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I'm looking at a health insurance plan that has a deductible of $3000, for each person enrolled. If you enroll one person, it pays out when that person has $3000 or more of medical expenses. If you enroll two people, it pays out if either enrolled person has $3000 of medical expenses, regardless of how much in medical expenses the other person has paid.

If I enroll a family of at least two people, this is not a High-Deductible Health Plan for IRS purposes, because the per-person "embedded deductible" is below the threshold for family HDHP deductibles for 2024. The plan can begin paying out at $3000 of family expenses, if they all were for one person, and $3000 is below the $3200 family threshold.

If I enroll just myself, I would have purchased health insurance for one person with a deductible of $3000, which is above the HDHP threshold for individual coverage. The plan seems to meet all other HDHP requirements.

Would I then have "self-only HDHP coverage" for IRS purposes? Or would the entire plan be disqualified from giving HDHP coverage to any individuals, regardless of the deductible amounts, because the coverage offered to families does not qualify?

2 Answers 2

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Is the plan being advertised as an "HSA" or "HDHP" plan? There are more requirements than just the deductible that need to be met to be compatible with HSAs.

The deductible you mentioned would have been okay for 2023, but not with the increased minimum deductible for 2024. However, there might be other features of the plan that are not HSA-compatible anyway. The best way to determine whether or not a plan is HSA-compatible is to explicitly ask the insurance company. Usually, plans that are HSA-eligible will have either the letters "HSA" or "HDHP" included in the name of the plan.

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    This is unfortunately very true. I have been browsing many plans with a high deductible that are not HSA compatible for whatever reason.
    – Craig W
    Nov 7, 2023 at 2:43
  • I've gotten I touch with the benefits people at my company, and they cite the low family deductible as evidence that the plan is not an HDHP, even for indiciduals. The plan itself doesn't seem to be marketed at all except by the benefits people, but isn't "the" HSA plan. But I'm not interested in relying on their advice without being able to replicate their determination of whether the plan qualifies.
    – interfect
    Nov 7, 2023 at 12:54
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    @interfect I think I agree with your benefits people that this plan you described does not meet the family deductible requirements for being a true HDHP. However, your suggestion in the question that it would be an HDHP if you only took single coverage might not be correct, depending on lots of other factors that are difficult to determine on your own. If they tell you that it is not an HDHP, they are probably correct.
    – Ben Miller
    Nov 7, 2023 at 13:19
  • How would I go about determining if they are actually correct?
    – interfect
    Nov 7, 2023 at 13:21
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    @interfect If you want to push this, you could ask to talk to the insurance company and then ask them. Or you could post more details about your plan here and perhaps we could determine what features make this plan a non-HDHP. Are you simply asking out of curiosity, or are you considering taking self-only coverage and contributing to an HSA?
    – Ben Miller
    Nov 7, 2023 at 13:26
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For the plan described in the question, if you enroll more than one person then the plan is not qualified for HDHP treatment. See the IRS Publication 969.

If you only enroll yourself then it's not a family plan and only individual deductible matters, and then the plan is in fact qualified (assuming all other eligibility conditions are satisfied).

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  • The page you point to explicitly mentions family high-deductable health plans, while saying that some do not qualify due to the way they handle the deductible across the multiple people covered. So I think what you've written isn't what you meant to say
    – keshlam
    Nov 7, 2023 at 7:26
  • @keshlam look a couple of paragraphs up, where the define what a "family plan" is
    – littleadv
    Nov 7, 2023 at 7:40
  • @keshlam I'm referring to the specific plan the OP was describing.
    – littleadv
    Nov 7, 2023 at 8:03
  • I've looked at Publication 969, but I haven't been able to find anything in it to directly support that the "family plan" and "individual plan" flavors of a plan are distinct "plan" instances, and that only one column of the deductible limit table can apply at a time. The examples make the most sense that way, but they don't contradict the other interpretation, which is the one my employer seems to believe. Could you point to text from the document or other sources that supports your interpretation?
    – interfect
    Nov 7, 2023 at 13:05
  • @interfect I linked directly to it, talks about your exact scenario
    – littleadv
    Nov 7, 2023 at 17:06

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