HSA Changes 2026: New Rules, Contribution Limits, and What They Mean for You

Overview

If you’ve ever wondered whether an HSA is worth having, 2026 might be the year that settles it.
New laws under the One Big Beautiful Bill Act (OBBB)—signed into law on July 4, 2025—introduce the biggest Health Savings Account (HSA) expansions in more than 20 years.

From new eligibility options and higher contribution limits to expanded telehealth and primary care coverage, these changes aim to help millions of Americans better manage healthcare costs while saving money tax-free. If you’re comparing new coverage options, now’s also a great time to compare the best health insurance companies of 2025 to find plans that balance value and benefits before 2026 open enrollment.

Let’s explore how the 2026 updates could make HSAs more accessible and flexible for individuals and families alike.

Major HSA Expansions Take Effect in 2026

Starting in 2026, new HSA rules take effect through the One Big Beautiful Bill Act (OBBB). This legislation introduces sweeping updates designed to make HSAs more inclusive, particularly for Americans who buy health insurance through the ACA Marketplace.

Standard Annual Contribution Limit Increases

The IRS has announced inflation-adjusted HSA limits for 2026, giving consumers more room to save.

High Deductible Health Plan (HDHP) requirements:

• Minimum deductible: $1,700 (individual) / $3,400 (family)
• Maximum out-of-pocket: $8,500 (individual) / $17,000 (family)

These modest increases keep pace with inflation and ensure that HSAs remain a powerful, tax-free savings tool for medical expenses.

(Yes, HSAs are tax-free when funds are used for qualified medical expenses.)

Expanded HSA Eligibility in 2026

The OBBB includes three major provisions expanding who qualifies for an HSA. Beginning January 1, 2026, millions more Americans will be able to open and contribute to these tax-advantaged accounts.

1. Bronze and Catastrophic ACA Plans Now Qualify

Historically, only high-deductible health plans (HDHPs) qualified for HSAs. Starting in 2026, all Bronze and Catastrophic ACA marketplace plans will automatically meet the requirements, making HSA eligibility much easier.

This change applies to individual coverage purchased through Healthcare.gov or state exchanges (not to small business or SHOP plans).

Why it matters:
About 7.3 million Americans currently enrolled in Bronze and Catastrophic plans (roughly 30% of marketplace enrollees) will now be able to open HSAs. As catastrophic plan access broadens, the eligible population could reach 10 million.

These changes could make ACA plans even more affordable for consumers who qualify for federal premium tax credits. Estimate your potential savings using our ACA Subsidy Calculator before choosing an HSA-qualified plan.

2. Direct Primary Care (DPC) Memberships Are Now HSA-Compatible

The OBBB also makes Direct Primary Care (DPC) arrangements eligible for HSA participation—something long requested by advocates of value-based care.

Under the new rules, you can:

• Contribute to an HSA even if you have a DPC plan, as long as monthly fees stay under $150 for individuals or $300 for families.
• Use your HSA to reimburse DPC membership fees, which are now classified as qualified medical expenses.

What is DPC?
Direct Primary Care is a healthcare model where patients pay a flat monthly fee for unlimited access to a primary care practice—covering visits, labs, vaccines, and basic tests without traditional insurance billing.

This update gives consumers more flexibility to combine personalized primary care with tax-advantaged healthcare savings.

3. Telehealth Coverage Becomes Permanently HSA-Compatible

During the COVID-19 pandemic, Congress temporarily allowed HDHPs to offer telehealth services before meeting the deductible. That rule expired at the end of 2024—but the OBBB makes it permanent.

Starting retroactively on January 1, 2025, HDHPs can now cover telehealth at no cost before the deductible, without jeopardizing HSA eligibility.

This shift recognizes telehealth as a vital part of modern care, improving access to virtual primary care, mental health visits, and chronic condition management.

Dependent Care FSA Limits Also Rise

While not technically an HSA update, the OBBB also boosts Dependent Care Flexible Spending Account (FSA) limits.

For tax years beginning after December 31, 2025, the annual maximum rises from $5,000 to $7,500 ($3,750 for married couples filing separately)—the first increase since 1986.

This update provides meaningful relief for working parents managing childcare or dependent care expenses.

What Didn’t Make the Cut

Not every HSA-related proposal made it into the final OBBB law. The following provisions were removed before passage:

• Gym and fitness membership reimbursements
• Income-based contribution limit increases
• HSA eligibility for Medicare Part A participants
• On-site clinic coverage compatibility
• Joint catch-up contributions for spouses over 55
• Reimbursement for pre-HSA expenses (within 60 days of account setup)

Industry groups such as the Health & Fitness Association expressed disappointment, calling the exclusion of wellness-related expenses a “missed opportunity” to encourage preventive health behaviors.

Employer Action Items for 2026

Employers offering HSAs or Dependent Care FSAs should prepare now. Key steps include:

1. Updating plan documents and Summary Plan Descriptions to reflect 2026 limits.
2. Adjusting salary reduction agreements for payroll deductions.
3. Reviewing FSA nondiscrimination testing procedures due to the higher contribution caps.
4. Communicating changes during open enrollment.
5. Considering first-dollar telehealth coverage options within HDHPs.

These updates will help employers stay compliant and ensure employees benefit from the expanded savings opportunities.

If your employer doesn’t offer ACA Marketplace coverage, you can learn about Marketplace healthcare alternatives that may still work with an HSA or other tax-advantaged accounts.

What It Means for You

If you’re currently enrolled in an ACA Bronze or Catastrophic plan, 2026 brings welcome news. You’ll not only gain HSA eligibility but also new ways to save for healthcare costs—tax-free.

Whether you’re self-employed, managing high out-of-pocket costs, or planning for long-term healthcare expenses, these updates make HSAs more accessible and flexible than ever before.

Bottom line: HSAs are evolving to match today’s healthcare reality—where virtual care, direct primary care, and consumer-driven coverage are the norm.

Quick Reference: 2026 HSA Updates

• Individual HSA limit
• • • 2026 Change: $4,400
    • Effective Date: Jan 1, 2026
• Family HSA limit
• • • 2026 Change: $8,750
      Effective Date: Jan 1, 2026
• DPC (Direct Primary Care) compatibility
• • • 2026 Change: Allowed (with fee limits)
    • Effective Date: Jan 1, 2026
• Telehealth coverage
• • • 2026 Change: Permanent, pre-deductible
    • Effective Date: Jan 1, 2025
• Bronze/Catastrophic ACA plans
• • • 2026 Change: Now HSA-qualified
    • Effective Date: Jan 1, 2026
• Dependent Care FSA limit
• • 2026 Change: $7,500
  • Effective Date: Jan 1, 2026

Bottom Line

The HSA changes for 2026 reshape how Americans save for and pay for healthcare. With expanded eligibility, permanent telehealth flexibility, and higher contribution limits, HSAs are more inclusive than ever before.

As open enrollment nears, review your health plan options and consider whether an HSA-qualified plan fits your needs. You can check our 2026 ACA Open Enrollment Guide for key dates and step-by-step enrollment tips.

These updates can help you save smarter, spend efficiently, and prepare confidently for future healthcare expenses.