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November 2025

2025 HSA Law Changes - One Major Change

The One Big Beautiful Tax Act (OBBBA) did contain some HSA law changes as will be discussed in this article. One change is a major change. However, many of the changes as originally set forth in the House bill were not enacted. The annual contribution limits were to be increased, contributions could be made regardless if a person was enrolled in Medicare, both married individuals could make a catch-up contribution and both spouses could have just one HSA. It may be that some of those proposals will be set forth in future tax legislation.

Here are the HSA changes which become effective as of January 1, 2026.

1. Direct Primary Care
A person may withdraw funds of a certain amount from their HSA to pay for the cost of direct primary care memberships and the withdrawals will be tax-free. An HSA owner with self-only HDHP may withdraw up to $150 per month. An HSA owner with a family HDHP may withdraw up to $300 per month.

The HSA owner is allowed to maintain a membership which will be provided by a primary care practitioner with certain primary care services. The HSA owner will be charged a fixed fee on presumably a monthly basis.

The Secretary of Health and Human Services is to issue a regulation or guidance as to what services may be rendered and would be primary care services, such guidance as of November 25, 2025 has not been issued. The statutory law specifically defines the following services as not qualifying as primary care services.
A. Any services requiring the use of general anesthesia;
B. Prescription drugs other than vaccines; and
C. Many laboratory services

2. Additional Plans Will Qualify as a HDHP so a Person is HSA Eligible
Under the laws applying to 2025 and prior years a person was HSA ineligible if he or she was covered by a health plan where the out-pocket limit exceeded a certain amount. For 2025 the maximum out of pocket limit was $8,300 for single coverage and $16,000 for family coverage. For 2026 the maximum out of pocket limit is $8,500 for single coverage and $17,000 for family coverage.

The new law will be that a person will still be HSA eligible if he or she has bronze level coverage or catastrophic coverage under the Affordable Care Act regardless of their out-of pocket limits. This is a far-reaching change. Many more individuals are now eligible to open and maintain an HSA.

3. Telehealth Coverage
Regardless if a person has met his or her annual deductible limit an HDHP is permitted to pay as a tax-free payment a service rendered via telehealth. This change is retroactively effective as of January 1, 2025. This law had expired on December 31, 2024.