09/02/2026
The largest expansion of health savings accounts in two decades took effect this year, and many of the people who became eligible have no idea.
Three changes as of January 1, 2026:
Bronze and catastrophic ACA plans now count as HSA-compatible. Most previously didn't qualify, which shut out a large share of marketplace enrollees. If you're self-employed and buying your own coverage, you may be able to open an HSA for the first time.
Direct primary care arrangements no longer disqualify you. If you pay a flat monthly fee to a primary care practice, you can still contribute as long as the fee is $150 or less per month for individual coverage ($300 for family). Those fees also became a qualified medical expense payable from the HSA.
Telehealth relief is now permanent. A plan can cover virtual care before you meet the deductible without costing you eligibility.
2026 contribution limits: $4,400 individual, $8,750 family, plus a $1,000 catch-up at 55.
Why it matters: the HSA is the only account in the code with a triple benefit — deductible going in, tax-free growth, tax-free out for medical costs. For a self-employed owner, it's often the most efficient dollar available after the retirement plan.
Review it before open enrollment, not during.