HSA Question - Insurance (Medicare) Payments from HSA.

26 U.S.C. 223(d)(2)(C) specifies that certain Insurance premiums may be paid from an HSA under some conditions.

"(iv) in the case of an account beneficiary who has attained the age specified in section 1811 of the Social Security Act, any health insurance other than a medicare supplemental policy (as defined in section 1882 of the Social Security Act)."

I read this as indicating that a person can pay (or reimburse one's self) for basic medicare premiums (Parts A-D). For most people, that will be age 65. However, 42 U.S.C. 1395c (where Section 1811 of the Social Security Act of

1935 is codified) indicates two other classes of people who qualify for medicare: The disabled and those with end-stage renal disease (aka kidney failure). NO AGE is specified for these latter two groups.

Q: Does that mean that for these two groups (the disabled et. al.) that there is NO age restriction, meaning that those people in these groups under 65 can use an HSA for medicare premiums?

I think it does. Does anyone know of anything that suggests not?

I know that the reference cannot refer to the original 1935 act because medicare wasn't added until 1965.

Text of 42 U.S.C. 1395c: "The insurance program for which entitlement is established by sections 426 and 426?1 of this title provides basic protection against the costs of hospital, related post-hospital, home health services, and hospice care in accordance with this part for

"(1) individuals who are age 65 or over and are eligible for retirement benefits under subchapter II of this chapter (or would be eligible for such benefits if certain government employment were covered employment under such subchapter) or under the railroad retirement system,

"(2) individuals under age 65 who have been entitled for not less than 24 months to benefits under subchapter II of this chapter (or would have been so entitled to such benefits if certain government employment were covered employment under such subchapter) or under the railroad retirement system on the basis of a disability, and

"(3) certain individuals who do not meet the conditions specified in either clause (1) or (2) but who are medically determined to have end stage renal disease."

Reply to
D. Stussy
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The Sec. 223(d)(2)(c) exception to paying for insurance says that you can include the premiums for any health insurance other than medigap (medicare supplement) if you attained the age specified in Sec. 1811 of the Soc. Sec. Act. Sec. 1811 has three parts: two are age related and one is not age related. I'll toss the third part as 223 says to look for the specified age. Part 1 specified age is 65 and part 2 is for those under age 65 entitled to coverage under Title II of the Act and have had that coverage for at least 24 months. I conclude that anyone paying for Medicare A, B, C & D who has attained age 65 can include the premiums as qualified medical expense. I conclude that anyone under age 65 paying for Medicare A, B, C & D and has been covered for at least 24 months can include the premiums as qualified medical expense because Title II includes all the people under age 65... early retirees, survivor benefits, disabilty benefits, etc.

Reply to
Alan

The Sec. 223(d)(2)(c) exception to paying for insurance says that you can include the premiums for any health insurance other than medigap (medicare supplement) if you attained the age specified in Sec. 1811 of the Soc. Sec. Act. Sec. 1811 has three parts: two are age related and one is not age related. I'll toss the third part as 223 says to look for the specified age. Part 1 specified age is 65 and part 2 is for those under age 65 entitled to coverage under Title II of the Act and have had that coverage for at least 24 months.

I conclude that anyone paying for Medicare A, B, C & D who has attained age 65 can include the premiums as qualified medical expense. I conclude that anyone under age 65 paying for Medicare A, B, C & D and has been covered for at least 24 months can include the premiums as qualified medical expense because Title II includes all the people under age 65... early retirees, survivor benefits, disabilty benefits, etc.

=========================== Interesting conclusion you came to. I was thinking that ONLY the disabled (not early retirees, survivors, dependents, or spouses which you also included) under 65 would have HSA-payable premiums. under 1395c(2). [Note the absence of a comma before "or" in "... or under the [RRS] on ...."]

This is the first year I have someone who became disabled under 65 who had an existing HSA, so I was trying to figure out if the medicare premiums were payable/reimbursable. It appears we agree.

Anyone disagree?

Reply to
D. Stussy

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