In most cases, you can’t have both a traditional Flexible Spending Account (FSA) and a Health Savings Account (HSA) at the same time. That’s because traditional FSAs can reimburse a wide range of medical expenses—including those already eligible under an HSA—which creates a conflict under IRS rules.
But here’s where it gets tricky: even if you don’t enroll in an FSA, your spouse’s FSA could disqualify you from HSA eligibility—if their FSA covers family members. FSAs can be used to reimburse medical expenses for spouses and dependents, so if your spouse has a general-purpose FSA that covers you, you’re not eligible to contribute to an HSA, even if you’re enrolled in a qualifying high-deductible health plan (HDHP).
If you want to maintain HSA eligibility, your spouse would need to:
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Decline a general-purpose FSA, or
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Enroll in a limited-purpose FSA, which only reimburses dental and vision expenses
Limited-purpose FSAs are specifically designed to work alongside HSAs, so they won’t interfere with your eligibility.
When in doubt, it’s always a good idea to check with your benefits administrator or broker to make sure you’re staying compliant.