Can you use an HSA to pay for direct primary care?

Short answer: yes, starting in 2026, if the membership follows a few rules and you have a health plan that allows an HSA. A new federal law lets people with a health savings account (HSA) also have a direct primary care membership, keep putting money into the HSA, and pay the membership with HSA money. Before 2026, having a direct primary care membership could stop you from putting money into an HSA.

What is an HSA?

A health savings account is a savings account for medical costs. The money you put in is not taxed, and you can spend it on approved medical costs, like doctor visits and prescriptions, without paying tax. You can only put money into one while you have a high-deductible health plan, which is insurance where you pay more yourself before the plan starts paying.

The rules a membership has to follow

If a membership follows all of these rules, you can keep putting money into your HSA while you are a member.

• Price limit. All your memberships together can cost at most $150 a month for one person, or $300 a month if the membership covers more than one person. These limits apply in 2026 and stay the same for 2027. If a membership costs more, you can still pay it with money already in your HSA, but you cannot add new money to your HSA while you are a member.
• Primary care only. The care must come from a primary care clinician, such as a family medicine, internal medicine, geriatric or pediatric doctor, a nurse practitioner, a clinical nurse specialist or a physician assistant.
• A fixed fee. You pay a set amount every month, quarter or year, not a separate bill for each visit.
• Some things are not allowed in the membership. It cannot include procedures that need general anesthesia (being put fully to sleep), prescription drugs other than vaccines, or lab tests that a normal primary care office would not do.
• Paid by you, not your employer. HSA money can pay a membership you pay for yourself. If your employer pays the fee, including through money taken from your paycheck before taxes, the HSA cannot pay you back for it.

What our price data shows

Of the 1,091 direct primary care practices whose prices we have checked, 984 (90%) start at $150 a month or less for one adult, which is within the limit. A price under the limit does not by itself mean a membership qualifies. Ask the practice whether its membership is set up to meet the HSA rules.

See direct primary care prices by state.

Before you pay with your HSA

• Ask the practice for its membership terms in writing, including what is included and what costs extra.
• Check with your HSA provider or a tax professional about your own situation.
• Keep your receipts, since you may need to show what the HSA money paid for.

Sources

Internal Revenue Service, Notice 2026-5 (December 2025), the rules for direct primary care memberships and HSAs. Internal Revenue Service, Revenue Procedure 2026-24, the 2027 limits for HSAs and direct primary care memberships.