Can I buy health insurance through the exchange that’s compatible with an HSA?

Can I buy health insurance that’s compatible with a health savings account (HSA) through the health insurance exchange in my state?

If you enroll in a high-deductible health plan (HDHP), you’ll be eligible to fund an HSA. HSAs let you contribute pre-tax dollars that you can then use to pay for qualified medical expenses. Marketplace HDHPs are available in all areas of the country in 2026.

Indeed, the number of available Marketplace HDHPs greatly increased in 2026. This is because all Bronze and Catastrophic Marketplace plans are now considered HDHPs, under the terms of federal legislation that was enacted in 2025.¹ This ensures that there are multiple HDHPs available to all Marketplace enrollees.

Depending on your income, you might be eligible for premium tax credits (subsidies) that make the premiums more affordable. Most enrollees are subsidy-eligible,² although access to subsidies declined a bit for 2026, after Congress failed to extend the subsidy enhancements that had been in place since 2021 (this issue was still under consideration in Congress in early 2026, so it could still change).

As a result, subsidies are not available in 2026 to Marketplace enrollees with household income above 400% of the federal poverty level (FPL). But it's important to note that contributions to your HSA will reduce your ACA-specific modified adjusted gross income, which could result in a larger premium subsidy, or access to a subsidy when you would otherwise not qualify.

The Affordable Care Act's open enrollment period (OEP) – from November 1 through January 15 in most states – is your chance to secure health coverage. You can also enroll outside of that window if you qualify for a special enrollment period. (Starting in the fall of 2026, the open enrollment period will end December 15 in most states, and will not be allowed to extend past December 31 in any states.)

Your goals in choosing a health insurance plan may include minimizing your total costs, while ensuring you have access to the services and providers you need.

And when you run the numbers on what each health plan will cost you, you're apt to focus on two main factors: premiums and out-of-pocket costs. But remember, there's a less obvious form of savings you might reap, depending on the plan you choose, and it's the tax savings associated with a health savings account (HSA).

Read one couple's story of how they ended up selecting an HSA-qualified health plan after transitioning away from a more robust employer-sponsored plan.

Am I eligible to contribute to an HSA?

To contribute pre-tax money to an HSA, you must sign up for a high-deductible health plan (HDHP). A plan is not an HDHP just because it has a high deductible; HDHPs also have to follow other rules laid out by the IRS, or they must be a Marketplace Bronze or catastrophic plan. Here are the criteria for a plan to be an HDHP in 2026:

• It can be a Bronze or catastrophic plan purchased in the health insurance Marketplace. These policies are all HDHPs, by definition, regardless of the plan design. (In other words, the IRS doesn't set specific rules for deductibles, out-of-pocket limits, or pre-deductible benefits for these policies.)
• If the policy isn't a Bronze or catastrophic Marketplace plan, it must have a deductible of at least $1,700 for an individual or $3,400 for a family, and the out-of-pocket maximum can't be more than $8,500 for an individual or $17,000 for a family.³ (These limits are indexed each year by the IRS, and are lower than the out-of-pocket maximums that apply to non-HDHPs.) In addition, the policy must be designed so that it doesn't pay for anything other than preventive care before the minimum deductible is met. (So a policy with copays for office visits would fail to be an HDHP, even if it has a deductible and out-of-pocket maximum in the allowable range.)

With an HDHP, you’re entitled to certain free preventive care services before the deductible is met. This is true regardless of whether you have a Marketplace plan or an employer-sponsored plan (as long as it isn't grandfathered). This works just like preventive coverage on any other ACA-compliant health plan.

And there are rules in place that allow insurers the option to provide treatment for certain chronic conditions, like asthma and diabetes, under the preventive care umbrella while allowing the plan to retain its HDHP status. If your insurer offers these additional benefits, you may be eligible to receive certain covered treatments before meeting your deductible. Plus, you can use your HSA funds to pay your deductibles under your HDHP.

How much can I contribute to an HSA?

If you're enrolled in an HDHP for 2026 (including a Bronze or Catastrophic plan purchased through the Marketplace in your state), you’ll be allowed to contribute up to $4,400 if you have self-only HDHP coverage, or up to $8,750 if you have family HDHP coverage.⁴ Note that HSA contributions will reduce your ACA-specific MAGI, potentially allowing you to qualify for premium subsidies or to qualify for a larger subsidy.

If you had HDHP coverage in 2025, you can contribute up to $4,300 to your HSA if you have self-only HDHP coverage, or up to $8,550 if your HDHP also covers at least one other family member.⁵ You have until the tax filing deadline in 2026 to make your contributions.

If you're 55 or older, you get an additional $1,000 on top of whichever limit applies to you. That additional catch-up amount is not indexed for inflation; it stays the same from one year to the next. If two spouses are each 55 or older, they must each have their own HSAs if they each want to make the catch-up contribution.

If they choose to just contribute the family amount to one spouse's HSA, they will only be allowed to make the additional contribution for one of them.⁶ (HSAs are not jointly owned, but the money in the HSA can be used to cover medical expenses for the owner, their spouse, and any tax dependents.)

Is an HDHP right for you?

There's no one-size-fits-all when it comes to health insurance. But here's an example of how selecting an HDHP and contributing to an HSA could be beneficial to an enrollee:

Consider a single adult, aged 45, living in Omaha, Nebraska. Let's say their projected 2026 income is $65,000. That's above 400% of the federal poverty level,⁹ which means they aren't eligible for any premium subsidies in the Marketplace for 2026 (that could still change, as Congress is considering an extension of the federal subsidy enhancements in early 2026).

The full-price premium for the lowest-cost plan available to this person is $558/month.¹⁰ But since that plan is a Bronze plan, enrolling in it will make this person eligible to contribute to an HSA. Let's say they contribute $3,000 (which can be done anytime between Jan. 1, 2026 and Apr. 15, 2027). That will reduce their ACA-specific MAGI to $62,000, which is under 400% of the federal poverty level. That will make them eligible for a premium subsidy of $211/month, bringing the cost of their policy down to about $347/month.

In other words, contributing $3,000 to an HSA (which they get to keep; there's no use-it-or-lose-it rule with an HSA) will allow them to get a premium subsidy of more than $2,500.

Some people prefer a more robust health plan, with lower out-of-pocket costs. There are trade-offs on both ends of the spectrum, and no single solution works for everyone. And even if you're set on an HSA-qualified plan, you'll want to be sure to compare other plan features and costs (like the scope of your provider network and prescription formulary) to land on the right decision.

HDHPs can be a smart choice because they open the door to HSA contributions, which can defray or, in some cases, completely cover the costs of the deductibles you then face (assuming you're willing and able to contribute to your HSA). As you weigh your health plan options during open enrollment – or during a special enrollment period if you have a qualifying event – you may find that it pays to switch to an HDHP to capitalize on the tax savings HSAs offer.