HSAs and Medicare
Stop contributing before you enroll. Keep spending after.
A Health Savings Account (HSA) can be a useful tool going into retirement, but it has a hard rule: once you're enrolled in any part of Medicare, you can't make or receive new contributions.
The 6-month look-back
When you apply for premium-free Part A after 65, your coverage is backdated up to 6 months, but not before the month you turned 65. Contributions made during those backdated months can create a tax problem. To avoid it, stop contributing 6 months before you apply for Medicare (or apply for Social Security, which enrolls you in Part A).
Delaying Medicare to keep contributing
If you have large-employer coverage through current work, you can delay both Part A and Part B and keep contributing. You can't delay Part A if you're getting Social Security benefits, since those come with Part A.
Using your HSA with Medicare
You can keep using money already in your HSA, tax free, for qualified medical expenses, including Part B, Part D and Medicare Advantage premiums, deductibles, copays and coinsurance. Medigap premiums generally aren't a qualified expense.
Common questions
If your spouse isn't on Medicare and has their own HSA-eligible coverage, they may be able to. Ask a tax professional about family contribution limits.
A separate kind of Medicare Advantage plan that deposits money into a savings account for you. You can't add your own contributions.
Want help with your own choices?
Every state runs a State Health Insurance Assistance Program (SHIP) with trained counselors who give free, unbiased Medicare help and do not sell plans. Find yours on our Medicare by state pages, or call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week).
Planning the rest of your coverage in retirement? We can help with life insurance later in life and final expense coverage.
Sources
- Working past 65, Medicare.gov. Checked September 29, 2026.
General information about the federal Medicare program, not advice about your situation. Figures are for 2026 unless stated and change every year; last reviewed September 29, 2026. Quote My Policy is a private company. Not connected with or endorsed by the United States government or the federal Medicare program.
Quote My Policy does not sell Medicare plans on this site. For plan-specific help, contact Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week) or your State Health Insurance Assistance Program.