise tax each year until corrected.
  • If you are 65 or older and withdraw money from your HSA for non-qualified medical expenses, the withdrawn amount will be subject to income tax.

It's crucial to stay informed about these rules to make the most out of your HSA and Medicare benefits without incurring unnecessary tax penalties.


Though having both a Health Savings Account (HSA) and Medicare can create a solid safety net for your healthcare expenses, it’s essential to grasp the specific tax implications tied to them. Understanding these potential penalties can save you from unexpected costs.

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