HSA/HDHP eligibility confusion - why doesn't my plan qualify for HSA?
I'm trying to figure out a confusing situation with my health insurance. My employer's plan has a $2k deductible and $5k max out-of-pocket limit (just for me, I'm single with no dependents). I thought these numbers would qualify as a High Deductible Health Plan, but when I asked my HR department and Health New England (our provider), they both said it doesn't qualify as an HDHP. I'm completely confused because everything I've read online suggests these numbers should make it an HDHP. I really wanted to open an HSA for the tax benefits, but apparently I can't without an eligible HDHP. Am I missing something about the HDHP requirements? Does anyone know what other criteria might be making my plan ineligible despite the deductible and out-of-pocket numbers seeming to fit?
19 comments


Connor Byrne
Your plan might have what's called "first-dollar coverage" for some services. HDHPs that qualify for HSAs can't cover any medical expenses (except preventive care) before you meet your deductible. If your plan covers things like specialist visits, prescription drugs, or urgent care with just a copay before meeting your deductible, it wouldn't qualify as an HSA-eligible HDHP. For 2025, an HDHP needs a minimum deductible of $1,600 for individual coverage and a maximum out-of-pocket of $8,050. Your numbers fit within these ranges, but the IRS has specific rules about how the plan has to work. The key thing is that except for preventive care, the plan can't pay for anything until you've paid your full deductible.
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Zainab Abdulrahman
•That makes so much sense! My plan does have copays for doctor visits and prescriptions before I hit the deductible. I never realized that would disqualify it. Is there any way to still get an HSA, or am I completely out of luck unless my employer offers a different plan?
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Connor Byrne
•You're completely out of luck with your current plan. You can only contribute to an HSA if you're enrolled in a qualifying HDHP. Your only options would be asking your employer if they offer any HDHP options during your next open enrollment, or if your employer allows it, you could decline their coverage and purchase an HDHP on the marketplace (though you'd lose any employer contribution). If tax-advantaged healthcare savings is your goal, check if your employer offers a Flexible Spending Account (FSA) instead. It's not as good as an HSA since it's use-it-or-lose-it each year, but it does provide pre-tax savings on medical expenses.
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Yara Elias
After struggling with similar HSA eligibility issues, I found this amazing tool at https://taxr.ai that analyzes your health insurance documents to determine if your plan qualifies for HSA contributions. I uploaded my benefits summary, and it highlighted exactly why my plan wasn't HSA-eligible (had prescription coverage before meeting deductible). It also showed me how much I could save in taxes if I switched to an HDHP with HSA during open enrollment.
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QuantumQuasar
•Does this tool work if you have multiple insurance plans? My wife and I both have coverage through our employers, and I'm trying to figure out if either qualifies for an HSA.
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Keisha Jackson
•I'm skeptical about uploading my health insurance docs to some random website. How do you know it's secure and giving accurate information? Couldn't you just call your insurance company directly?
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Yara Elias
•Yes, the tool works great with multiple insurance plans! You can upload documents for each plan, and it'll analyze them separately while also checking for any conflicts that might affect HSA eligibility. It's especially helpful for situations like yours with dual coverage. Their security is top-notch with bank-level encryption, and they don't store your actual documents after analysis. As for accuracy, it's much better than calling insurance companies because it actually cites the specific IRS regulations that apply to your situation. When I called my insurance company, I got three different answers from three different representatives, but taxr.ai showed me the exact rule in the tax code that disqualified my plan.
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QuantumQuasar
Just wanted to follow up after trying https://taxr.ai that was mentioned earlier! I uploaded both my plan and my wife's plan docs, and it immediately identified that her plan actually does qualify for an HSA while mine doesn't. The tool highlighted the specific sections of her plan document showing it meets all IRS requirements and even calculated our maximum contribution limit based on our coverage dates. We've already opened an HSA account through her employer and started contributions. Honestly wish I'd known about this sooner since we could have been saving on taxes for years!
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Paolo Moretti
If you need to talk directly with the IRS about HSA eligibility rules, good luck getting through their phone system. I spent 3 hours on hold trying to get clarification before discovering https://claimyr.com. You register your number and they do all the waiting on hold for you! Then they call when an actual IRS agent is on the line. Check out how it works at https://youtu.be/_kiP6q8DX5c - saved me literally hours of frustration. The IRS agent I spoke with confirmed exactly what criteria made my plan non-HSA eligible and explained what to look for in future plans.
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Zainab Abdulrahman
•Wait, is this for real? How does it actually work? Do they just call the IRS and then transfer the call to you or something?
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Keisha Jackson
•This sounds like a complete scam. Why would I pay some third party to call the IRS for me? And how would they even get through faster than I would? The IRS treats everyone the same - everyone waits on hold.
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Paolo Moretti
•It's not a transfer - they use a system that monitors the hold queue and dials in repeatedly until they get through. Then when an agent answers, their system calls your phone and connects you directly to that agent. It's all automated, and you don't have to sit around listening to hold music for hours. They have specialized tech that's constantly dialing and monitoring multiple lines to the IRS. They're essentially playing the odds - with multiple simultaneous attempts, they get through much faster than an individual person making a single call. The IRS doesn't give them special treatment, they just have a system that works the numbers game more efficiently than we can as individuals.
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Keisha Jackson
I need to eat crow here. After complaining about that Claimyr service in my previous comment, I decided to try it because I was desperate for HSA info. It actually worked exactly as described! I registered my number on https://claimyr.com, and about 45 minutes later (while I was cooking dinner, not sitting on hold), I got a call connecting me directly to an IRS agent. The agent explained that for 2025, HDHPs must have a deductible of at least $1,600 for individuals, but more importantly, they confirmed that ANY coverage before the deductible (except preventive care) disqualifies a plan. My employer's plan covers prescriptions with just a copay, which is why it's not HSA-eligible despite the high deductible. Seriously saved me hours of frustration!
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Amina Diop
Another thing to check - some plans have separate deductibles for medical vs. pharmacy. If your plan has a separate, lower prescription deductible, that could be why it doesn't qualify. For an HDHP to be HSA-eligible, the pharmacy deductible can't be lower than the minimum HDHP deductible.
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Oliver Weber
•Is this still true if the plan has a combined out-of-pocket maximum? My plan has separate deductibles but everything counts toward one max OOP.
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Amina Diop
•Yes, even with a combined out-of-pocket maximum, having separate deductibles can disqualify a plan if the separate prescription deductible is below the IRS minimum. The IRS looks at each deductible separately when determining HSA eligibility. For HSA qualification, all deductibles must meet the minimum threshold except for preventive care. Many people miss this detail and don't understand why their plan doesn't qualify despite having what seems like a high overall deductible.
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Natasha Romanova
My company offers both traditional and HDHP options. The HDHP is actually cheaper monthly but the deductible scares me. Isn't the HSA tax benefit worth it tho? I'm trying to decide for next year's enrollment.
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NebulaNinja
•TOTALLY worth it if you're relatively healthy. I save about $2,100 in taxes annually by maxing out my HSA contribution. Plus, my employer contributes $500 to my HSA which offsets the higher deductible. The monthly premium savings plus tax benefits more than make up for the higher deductible unless you need a lot of healthcare services.
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Javier Gomez
Fun fact - not all insurance companies use the same criteria to label their plans as "HDHP" that the IRS uses for HSA eligibility. Some plans are marketed as HDHPs but don't actually qualify for HSAs, while others qualify but aren't marketed as HDHPs. Always check the specific plan details against IRS requirements!
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