Why It Matters Now

October is when a lot of households revisit their health plan elections for next year, so it is a good moment to get familiar with how the account works.

A common assumption is that eligibility depends on the store. In practice it comes down to three checkpoints set by the IRS and an independent licensed practitioner, not a retailer.

Three Things To Know About Eligibility

First, the health plan. To contribute to an HSA, IRS rules require enrollment in a qualifying high deductible health plan on the first day of the month.

Second, the annual limit. For 2026, the IRS contribution limit is $4,400 for a self-only HSA and $8,750 for a family HSA, plus a $1,000 catch-up contribution if you are 55 or older. For 2027, the limits rise to $4,500 and $9,000.

Third, the documented connection. A health survey gets reviewed by an independent licensed practitioner, who determines whether a specific purchase treats, mitigates, or prevents a diagnosed condition. That review is what a letter of medical necessity represents, and it is the actual decision point, not the product category.

Same dollars, different paperwork. The money is already set aside, and the letter of medical necessity is what can open it up to a wider set of health purchases.