I am in United States on work visa and want to set up a HSA account. I have insurance from my employer and need to know I am eligible for HSA account. I contacted the insurance company 3 different times and I don't know why, but they can't seem to figure out if my medical plan is high deductible or not. On time they told me it is "moderately deductible", another time they said "No" and one time "Yes". This confused me a lot.

I don't want to commit any financial fraud unknowingly, so I am reaching out to this community for help.

Insurance details (My plan is individual):

In network:

Deductible: $2000, Out of Pocket Max: $6500


Deductible: $5000, Out of Pocket Max: $10,000

I have read the regulations/rules on IRS website but still not sure if I am eligible or not as I don't see any mention of "in-network" or "out of network" terms.

Any help is appreciated. Thank you.

  • Your employer will tell you whether it’s an HDHP. They should offer an HSA for people in such plans.
    – RonJohn
    Commented Dec 22, 2022 at 18:52

2 Answers 2


This is not enough information to be able to tell if this plan is an HSA-compatible "High Deductible Health Plan" (HDHP). In addition to the deductible and out-of-pocket maximum numbers, HSA-compatible plans are only allowed to cover certain specific expenses before your deductible is reached. Sadly, I am noticing that there are fewer HSA-compatible health plans available next year than in previous years.

I would talk to either the insurance company or your employer's Human Resources department again, and instead of mentioning the words "high deductible" (which can be subjective), explicitly ask them if your health plan is an HSA-compatible health plan.

Usually, plans that are HSA-compatible will have the text "HSA" or "HDHP" in the full name of the plan itself.

  • While I agree that this is not enough information for HSA eligibility, the assumption that the employer-sponsored plan is ACA compliant seems IMHO to be a reasonable one. As such, the plan is compatible. As to are only allowed to cover certain specific expenses before your deductible is reached - that's for preventative care, which is again an ACA requirement.
    – littleadv
    Commented Dec 22, 2022 at 17:52
  • 1
    @littleadv ACA-compliant and HSA-compatible are not the same thing at all. There are many ACA-compliant plans that have the deductible and out-of-pocket maximums within the HDHP ranges that are not HSA-compatible. The majority of plans on the healthcare.gov marketplace are not HSA-compatible.
    – Ben Miller
    Commented Dec 22, 2022 at 18:46
  • That's just not true. Just did a quick search on Covered California ACA marketplace site, all the plans that matched the deductible limits were also marked as "HSA eligible".
    – littleadv
    Commented Dec 22, 2022 at 18:50
  • @littleadv In my area, it is true. I know that there are different plans available in different areas. In any case, your answer makes generalities that are not true.
    – Ben Miller
    Commented Dec 22, 2022 at 19:08

Yours is a high deductible plan, assuming you're insured as an individual, without dependents.

The IRS lists the criteria:

Minimum deductible: $1,400 - Yours is $2,000.

Maximum out of pocket: $7,050 - Yours is $6,500.

The IRS does mention in- and out-of-network in this context:

  • This limit doesn’t apply to deductibles and expenses for out-of-network services if the plan uses a network of providers. Instead, only deductibles and out-of-pocket expenses for services within the network should be used to figure whether the limit applies.

Worth mentioning that for HSA eligibility the deductible is not the only variable. The plan may only provide preventative care without applying the deductible (the examples are listed on the same IRS page you linked to), and you also should not have any other health coverage (including FSA, but you may have LPFSA) - this is also listed on that page.

Worth asking the insurance company not whether they're "high deductible" (the person who said "moderately deductible" is an idiot, it's a yes/no question and the term is well-defined), but whether it is HSA-eligible.

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