Navigating Medicare, Social Security, and HSAs

There are about 77 million baby boomers in the United States, and approximately 10,000 individuals representing this generation turn 65 each day. As more people move toward retirement age, that means more people will opt in for Social Security and Medicare.

So what does that mean for baby boomers with a health savings account (HSA)?

Navigating the nuances of Medicare and Social Security can be tricky, and when you throw an HSA into the mix, the rules and regulations become even more confusing.

If you’re a broker or Registered Investment Advisor (RIA), you may be fielding a variety of questions from your clients who are thinking about retirement. To assist your clients, it’s important to have a basic knowledge of Social Security, Medicare, AND HSAs. (A small task, I know.)

In this post, I’ll demystify HSAs and how they intersect with Social Security and Medicare, so you can help your clients make educated decisions for retirement—from age 65 and beyond.

First things first: A quick overview of Social Security and Medicare

Starting at age 61 years and 9 months, a person can apply for retirement benefits, otherwise known as Social Security. Those who are already age 62 may be able to start collecting those benefits within the month they apply.

When a person does sign up for Social Security benefits, it automatically triggers Medicare Parts A and B when they turn 65. Part A covers hospital care and typically doesn’t require a monthly premium since most people pay into it while they worked (if they worked 10 years or more). It’s common for people to receive Part A for this reason. Medicare Part B is considered “medical insurance” and covers doctor’s visits, and typically has a monthly premium. It’s possible for a person to opt out of receiving Part B, even if they’re enrolled in Social Security or Part A.

Where HSAs Come In

Here’s where it starts to get tricky: Your client does not actually have to be retired to collect Social Security and Medicare Parts A and B; in fact, they can be covered by an employer health care plan and still receive Medicare if they choose. However, if a person has a high-deductible health plan (HDHP) and an HSA with their employer, the IRS says you they can no longer contribute to their HSA if that person is enrolled in any part of Medicare.

This is where clients really start to ask questions. “Is there a way for me to keep my HSA after age 65?” “Can I collect Social Security without collecting Medicare Part A?” In short, it’s complicated. I’ll answer those questions below.

To Keep an HSA After Age 65?

For those nearing retirement age, but haven’t signed up for Social Security or Medicare

If an employee decides they want to keep contributing to their HSA before they become eligible for Social Security and Medicare, they probably don’t need to do anything (depending on their age). In many cases, they could simply hold off on applying for both types of benefits until they no longer want to contribute to an HSA (or until they lose their employer-based health care). But keep in mind: Delaying enrollment in Medicare may result in a lifetime Medicare premium penalty unless the client is covered by their employer or their spouse’s employer’s health plan. This coverage is due to the fact that the client or their spouse is an active employee, and the employer has 20 or more employees.

For those who have applied for or already receive Social Security

This person cannot contribute to their HSA because signing up for Social Security automatically enrolls them in Medicare Part A. (Yep, bummer.) In this case, the only way to opt out of Part A and keep contributing to an HSA is to pay back the government the money received from Social Security, as well as the money spent on medical claims though Medicare. Your client’s application to drop out of Part A won’t be processed until they repay these amounts.

For those who applied to Part A at age 65 or later, but who have not applied for Social Security benefits:

This person can simply withdraw their application for Part A.

What’s the best-case scenario for those who want to keep working and keep contributing to their HSA?

Everyone’s circumstances are different, so it’s important for current employees nearing retirement age to talk to their financial, tax, and benefits advisors to see if it makes sense for them to delay Medicare Parts A and B. If an employee is looking to keep contributing to their HSA as they work, it’s possible for them to delay enrolling in Social Security and Medicare altogether until they’re no longer covered under their employer’s HDHP and HSA. If an employee is really ahead of the game, they could also take advantage of the $1,000 catch-up contribution that they can add to their HSA each year once they turn 55, on top of the IRS-mandated limits.

While there are more rules and regulations around Medicare, Social Security, and HSAs, this should give you a jump start when it comes to helping clients make educated decisions around their HSAs after retirement. If you’d like more information about HSAs and Medicare, check out this blog post that digs deeper on this topic.

Author: Juan Godina
Juan Godina is a health care banking and insurance service professional with two decades of experience. He has helped thousands of individuals figure out the rules of the road with HSAs, Medicare, and Social Security. He enjoys educating consumers about the benefits of HSAs and how to maximize their triple tax benefits, rounding out their understanding of their High Deductible Health Plan insurance.

His background in health care banking, insurance regulations and technology provide a holistic perspective into consumer-driven health care for individuals, families, and businesses.