I am recently divorced (in Iowa). My spouse got a large bill in the mail covered by insurance for an emergency room visit. She still owes money even after insurance paid a portion of the bill.

I'm not obligated to pay her bill according to the decree. If I wanted to be nice, could I pay this out of my HSA account that is now solely in my name for an expense that occurred while we were still married? Or is this account not valid for my ex because she's no longer covered by my insurance and she is no longer my dependent?

  • You stated, "my HSA account that is now solely in my name" as if it wasn't solely in your name before. There is no concept of a joint HSA account, even when married.
    – TTT
    Commented Aug 5, 2020 at 21:37
  • 2
    This is a good question. I know that when you get married, you can't use your HSA for your spouse's expenses from before you were married, so you would think the reverse would be true too (you can use when no longer married, if for expenses from when married). But I want to find a reference proving that.
    – TTT
    Commented Aug 5, 2020 at 21:38
  • @TTT - Updated to say she is no longer my dependent. Commented Aug 6, 2020 at 12:34

1 Answer 1


The key thing regarding expenses and HSA is the date the service is provided and the date of the "split" of responsibilities. On the date of service it doesn't matter if they have their own policy, or the type of policy they have.

I am going to assume that the HSA already existed at the time that service was provided, because if it was established after the date of service the question is moot.

The HSA funds can be used by the tax household, which is the married couple and the tax dependents. If the date the medical service was provided was before the date that the court severed responsibility, then the HSA funds can be used without tax consequence.

If the service was provided after that date, then if HSA funds are used there are tax issues.

The bill can be paid days, weeks, or months after the date of service. We al have experienced long delays sometimes before the final bill is determined.

I am basing this on the instructions for form 8889 line 15:

Only include on line 15 distributions from your HSA that were used to pay you for qualified medical expenses (see Qualified Medical Expenses, earlier) not reimbursed by insurance or other coverage and that you incurred after the HSA was established. Do not include the distribution of an excess contribution taken out after the due date, including extensions, of your return even if used for qualified medical expenses.

In general, include on line 15 distributions from all HSAs in 2019 that were used for the qualified medical expenses (see Qualified Medical Expenses, earlier) of:

  1. You and your spouse.

  2. All your dependents.

  3. Any person who would be a dependent except that:

    • The person filed a joint return.

    • The person had gross income.

    • You, or your spouse if filing jointly, are dependents of someone else.

On the date of service they were still your spouse.

  • Logically this must be true. If you wish to pay an eligible expense the day before your divorce but you don't complete the payment, it would be weird if suddenly that expense becomes no longer eligible the day after your divorce. The only reason I hesitated is because this site seems to say otherwise, but I don't see how that's possible, unless somehow the "if" clause of a divorce decree can change that: hsastore.com/learn/accounts/hsa-divorce
    – TTT
    Commented Aug 6, 2020 at 14:58
  • Really this comes down to your last sentence, which I think are your own words? I agree with it but there is a possible wrinkle. During a divorce it is allowed to split up the HSA and move money between two accounts, however is deemed fair, and there are no tax issues of doing that. I wonder if, since that option exists, it also closes the spousal relationship completely and retroactively, even if you don't take that option?
    – TTT
    Commented Aug 6, 2020 at 15:09
  • 1
    +1 on this answer. With the HSA, it is all about when the expense was incurred, and medical expenses are considered incurred when the service was performed, not when it was billed. @TTT, that page from hsastore.com is talking about expenses incurred after the divorce: it says that even if the divorce decree may require you to keep your ex on your insurance after the divorce, you still cannot use your HSA funds for your ex's expenses that are incurred after the divorce.
    – Ben Miller
    Commented Aug 16, 2020 at 21:00
  • 1
    @BenMiller-RememberMonica - Hah- yes! I was getting tripped up because it actually says before not after: "even if these were "qualified medical expenses" before the divorce." But I do see now that despite that wording it actually does mean what you wrote. They were trying to say: "even if these expenses that occur after the divorce, would have been covered before the divorce."
    – TTT
    Commented Aug 16, 2020 at 21:37

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