Direct Primary Care + HSA Eligibility Calculator
Find out if your direct primary care membership disqualifies your HSA eligibility. Under the One Big Beautiful Bill Act, DPC fees up to $150/month ($300 family) don't affect HSA eligibility -- see your exact tax savings at stake.
Enter Your Details
Adjust values to see instant results
Additional Details
Your HSA Tax Savings (This Scenario)
$1,386.00
Estimated • Based on your inputs
Tax Savings at Risk if Fee Exceeds Threshold
$1,386.00
Detailed Breakdown
Disclaimer: This calculator provides estimates for informational purposes only. Results should not be considered financial, tax, or legal advice. Consult a qualified professional for your specific situation.
How This Calculator Works
Calculation methodology and assumptions
Section 71308 of the One Big Beautiful Bill Act (Pub. L. 119-21) added 26 U.S.C. Sec. 223(c)(1)(E), effective for months beginning after December 31, 2025. Before this change, paying a monthly fee for a direct primary care (concierge-style) membership could count as disqualifying "other coverage" under Sec. 223(c)(1)(A)(ii) -- making you ineligible to contribute to an HSA at all, even though a Direct Primary Care Service Arrangement (DPCSA) isn't insurance. Under the new rule, a DPCSA is NOT treated as disqualifying coverage as long as the aggregate monthly fees don't exceed $150 for an arrangement covering one individual, or $300 for one covering more than one individual. IRS Rev. Proc. 2026-24 confirms these are the same 2027 inflation-adjusted figures (rounded, they come out unchanged from the original statutory amounts), so the $150/$300 thresholds apply identically in 2026 and 2027. This is an all-or-nothing monthly rule: staying at or under your threshold preserves HSA eligibility for that month, but exceeding it disqualifies the month rather than merely reducing eligibility by the excess fee. This calculator assumes the same DPC membership is active for all 12 months; partial-year eligibility can prorate the annual HSA limit, subject to the separate last-month rule and testing period. Tax savings include 7.65% FICA only when contributions are made through an employer's Section 125 payroll plan; direct HSA contributions receive income-tax deductions but no FICA savings.
How to Use This HSA Calculator Calculator
- 1
Confirm you have a qualifying HDHP
Health Savings Accounts require enrollment in a High Deductible Health Plan. For 2026, the minimum deductible is $1,700 (individual) / $3,400 (family), with out-of-pocket maximums of $8,500 / $17,000.
- 2
Enter your planned annual contribution
2026 contribution limits: $4,400 (individual) / $8,750 (family). Age 55+ catch-up: additional $1,000. Employer contributions count toward these limits.
- 3
Set your investment strategy
Most HSAs allow investing contributions (beyond a minimum cash balance) in mutual funds or index funds. HSA funds grow tax-free for qualified medical expenses — even decades later.
- 4
Review the triple tax advantage
HSAs are the only account that's tax-deductible going in, tax-free growing, and tax-free coming out (for medical expenses). The calculator shows the long-term value of maximizing this triple benefit.
Example Calculation
Let's calculate the long-term value of maxing out an HSA.
A 35-year-old contributes $4,400/year (individual limit) to an HSA, investing in a total stock market index fund averaging 8% annual returns. They pay current medical expenses out of pocket and let the HSA grow untouched for 30 years.
Result: After 30 years: approximately $498,000 in tax-free medical savings. If they contributed $4,400/year for 30 years ($132,000 total contributions), the remaining ~$366,000 is pure investment growth — all tax-free for medical expenses. After age 65, HSA funds can be used for ANY expense (non-medical withdrawals taxed as income, like a Traditional IRA). The HSA effectively becomes a super-powered retirement account.
What Affects Your Results
Contribution Amount
Maximizing contributions ($4,400 individual / $8,750 family for 2026) maximizes both the immediate tax deduction and long-term tax-free growth. Employer contributions count toward the limit.
Investment Returns
Invested HSA funds grow tax-free indefinitely. At 8% average returns, $4,400/year grows to ~$498K over 30 years. Cash HSA balances earn 0.01-0.5% — investing the balance is crucial for long-term value.
Time Horizon
The longer HSA funds are invested, the more powerful the triple tax advantage becomes. Someone starting at 25 with 40 years of growth benefits dramatically more than someone starting at 55.
State Tax Treatment
Most states mirror federal HSA tax treatment (deductible contributions, tax-free growth). However, California and New Jersey tax HSA contributions and earnings at the state level — reducing the benefit by 5-13%.
Medical Expense Timing
There's no deadline to reimburse yourself from your HSA. Pay medical bills out of pocket now, save receipts, and reimburse yourself years or decades later — the funds grow tax-free in the meantime.
Tips & Best Practices
- The HSA is the single most tax-advantaged account in the US tax code. If you can afford to, pay current medical bills out of pocket and let HSA funds grow invested. There's no time limit on reimbursing yourself — save receipts indefinitely.
- After age 65, HSA funds can be used for any expense (not just medical) with no penalty — non-medical withdrawals are simply taxed as regular income, identical to a Traditional IRA. Medical withdrawals remain tax-free at any age.
- Check if your state gives HSA contributions a state income tax deduction. Most states do, but California and New Jersey do NOT — they tax HSA contributions and earnings at the state level.
- Invest your HSA balance beyond the minimum cash threshold. Most HSA providers require keeping $1,000-$2,000 in cash, but everything above that can be invested in index funds for long-term growth.
- When changing jobs or HSA providers, you can transfer your HSA balance to a provider with better investment options (lower fees, better fund selection) with no tax consequences. Fidelity and Lively are popular for low-cost index fund investing.
Newsletter Signups Are Paused
We're building the email delivery behind our newsletter so we can do it properly — signups aren't open yet. Check back soon.
No form here and nothing is collected. Read our privacy policy.
StateCalc Team
Editorial Team
The StateCalc team builds free financial calculators using data from official government sources including the IRS, U.S. Census Bureau, BLS, and state revenue departments. All formulas are validated by an automated test suite and cross-referenced against published data.
Our editorial standardsFrequently Asked Questions
Can I have a direct primary care membership and still contribute to an HSA?
Yes, starting with months after December 31, 2025. A provision from the One Big Beautiful Bill Act (26 U.S.C. Sec. 223(c)(1)(E)) says a Direct Primary Care Service Arrangement (DPCSA) no longer counts as disqualifying health coverage as long as the aggregate monthly membership fees don't exceed $150 for individual coverage or $300 for an arrangement covering more than one person. Before this change, most DPC memberships would have made you ineligible to contribute to an HSA at all.
What happens if my DPC membership fee is over the $150/$300 limit?
It's an all-or-nothing rule, not a partial one. If your aggregate monthly DPCSA fees exceed the applicable threshold, the entire arrangement is treated as disqualifying "other coverage" under Sec. 223(c)(1)(A)(ii) -- meaning you are not an HSA-eligible individual at all for any month the arrangement is in effect, not just for the amount over the threshold. Some DPC providers offer tiered membership levels specifically so patients can stay at or under the IRS threshold and keep their HSA eligibility.
Are the $150 and $300 DPC thresholds the same in 2026 and 2027?
Yes. The original statute set $150 (individual) and $300 (multi-person) effective for months after December 31, 2025, with inflation adjustments starting for months after December 31, 2026. IRS Rev. Proc. 2026-24 -- which sets the 2027 HSA and DPCSA figures -- confirms the 2027 inflation-adjusted thresholds round to the same $150 and $300 amounts, so there is no change between 2026 and 2027.
Does the DPC fee threshold apply per person or per household?
It applies based on how many individuals a single DPCSA covers, not literally per-person dollar totals. A DPCSA that covers only you is subject to the $150/month threshold. If the same arrangement covers you plus one or more family members (e.g., a family DPC membership), the higher $300/month threshold applies to the combined fee for everyone covered under that one arrangement.
Do I still need a High Deductible Health Plan (HDHP) to be HSA-eligible with a DPC membership?
Yes. The DPCSA carve-out only removes one specific obstacle -- it stops a compliant DPC membership from itself disqualifying you. You still need to be enrolled in a qualifying HDHP (a plan meeting the IRS's minimum deductible and out-of-pocket maximum thresholds) and meet the other standard HSA eligibility rules (e.g., not enrolled in Medicare, not claimed as a dependent) to contribute to an HSA at all.
Do all HSA contributions avoid Social Security and Medicare tax?
No. HSA contributions made through an employer payroll deduction under a Section 125 cafeteria plan generally avoid federal income tax, state income tax where applicable, and FICA tax. Contributions you make directly to an HSA can generally be deducted for income tax, but they do not reduce Social Security or Medicare tax. Use the contribution-method input so the estimate reflects your situation.
People Also Calculate
Frequently used together with this calculator