HSA Mistakes to Avoid: Spouse Rules

One of the most frequently asked questions is, "Can I use my Health Savings Account (HSA) for my spouse?" The answer is yes—you can use your HSA to pay for your spouse's medical bills, even if they aren't covered under your High Deductible Health Plan (HDHP), as long as they are your legal spouse and meet Internal Revenue Service (IRS) eligibility rules.

Those rules can be confusing, especially for married spouses who have more than one reimbursement account, or if they work for the same employer. Here are some tips to help you understand key HSA topics including spouse eligibility, contribution limits, and how to coordinate plans effectively.

How Does the IRS Determine Spouse Eligibility?

For HSA distribution purposes, you may use your HSA for your spouse's medical expenses when:

• Your spouse is your legal spouse, regardless of whether they are on your HSA-qualified HDHP
• Your spouse has their own HSA and has not claimed the same expense
• Your spouse is not claimed as a tax dependent on a joint tax return

Family vs. Individual Coverage

When choosing a HDHP that qualifies for HSA use, it's important to know that an HSA is always individually owned, even if you're enrolled in a family HDHP. While the HSA is owned by one person, the funds can be used to cover your spouse and eligible dependents. For example, you can use your HSA to pay for your child's doctor visits or your spouse's prescriptions, even if they don't have their own HSA or are not eligible to open one.

How Much Can Be Contributed to an HSA?

Family vs. Individual HSA Contributions

For HSAs, the type of qualified HDHP coverage (individual vs. family) you have helps determine the maximum contribution*. Keep in mind that employer contributions to an HSA count towards the maximum contribution limits. 

Here are the maximum contribution limits for 2026:

HSA Contribution Rules for Spouses

The IRS defines family coverage as an HDHP that covers two or more people, such as a spouse or child. If either spouse has family HDHP coverage, the couple is considered to have family coverage for HSA contribution purposes. By contrast, individual coverage applies to a plan that covers only one person. Contribution limits are higher for family coverage than individual coverage. See the scenarios below if you are both HSA eligible for a better understanding.

Scenario 1: Both Have Individual HDHPs

You can each open and contribute to your own HSA up to the individual maximum limit of $4,400 to your respective HSAs.

Scenario 2: One Has Family HDHP, One Has Individual HDHP

If both of you are covered under the family HDHP plan, you can each open and contribute to your own HSA. Combined contributions into the two accounts cannot exceed the family maximum limit of $8,750. You can split the contributions between your HSAs however you choose. If you each have your own accounts, you can maximize any employer contributions and direct the rest to whichever account has better investment options.

Scenario 3: One Has Individual, Non-HDHP Coverage (e.g., PPO, HMO, Non-Qualified HDHP), One Has Family HDHP

If you are both covered under the qualified family HDHP, then the person with the qualified family HDHP may contribute up to the maximum family limit. Even though only one of you is contributing and owns the HSA, the funds can still be used for both of your eligible medical expenses.

Scenario 4: One Has Non-HDHP Family Coverage

If either spouse has non-HDHP family coverage (such as an HMO, PPO, or non-qualified HDHP) that covers both spouses, they're both ineligible to make contributions to an HSA.

Scenario 5: You Work for the Same Employer

When you are both employed by the same company, navigating HSA contributions can be tricky, especially when both are enrolled in an HSA-qualified HDHP. There are a couple of options in this situation. Each of you may open your own HSA and contribute separately or one of you can open an HSA and only the payroll contributions from the one with the HSA go to that account. If only one of you opens an HSA, you could miss out on additional employer contributions that might be available if both were enrolled individually.

Scenario 6: Domestic Partnership

If you are in a domestic partnership, but not legally married, the person who owns the HSA can contribute up to the individual maximum limit. They can use the funds for their own eligible medical expenses but cannot use them on their partner unless they are a tax dependent. 

Catch-Up Contributions for Spouses Over 55

If you or your spouse are at least age 55 by the end of the taxable year, or are 65 or older and not enrolled in Medicare Part A or Part B, you may qualify for catch-up contributions. Catch-up contributions are tied to individual HSA accounts, and the IRS does not allow catch-up contributions to be combined into a single account. Here are a few examples to help explain how it works:

• If you are both eligible and have separate HSAs, you can each contribute an additional $1,000 to your respective HSAs in addition to the standard limit
• If you are both eligible and have one HSA, you can only contribute $1,000 total to the account in addition to the standard limit
• If you only have one HSA and the spouse who is eligible is not the account owner, you will not be eligible for any catch-up contributions

What Are Some IRS Rules Surrounding HSAs?

Joint Contributions Are Limited

Under IRS rules:

• An HSA is individually owned and cannot be jointly held between spouses
• Two spouses working for the same employer cannot contribute to a single HSA via payroll deduction
• Employers often make HSA contributions based on individual employee participation, which can affect how benefits are distributed

Divorced or Separated Spouses

HSA rules can get complicated during or after divorce. Understanding how HSA ownership, spending, and tax treatment changes post-separation is essential to avoid potentially costly mistakes. What to consider in the event of divorce or legal separation:

• Account remains with the named owner, unless a portion is awarded to the ex-spouse through a court order as part of the divorce settlement
• Any portion transferred to the former spouse becomes their own HSA and no taxes or penalties apply to that transfer

Once divorced, you cannot use your HSA funds to pay for an ex-spouse's medical bills unless they still qualify as your tax dependent (which is rare post-divorce). Doing so:

• Triggers a non-qualified distribution,
• Results in income tax on the amount, and
• May include a 20% penalty if you're under age 65

Dependent Rules After Divorce or Separation

You can continue to use your HSA to pay for eligible medical expenses for any children who still qualify as your tax dependents, regardless of who claims custody or insurance coverage. Keep in mind that only the custodial parent can typically claim a child as a dependent unless otherwise agreed upon in a legal agreement. If you both remain HSA eligible under your own HDHPs, you can use your account for expenses related to dependents you claim. 

What Counts as an Eligible Medical Expense?

The IRS defines eligible medical expenses as costs paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, and for treatments affecting any part or function of the body. These expenses must be primarily to alleviate or prevent a physical or mental defect or illness.

These include but are not limited to:

• Doctor's visits and copays
• Prescription medications
• Dental treatment and cleanings
• Vision exams and prescription eyeglasses
• Chiropractic care
• Mental health services
• Physical therapy
• Lab fees and diagnostic tests

Surprising HSA-Eligible Expenses

In addition to routine healthcare, you may be able to use your HSA:

• Fertility treatments
• Hearing aids
• Smoking cessation programs
• Weight-loss programs prescribed by a doctor
• Acupuncture
• Breast pumps and lactation supplies
• Long-term care services (some limitations apply)

Remember, HSA distributions for non-medical expenses are subject to taxation and penalties.

HSA Planning Tips

To get the most value from your HSA consider the following:

• Coordinate with your employer's HR or benefits team to understand how HSA funding works for dual employees
• Open two HSAs if both spouses want to contribute and take advantage of catch-up contributions
• Monitor combined contributions to ensure they do not exceed the annual family limit
• Use either HSA to pay for eligible medical expenses for both spouses and any tax dependents

For more detailed information, refer to the IRS Publication 969, which outlines contribution rules, eligibility criteria, and how to manage HSAs in family situations.

Frequently Asked Questions

Can both spouses contribute to the same HSA?

No. An HSA is individually owned. Each spouse must have their own HSA to make contributions. 

Can I use my HSA to pay for my spouse's medical expenses?

Yes, if your spouse is your legal spouse, a tax dependent, does not have disqualifying coverage, and the expense is eligible. 

How does family coverage impact HSA limits?

If either spouse has family-qualified HDHP coverage, the combined contribution limit is the family maximum ($8,750 in 2026).

What happens to an HSA if I get divorced?

The HSA remains with the original account holder unless a portion is awarded to the ex-spouse via divorce settlement. 

Navigating Rules and Maximizing Benefits

Understanding how HSA rules apply to spouses is key to making the most of your account benefits. From contribution limits to eligible expenses and tax implications, careful planning helps couples and families unlock the full value of this tax-savings account. 

Whether you're coordinating contributions under a family HDHP plan, considering catch-up contributions, or wondering what counts as an eligible expense, having clear guidance helps avoid mistakes and maximize savings for future medical bills, if you have more questions about HSAs, visit our support page. 

This blog is up to date as of January 2026 and has not been updated for changes in the law, administration, or current events. Content is provided for informational purposes only and should not be considered financial, legal, or tax advice. Consult an attorney or a tax professional regarding your specific situation. 

 

 

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