Tax Planning
Optimizing Health Savings Accounts Under Recent Changes
Recent guidance makes HSAs more flexible — from expanded eligible plans to tax-free telehealth and direct primary care. Learn how to make HSAs work for you.
By NomadicTax Research Team • 5-8 min read • June 22, 2026
## What’s New with HSAs under the One, Big, Beautiful Bill (OBBB)
Several recent changes expand how and when Health Savings Accounts (HSAs) can be used, making them more useful for more people. **Effective Jan. 1, 2025** for many changes, with new provisions from Jan. 1, 2026 as specified. ([irs.gov](https://www.irs.gov/newsroom/treasury-irs-provide-guidance-on-new-tax-benefits-for-health-savings-account-participants-under-the-one-big-beautiful-bill?utm_source=openai))
### Key Changes
- **Telehealth and remote care before meeting the deductible:** HSA eligibility is preserved even if you use telehealth services before reaching the HDHP deductible. ([irs.gov](https://www.irs.gov/newsroom/treasury-irs-provide-guidance-on-new-tax-benefits-for-health-savings-account-participants-under-the-one-big-beautiful-bill?utm_source=openai))
- **Bronze and catastrophic plans:** As of Jan. 1, 2026, these plans (including those not purchased on an Exchange) are considered HSA-compatible. ([irs.gov](https://www.irs.gov/newsroom/treasury-irs-provide-guidance-on-new-tax-benefits-for-health-savings-account-participants-under-the-one-big-beautiful-bill?utm_source=openai))
- **Direct Primary Care (DPC) arrangements:** Membership or periodic fees paid for certain DPC services can be paid with HSA funds once eligible. ([irs.gov](https://www.irs.gov/newsroom/treasury-irs-provide-guidance-on-new-tax-benefits-for-health-savings-account-participants-under-the-one-big-beautiful-bill?utm_source=openai))
## Who Benefits the Most
- Individuals who rely on **telehealth or remote services** before their deductible is met.
- Those with **lower-premium HDHP alternatives** like bronze or catastrophic plans.
- People in rural or underserved areas with access to DPC models.
## Planning Opportunities & Action Items
- **Review your health plan options for 2026:** If you can choose a bronze or catastrophic plan, you may now get HSA eligibility benefits. Compare premiums, deductibles, and out-of-pocket costs.
- **Use telehealth earlier in the year:** Don’t wait until you’ve met your deductible—the expanded rules allow use without losing HSA eligibility.
- **Evaluate DPC participation:** If your DPC arrangement meets IRS criteria, fees may come from HSA funds—use this to your tax-saving advantage.
- **Check compatibility:** Confirm your plan is considered “HDHP equivalent” under the updated rules to avoid surprises.
## Example Scenario
> **Raj**, age 35, lives in a rural county and chooses a **bronze health plan** for 2026. Thanks to the OBBB rule changes, even though his plan doesn’t meet traditional HDHP thresholds, he’s now eligible to contribute to an HSA. Plus, he enjoys telehealth visits in February without waiting to meet his deductible.
By staying up to date with these HSA changes, you can save more on healthcare costs and get broader coverage without losing tax benefits.