Plain version: think of the high deductible health plan (HDHP) as the ticket and the health savings account (HSA) as the wallet. Only someone covered by a qualifying HDHP can put new money into an HSA, but the wallet itself belongs to the individual. It is a trust or custodial account that stays with the person who changes employers or leaves the work force.
The HDHP test for 2026, self-only coverage: an annual deductible of at least $1,700 AND an out-of-pocket maximum of no more than $8,500 (Rev. Proc. 2025-19). A plan must pass both tests; a high deductible alone is not enough. An HDHP may still cover preventive care, such as annual physicals and immunizations, before the deductible. For months after 2025, bronze and catastrophic plans available as individual coverage through an Exchange are treated as HDHPs even if they would not otherwise qualify (IRS Notice 2026-5); silver and gold plans must meet the regular rules.
Staying eligible: an eligible individual generally can have no other health coverage.
Permitted alongside the HDHP: dental, vision, disability, accident, long-term care and telehealth coverage.
Disqualifying: a general purpose health FSA or a first-dollar HRA; a spouse's non-HDHP plan, but only if it covers the individual.
Medicare: beginning with the first month a person is enrolled in Medicare, the HSA contribution limit is zero, even if he or she is still working. The account does not have to be closed.
Contributions:
Anyone may contribute: the eligible individual, an employer or a family member. The limit covers amounts from everyone combined.
The HSA owner deducts his or her own contributions and those made by anyone other than the employer, even without itemizing. Employer contributions are excluded from the employee's income for federal purposes, so they are not deducted again.
There is no joint HSA. Each eligible spouse opens a separate account, and a spouse age 55 or older (not enrolled in Medicare) makes the extra catch-up contribution to his or her own HSA.