Health Savings Accounts · IRC §223 · Notice 2026-5
HSA Eligibility in 2026: What Changed and Whether You Qualify
Three §223 rules changed on 2026/01/01. Two of them let people contribute who could not before.
Who can contribute to an HSA in 2026?
As of January 1, 2026, HSA eligibility extends to anyone enrolled in a Marketplace bronze or catastrophic plan, in addition to traditional HSA-qualified high-deductible plans. Direct primary care membership no longer blocks eligibility, and pre-deductible telehealth coverage is permanently allowed. Medicare enrollment, a general-purpose health FSA, dependent status, and other non-HDHP coverage still disqualify you.
- Bronze and catastrophic Exchange plans are treated as HDHPs (P.L. 119-21; Notice 2026-5).
- A direct primary care arrangement stops disqualifying you as long as your fees, added up across all of your DPC arrangements, stay at or below $150/month, or $300/month if any of your arrangements covers more than one person — that is an ELIGIBILITY threshold, not a reimbursement cap. Notice 2026-5 A-20 places no specific fee limit on reimbursing DPC fees from the HSA.
- 2026 limits: $4,400 self-only, $8,750 family, plus $1,000 at age 55+.
- 2027 limits: $4,500 self-only, $9,000 family (Rev. Proc. 2026-24).
Eligibility checker
Notice 2026-5 A-6 still treats it as an HDHP if the same plan is offered as individual coverage on an Exchange.
Age 55 or older adds the $1,000 catch-up.
Other coverage
No longer disqualifying in 2026.
Still a hard stop on contributions.
Limited-purpose FSAs are fine.
A spouse's PPO, TRICARE, recent VA medical benefits.
§223(b)(6) excludes dependents.
Eligible — up to $4,400 for 2026 if you're eligible every month (or on December 1, under the last-month rule)
Self-only limit $4,400. Eligibility is tested month by month, so a mid-year change prorates the limit (subject to the last-month rule and its 13-month testing period).
- Starting January 1, 2026, bronze plans are treated as HDHPs for HSA purposes (P.L. 119-21; Notice 2026-5). Before 2026 this plan would not have made you HSA-eligible unless it happened to meet the §223 deductible test.
- Pre-deductible telehealth and remote-care coverage is permanently allowed, retroactive to plan years beginning after December 31, 2024 (Notice 2026-5 Sec. II.B.1) — so 2025 plan years are covered too.
The three changes
1. Bronze and catastrophic plans count
Enrolling in a bronze or catastrophic plan through the Marketplace or a state Exchange now makes you an eligible individual under §223, regardless of whether the plan meets the traditional deductible test. Notice 2026-5 A-6 extends the same treatment to a bronze or catastrophic plan bought off-Exchange on the individual market, provided the identical plan is offered as individual coverage through an Exchange. A-7 covers the harder case: if the plan is available as individual coverage on the individual market but not on an Exchange, and you have no reason to believe it is unavailable on an Exchange, the IRS still treats you as an eligible individual. Employer group plans are not covered by this rule — they still have to meet the §223 definition on their own terms.
2. Direct primary care no longer disqualifies
A DPC arrangement used to be treated as a second health plan, which blocked HSA eligibility outright. Now the membership is compatible and the fee is a qualified medical expense with no specific fee limit for HSA reimbursement (Notice 2026-5 A-20 — fees above the eligibility cap stay reimbursable even though they end your eligibility to contribute). The $150/month and $300/month figures are the §223(c)(1)(E)(ii)(II) ceiling on your fees added up across all of your DPC arrangements, and it decides whether they count as DPCSAs at all — pay more in total and they become disqualifying coverage. The higher figure applies if any of your arrangements covers more than one individual; it does not depend on whether your HDHP is self-only or family. Two separate $100 single-person memberships total $200 and fail the test. Those 2026 caps are indexed for later years.
3. Pre-deductible telehealth is permanent
The telehealth safe harbor first enacted in 2020 was extended piecemeal, lapsed twice, and was twice restored retroactively. It is now permanent for plan years beginning after December 31, 2024 (Notice 2026-5 Sec. II.B.1), so 2025 plan years are already covered and a plan can pay for remote care before the deductible without costing anyone HSA eligibility.
If you downgraded to bronze after your subsidy disappeared
The enhanced premium tax credits expired at the end of 2025 and the 400%-of-poverty cliff returned, which pushed a large number of households from silver plans down to bronze. That same move almost certainly made you HSA-eligible on January 1, 2026 — and the HSA deduction reduces the modified adjusted gross income that sets your final 2026 premium tax credit on Form 8962. Very few people who made the switch know this.
Frequently asked questions
Can I contribute to an HSA with a bronze plan in 2026?
Yes. Effective January 1, 2026, bronze and catastrophic Exchange plans are treated as high-deductible health plans for §223 purposes under P.L. 119-21, as implemented by Notice 2026-5. That is true even if the plan's deductible would not otherwise meet the §223 minimum.
Does a direct primary care membership block my HSA?
Not if it qualifies as a direct primary care service arrangement. Starting in 2026 a DPCSA is not disqualifying other coverage, and Notice 2026-5 A-20 says there is no specific limit on the fixed periodic fee for §223(d)(2) reimbursement purposes. The $150 per month and $300 per month figures are the §223(c)(1)(E)(ii)(II) ceiling on your fees, added up across all of your DPC arrangements: $150, or $300 if any of your arrangements covers more than one individual. Pay more than that in combined fees, or have an arrangement that bundles prescription drugs other than vaccines, general-anesthesia procedures, or non-ambulatory lab work, and it is not a DPCSA and does disqualify you.
What about silver and gold Marketplace plans?
They were not included. Only bronze and catastrophic plans are deemed HDHPs. A silver, gold, or platinum plan qualifies only if it independently satisfies the §223(c)(2) minimum deductible and out-of-pocket maximum tests and pays nothing before the deductible except preventive care or telehealth — plans that do are usually labeled HSA-eligible.
Is telehealth still allowed before the deductible?
Yes, permanently, and retroactively to plan years beginning after December 31, 2024 (Notice 2026-5 Sec. II.B.1). The safe harbor, which had been renewed year by year since 2020 and lapsed twice, is now a permanent feature of §223, so 2025 plan years are covered as well.
I lost my ACA subsidy and switched to bronze. What should I do?
Open an HSA. The subsidy cliff pushed a large number of households into bronze coverage in 2026, and almost none of them realize that same switch made them eligible to contribute — a deduction that reduces your 2026 MAGI, which sets your final 2026 premium tax credit on Form 8962; contributions made by April 15, 2027 count. 2027 eligibility depends on 2027 income.
Sources & References
Primary references used for this content
Health Savings Accounts
Eligible individual definition, HDHP tests, and disqualifying coverage
View on law.cornell.edu
One Big Beautiful Bill Act — health provisions
Bronze/catastrophic HDHP treatment, DPC, and permanent telehealth
View on congress.gov
IRS guidance on the OBBB HSA provisions
Implementation guidance effective January 1, 2026
View on irs.gov
2027 HSA and HDHP inflation-adjusted amounts
Official 2027 contribution and deductible limits
View on irs.gov
Health Savings Accounts and Other Tax-Favored Health Plans
Eligibility, the last-month rule, and qualified expenses
View on irs.gov
✓5 primary sources; links re-checked on a weekly rotation by the source watcher
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