What Qualifies as a High Deductible Health Plan?

Understanding what qualifies as an HDHP is essential for anyone looking to pair their health coverage with a Health Savings Account. Not every health plan with a high deductible automatically qualifies. The IRS sets specific thresholds that your plan must meet before you can enjoy the tax advantages of an HSA.

Let's break down exactly what makes an HSA-qualified HDHP and how you can determine if your current plan meets the requirements.

IRS Requirements for a Qualified HDHP in 2025

A qualified high deductible health plan must meet specific deductible and out-of-pocket limits set by the IRS each year. For 2025, your health plan must satisfy both minimum deductible thresholds and maximum out-of-pocket caps to be considered HSA-eligible.

According to IRS Publication 969, for 2025, an HDHP must have a minimum annual deductible of $1,650 for self-only coverage and $3,300 for family coverage. The maximum out-of-pocket expenses cannot exceed $8,300 for individual coverage or $16,600 for family coverage. Plans falling outside these thresholds won't qualify you for HSA contributions, regardless of how the plan is marketed.

Minimum Deductible Requirements

For individual coverage, your plan must have a deductible of at least $1,650. Family plans require a minimum deductible of $3,300. Any plan falling below these thresholds won't qualify as an HSA-qualified HDHP, which means you cannot make tax-advantaged contributions to a Health Savings Account.

Maximum Out-of-Pocket Limits

Your plan's out-of-pocket maximum cannot exceed the IRS limits. Out-of-pocket expenses include your deductible, copayments, and coinsurance, but not your monthly premiums. Staying within these caps is essential for maintaining HSA eligibility throughout the year.

The Embedded Deductible Rule

Family HDHPs have an additional requirement that often catches people off guard. If your family plan includes an embedded individual deductible, meaning one family member can satisfy their own deductible before the family deductible is met, that individual deductible must be at least $3,300 in 2025.

Plans with lower embedded deductibles won't meet what qualifies as an HDHP under IRS rules. Your employer or benefits administrator should be able to confirm whether your plan structure meets these requirements.

HSA Contribution Limits for 2025

Once you're enrolled in a qualified high-deductible health plan, you can contribute to an HSA up to the annual limits. For 2025, the contribution limit is $4,300 for individual coverage and $8,550 for family coverage. Employees age 55 and older can contribute an additional $1,000 as a catch-up contribution, allowing them to accelerate their healthcare savings as they approach retirement.

What Makes an HDHP Different from Standard Plans

HDHPs typically feature lower monthly premiums compared to traditional health plans. You'll pay less each month, but you're responsible for more costs upfront before your insurance coverage kicks in.

The key advantages of an HSA-qualified HDHP include lower monthly premiums that free up cash flow, preventive care coverage before meeting your deductible, and the triple tax advantage when paired with an HSA. Your contributions are tax-deductible, your earnings grow tax-free, and your withdrawals for qualified medical expenses are tax-free as well. HSA funds also roll over year after year, creating long-term savings potential.

Employees who are generally healthy and don't anticipate significant medical expenses often find HDHPs to be a cost-effective choice, especially when their employer contributes to their HSA.

Recent Changes to HDHP and HSA Rules

The IRS has made some notable updates that affect what qualifies as a high deductible health plan. Telehealth and remote care services can now be received before meeting your HDHP deductible without affecting HSA eligibility. Previously, using telehealth before meeting your deductible could disqualify you from HSA contributions.

Starting January 1, 2026, bronze and catastrophic plans available through the Health Insurance Marketplace will be considered HSA-compatible, regardless of whether they meet the traditional HDHP definition. This change will expand access to HSA benefits for more Americans purchasing individual coverage.

How to Verify Your Plan is HSA-Qualified

Not all health plans marketed as high deductible are automatically HSA-qualified. To confirm your plan's status, review your Summary of Benefits and Coverage for deductible and out-of-pocket maximum amounts. Check if your plan explicitly states it's HSA-eligible or HSA-compatible, and confirm with your HR department or benefits administrator. For family plans, verify that any embedded deductible amounts meet the $3,300 minimum.

Your broker or benefits advisor can help you navigate these details and ensure you're selecting a plan that meets IRS requirements for a qualified high deductible health plan.

How Venteur Simplifies Health Benefits

For companies exploring flexible health benefits options, we offer a comprehensive Individual Coverage Health Reimbursement Arrangement platform at Venteur. ICHRA allows you to provide tax-free reimbursements for individual health insurance premiums, giving employees the freedom to choose plans that best fit their needs, including HSA-qualified HDHP options.

Whether you're a startup, SMB, or enterprise organization, our platform handles compliance across all 50 states. The employer experience integrates with your existing systems, and employees get personalized plan options through an intuitive interface. With no setup fees or monthly minimums, we help businesses of all sizes offer competitive health benefits while maintaining cost control.

Finding the Right Coverage

A qualified high deductible health plan must meet the IRS minimum deductible of $1,650 for individuals or $3,300 for families, while keeping out-of-pocket maximums at or below $8,300 and $16,600, respectively, for 2025. Verifying your plan meets these thresholds is crucial before opening or contributing to an HSA. When paired with the right health plan, an HSA offers powerful tax advantages and long-term savings potential that can benefit you throughout your career and into retirement.