The One Big Beautiful Bill (OBBB), signed into law July 4, 2025, made several changes to Health Savings Account (HSA) rules. While not mandatory, some employers may want to consider whether to modify their HSA programs accordingly.
- No-Deductible Telehealth Coverage Now Permanent for High Deductible Health Plans (HDHPs)
The no-deductible telehealth exception, originally implemented by the Coronavirus Aid, Relief, and Economic Security (CARES) Act, is now permanent.
The OBBB telehealth exception is effective January 1, 2025, essentially continuing the CARES Act provision that otherwise expired December 31, 2024. Now, under the OBBB, health plans can indefinitely continue to provide telehealth and remote care services with no deductible without affecting participants’ HSA eligibility.
- Direct Primary Care Arrangements Will Not Make Participants Ineligible for HSA Contributions
Effective January 1, 2026, Direct Primary Care Arrangements will not be treated as “health plans” for HSA eligibility purposes. This means individuals can participate in both a HDHP and a Direct Primary Care Arrangement without jeopardizing their eligibility to contribute to an HSA.A Direct Primary Care Arrangement is an arrangement through which an individual pays only a flat periodic fee for primary care services provided by primary care practitioners. There are restrictions for Direct Primary Care Arrangements, such as:
- The fee cannot exceed $150/month (or $300/month if the arrangement covers more than one person).
- Exclusions for the following services:
- Procedures that require general anesthetics.
- Prescription drugs (other than vaccines).
- Laboratory services not typically administered in an ambulatory primary care setting.
- Direct Primary Care Arrangements Will Be Eligible for HSA Reimbursement
Effective January 1, 2026, Direct Medical Care Arrangement fees will be considered qualified medical expenses. This means individuals with HSA accounts may be reimbursed for their Direct Primary Care Arrangement fees.
- Bronze and Catastrophic Plans
Bronze and catastrophic plans available through the Health Exchange Marketplace will be considered HSA eligible HDHPs beginning January 1, 2026. As such, individuals enrolled in bronze or catastrophic plans will be eligible to contribute to an HSA, if all other requirements are met.
If you have questions about the changes to HSA rules, please contact a member of the Faegre Drinker benefits and executive compensation team.
The material contained in this communication is informational, general in nature and does not constitute legal advice. The material contained in this communication should not be relied upon or used without consulting a lawyer to consider your specific circumstances. This communication was published on the date specified and may not include any changes in the topics, laws, rules or regulations covered. Receipt of this communication does not establish an attorney-client relationship. In some jurisdictions, this communication may be considered attorney advertising.
