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Potential HSA Contribution Issues for Those 65+

by Vita, on December 10, 2020

There are an increasing number of over-age-65 individuals who are contributing to their HSA accounts.

Is this a problem?

Sometimes, yes. Sometimes, no. It is possible to remain eligible and make contributions to an HSA after age 65, however, the details of accomplishing this can be tricky. The key is to understand when making contributions after age 65 works and when it does not.

The Rule

The HSA contribution rules say that if an individual has any other disqualifying coverage (meaning any coverage other than or in addition to a qualifying HDHP plan), they cannot make contributions to an HSA.

Medicare is Disqualifying Coverage

Importantly, Medicare is considered such disqualifying coverage. Medicare has multiple parts which include Part A, Part B, and Part D for traditional Medicare and Part C (Medicare Advantage or Medicare HMO plans, Medicare Supplement/Medigap plans). Being covered by any part of Medicare is considered disqualifying coverage and thus makes individuals ineligible to contribute to an HSA.

Eligible vs. Entitled vs. Enrolled

Medicare terminology can be confusing but understanding the definition and application of these three terms is critically important.

  • Eligible means eligible to sign up for Medicare benefits but it does NOT presume any actual enrollment.
  • Entitled means actually enrolled in Medicare coverage such that benefits would be payable (under any part). This is the term that is used by the Medicare program.
  • Enrolled means the same as entitled in Medicare-speak.

Social Security Payments and Medicare Part A are Linked

Enrollment in Medicare Part A is oftentimes automatic, and thus can create an unintended consequence of disqualifying future HSA contributions. The Social Security Administration automatically enrolls individuals in Medicare Part A at age 65 if Social Security benefits payments commence. There are five potential scenarios to consider:

  1. Social Security Prior to Age 65: When Social Security benefit payments began prior to age 65, enrollment in Medicare Part A is automatic at age 65. In this case, individuals lose the ability to make HSA contributions.
  2. Social Security at Age 65: When Social Security benefits begin concurrently with turning age 65, enrollment in Medicare Part A is automatic concurrently at age 65. In this case, individuals lose the ability to make HSA contributions.
  3. Social Security Deferred: When Social Security benefit payments are deferred, enrollment in Medicare Part A is also deferred until the beneficiary activates Medicare Part A (and other parts of Medicare). In this case, individuals retain the ability to make HSA contributions.
  4. Elective Opt Out from Social Security and Medicare: When Social Security benefits are activated but an individual does NOT want current coverage under Medicare Part A, the individual may complete a form to actively disenroll themselves from Medicare Part A. In the absence of completing the SS form, HSA contributions would be disqualified, even if an individual did not “want” to have or intend to use Medicare Part A benefits. Notably, it is not possible to retain Social Security benefits and electively opt out of Medicare Part A. If an individual wants to opt out of Medicare Part A, they must opt out of both. When an elective opt out form is completed, individuals preserve the ability to make HSA contributions.
  5. Employed at Small Employer: Individuals that work for smaller employers (fewer than 20 employees) have Medicare as their primary insurance at age 65, therefore it would not work to “opt out” of Medicare in favor of retaining HSA eligibility. In this case, individuals do not have the ability to make HSA contributions.

Medicare Part B and Part D Require Action

Enrollment in Medicare Part B and Part D require participant action and there are premiums that must be paid pursuant to enrollment in these parts. These coverages still disqualify HSA contributions, but because they require specific action to enroll, they are less often the subject of inadvertent coverage entitlement.

Stopping Medicare to Reclaim HSA Eligibility

Medicare Part A coverage can be declined (if coverage was activated either previously or unintentionally) by submitting a request form to the Social Security Administration.

If Social Security benefit payments have not commenced, this action will reestablish eligibility for making HSA contributions proactively. If Social Security benefit payments have commenced, a Social Security/Medicare Part A opt out requires repayment to the government of all Social Security payments received and all monies received as reimbursement for Medicare claims. Part A benefits may be activated after group health benefits are terminated in the future.

Pro-Rata Contribution for Year Individual Turns 65

HSA contributions are pro-rated in the year an individual turns age 65. The proration is based on the months of actual eligibility, after turning age 65 and enrolling in disqualifying coverage (in this case, Medicare). Beginning with the first month of Medicare enrollment, the contribution limit is zero. This rule also applies to periods of retroactive Medicare coverage.

Example: Bonnie was covered by a self-only HDHP and eligible for an HSA in 2020. She turned 65 on July 2, 2020 and enrolled in Medicare, effective July 1, 2020. Bonnie lost eligibility for her HSA as of July 1, 2020 and thus was only eligible for six (6) months of the year. Her federal HSA limit was $4,550 ($3,550 individual HSA limit plus a $1,000 catch-up). Accordingly, Bonnie’s maximum contribution is 6/12 X $4,550 = $2,275. Bonnie has until April 15, 2021 to make this contribution.

If a delay occurred in applying for Medicare and an enrollment is later backdated, any HSA contributions made during the period of retroactive coverage are considered excess contributions.

Anticipating Post Age 65 Enrollment in Medicare Part A

Individuals who have deferred enrolling in Medicare Part A for HSA eligibility purposes must plan ahead for the reality that, upon activation, the effective date of Part A coverage will be up to six months retroactive (no earlier than the first month of Medicare eligibility or the individual’s age 65). This means that HSA contributions must be stopped six months prior to Medicare Part A enrollment since the retroactive nature of Part A coverage will disqualify HSA contributions during that six-month period.

Excess Contributions

The IRS annual contribution limits for HSAs for 2021 is $3,600 for individual coverage and $7,200 for family coverage. Individuals age 55+ can contribute an additional $1,000 per year as a “catch-up” contribution. These limits are based on inflation, and generally increase by moderate amounts every year.

Excess contributions also include any amount in excess of the pro-rated monthly amount for an individual who was only eligible to make HSA contributions for a portion of the full tax year (such as for someone who turns 65 mid-year).

Excess contributions are not tax deductible and must be reported as "Other Income" on an individual’s tax return. Excess contributions made by an employer must be included in gross income (Box 1 of Form W-2).

6% Excise Tax

If excess contributions are left in an HSA, a 6% excise tax must be paid on the contributions. For example, if an excess contribution of $100 was made, the penalty tax would be $6.00. If an excess contribution of $1,000 was made, the penalty tax would be $60.

Importantly, the excise tax applies to each tax year the excess contribution remains in the account. This means the 6% excise tax applies annually until the excess contributions are withdrawn from the account. Alternatively, a reduction in future year contributions may be made to offset a prior year’s excess contribution.

IRS Form 5329 (Additional Taxes on Qualified Plans and Other Tax-Favored Accounts) is used to calculate and report the excise tax.

Withdrawing Excess Contributions

Some or all of the excess contributions may be withdrawn to avoid paying the excise tax. The following conditions must be met:

  • Same Tax Year: Withdrawals of excess contributions must be made by the due date (including extensions) of the federal tax return for the year the contributions were made.
  • Interest Withdrawn: Net income attributable to the excess/withdrawn contributions (interest) must also be withdrawn and included in the earnings in "Other Income" on the tax return for the year the contributions and earnings withdrawals are made.
  • Report as Income: Income taxes must be paid on the withdrawn amounts (contributions and earnings). Withdrawn excess contributions should be reported as “Other Income” on the tax return.

The Process of Withdrawing Contributions

Essentially every HSA vendor has a mechanism for withdrawing excess contributions (both employee contributions and employer contributions). Typically, an individual must inform the HSA administrator as it is not their responsibility to police contribution amounts. Most withdrawal transactions simply require completion of a special form. It is critical that excess contributions be withdrawn within the same tax year as deposited. There is no way to avoid the 6% excise tax if excess contributions are not withdrawn within the same tax year.

Excess funds withdrawn will be listed on Form 1099-SA as a distribution (Box 1) for the tax year in which the distribution was taken. Earnings on excess contributions withdrawn will also be reported (Box 2 and included in Box 1). Form 5498-SA will report the market value of your HSA at the end of the calendar year, the total contributions made within the calendar year, and the total contributions for the tax year through the tax filing deadline. Both IRS forms are typically generated by the HSA vendor and should be retained for record keeping purposes but is not required to submit to the IRS. Lastly, any excess contributions made by an employer should be included in gross income (Box 1 of Form W-2).

Practical Advice for Employers

It is solidly not the employer’s responsibility to track employee HSA contributions nor to cross check for potential excess contributions. These matters fall in the hands of employees and their tax advisors.

That said, HSA rules are confusing at baseline and even more so for individuals turning age 65 as they look to enter the period of entitlement to Medicare benefits. Many are not aware that Medicare coverage disqualifies future HSA contributions while still others are not even aware that they automatically became enrolled in Medicare Part A when their Social Security benefit payments commenced (and therefore are newly prohibited from making HSA contributions).

The team at Vita recommends that, to the extent possible, employers reach out to individuals turning age 65 and provide a copy of this article to provide plan participants with baseline information. Because we have seen an increasing trend of age 65+ individuals making HSA contributions, Vita has performed a Vita Flex HSA database sweep and is providing a list of employees who fall into this category to ease the outreach and communication process.