Is direct primary care HSA eligible?
Yes, from 2026. An HSA can pay a direct primary care practice’s monthly fee, and up to $150 a month ($300 for more than one person) it no longer stops you contributing.
The rule
A direct primary care practice charges a fixed fee, usually monthly, for primary care from a family, internal, geriatric or pediatric doctor, a nurse practitioner or a physician assistant. Before 2026 joining one generally meant you couldn’t put money into an HSA.
The One, Big, Beautiful Bill changed both sides from January 1, 2026. The fees are a medical expense an HSA can pay. And an arrangement whose fees are $150 a month or less, or $300 when it covers more than one person, doesn’t count as other coverage, so you can still contribute. The limit rises with inflation after 2026.
It has to be only primary care: no procedures under general anesthesia, no prescription drugs other than vaccines, and no lab work beyond what a primary care office usually does.
Paid yourself, it waits in the HSA until you take the money out, this year or decades from now.
- What to keep
- The practice’s membership agreement and a receipt for each fee.
- Watch for
- A fee over the monthly limit can still be paid from the HSA, but you can’t put money in for the months you are a member.
- Fees your employer paid, including through payroll before tax, can’t also come out of the HSA.
Checked on October 2, 2026 against Notice 2026-5, HSAs under the One, Big, Beautiful Bill and Publication 969, Health Savings Accounts. An estimate for your records, not tax advice.
Keep the receipt. Take the money out later.
Pay a medical bill yourself and Reimburse keeps the receipt, with who it was for, until you take the money out of your HSA tax-free.