HSA & Medicare
How to avoid tax penalties, protect your savings, and plan confidently for age 65 and beyond
You’ve been doing it right:
Saving into your HSA
Planning ahead for retirement
Thinking carefully about Medicare
But then the questions start...
When do I have to stop contributing to my HSA
Can I delay Medicare if I have employer coverage?
Will I owe a penalty if I mess this up?
You’re not alone—and the truth is, many people make costly mistakes they could have easily avoided with the right guidance.
At Mere, we simplify your Medicare transition and help you understand how your HSA fits into the picture—before and after you turn 65.
What Is an HSA—and How Does It Work With Medicare?
An HSA (Health Savings Account) is a powerful savings tool with triple tax advantages:
Pre-tax contributions
Tax-free growth
Tax-free withdrawals for qualified medical expenses
But when you start Medicare, the rules change.
When You MUST Stop Contributing
Once you enroll in any part of Medicare (A, B, or D)—you can no longer contribute to your HSA.
If you do, you could owe a 6% excise tax on excess contributions.
⚠️ Even worse?
If you enroll after 65, Medicare Part A can backdate up to 6 months, and those months count against your HSA eligibility.
💡 Pro Tip:
We recommend stopping HSA contributions at least 6 months before your Medicare effective date to stay penalty-free.
Have questions?
Our MereCare Team is here to help you every step of the way—from scheduling your appointment to making sure your enrollment is smooth and stress-free.
What You Can Still Do With Your HSA After Medicare
Even though contributions stop, your HSA can still serve you well.
You can use HSA funds tax-free to pay for:
Medicare premiums (Parts A, B, C, D)
Deductibles, copays, and coinsurance
Vision, dental, and hearing costs
Qualified long-term care services and insurance premiums (up to IRS limits)
Non-medical expenses (after age 65, taxed but no penalty)
Key Planning Tips
Still working and have employer coverage? You may be able to delay Medicare and keep contributing to your HSA
Receiving Social Security at 65 or later? You’ll be auto-enrolled in Medicare Part A—contributions must stop
Spouse under 65? They can keep their own HSA even if you enroll in Medicare
Want to play it safe? Stop contributions 6 months before your Medicare effective date to avoid retroactive issues
One of the most common mistakes? People unknowingly contribute to their HSA after Medicare begins. We help you catch it early—or fix it if it’s already happened.
Need Help Sorting It All Out?
You don’t need to guess. We’re here to help.
Whether you’re approaching 65, still working, or unsure how Medicare will affect your finances, we’ll help you:
Avoid IRS penalties
Understand your options
Use your HSA wisely during retirement
Coordinate with your Social Security decisions
Take the Next Step
Frequently Asked Questions
Can I use my HSA to pay for Medicare premiums?
Yes! You can use it tax-free for Parts A, B, C (Advantage), and D. Medigap (Supplemental) premiums are not eligible.
What happens if I contribute to my HSA after Medicare starts?
You’ll owe a 6% excise tax on excess contributions. You’ll need to remove the excess and file IRS Form 5329.
Can I delay Medicare to keep contributing?
Yes, if you have credible employer coverage (from a group with 20+ employees). But if you're receiving Social Security, you'll automatically be enrolled in Part A.
Can I still use my HSA after Medicare starts?
Yes! You can use it tax-free for qualified expenses or take taxable withdrawals for anything after age 65 without penalty.
Can my spouse keep contributing if I’m on Medicare?
Yes. If they’re under 65 and not on Medicare, they can contribute to their own HSA.
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