Short answer: Yes. Once you are enrolled in Medicare, you can use HSA funds tax-free to pay for Medicare Part A, Part B, Part D, and Medicare Advantage premiums, but not Medigap premiums.
After you enroll in Medicare, IRS rules allow you to use Health Savings Account funds on a tax-free basis to pay certain Medicare-related premiums.
Qualified Medicare premiums include Medicare Part A (hospital insurance, for the minority of people who must pay a Part A premium), Medicare Part B (medical insurance), Medicare Part D (prescription drug coverage), and Medicare Advantage (Part C) plan premiums. HSA funds may also be used for premiums under certain employer-sponsored retiree health plans.
Medigap, also known as Medicare Supplement insurance, is specifically excluded. Premiums for Medigap policies are not considered qualified medical expenses, and using HSA funds for those premiums would result in taxable income (plus a 20% penalty before age 65).
You must be enrolled in Medicare to use HSA funds for Medicare premiums. While enrollment in Medicare generally begins at age 65, individuals who delay Medicare because they are still working cannot use HSA funds for Medicare premiums until they are actually enrolled.
Using HSA funds for Medicare premiums does not affect your ability to use the HSA for other qualified medical expenses, but remember that you can no longer contribute to an HSA once you are enrolled in any part of Medicare.
Sources
- IRS, Publication 969: Health Savings Accounts: https://www.irs.gov/forms-pubs/about-publication-969
- IRS, Publication 502: Medical and Dental Expenses: https://www.irs.gov/publications/p502
Content history
Originally published: March 27, 2025
Last reviewed: June 16, 2026