IRS Sets 2027 HSA Limits at $4,500 and $9,000, Keeping the Triple Tax Break in Play

The IRS on May 29, 2026, released the 2027 inflation adjustments for health savings accounts, raising the maximum contribution to $4,500 for self-only coverage and $9,000 for family coverage. The figures, published in Rev. Proc. 2026-24, arrive early enough for employers to set 2027 benefit elections this fall. For high earners, the modest increase matters less than the account's unusual tax treatment, which many planners regard as the most generous in the code.

What changed

The 2027 contribution limits rise by $100 for self-only coverage, from $4,400, and by $250 for family coverage, from $8,750, according to the Journal of Accountancy. The additional catch-up contribution for account holders 55 and older is set by statute and stays at $1,000.

To contribute, a person must be covered by a high deductible health plan. For 2027 that means a plan with a deductible of at least $1,750 for self-only coverage or $3,500 for family coverage, up from $1,700 and $3,400. Out-of-pocket costs, excluding premiums, cannot exceed $8,700 for self-only coverage or $17,400 for family coverage, up from $8,500 and $17,000. The maximum that can be made newly available in an excepted benefit health reimbursement arrangement rises to $2,250 from $2,200.

The revenue procedure also reflects a change from the One, Big, Beautiful Bill Act. Beginning in 2026, a direct primary care arrangement is not treated as a disqualifying health plan as long as monthly fees do not exceed $150 for one person or $300 for an arrangement covering more than one person. Those amounts are unchanged for 2027 and will be indexed for inflation after that.

Who is affected

Any worker or self-employed person enrolled in a qualifying high deductible plan can contribute. Households that pay a monthly retainer to a concierge-style primary care practice were previously at risk of losing HSA eligibility, and the new rule removes that obstacle as long as fees stay under the caps. There is no income limit on HSA contributions, which distinguishes them from direct Roth IRA contributions, whose 2026 eligibility phases out for joint filers between $242,000 and $252,000 of modified adjusted gross income.

The after-tax math

HSA contributions are deductible, or excluded from pay when made through an employer's cafeteria plan, investment growth is not taxed, and withdrawals for qualified medical expenses are tax-free. A simplified example with round numbers shows the effect for a family in the 37% federal bracket.

In a taxable brokerage account, the same investment gains could be subject to capital gains rates plus the net investment income tax for high earners. Households that can pay current medical bills from other cash sometimes keep receipts and leave the HSA invested, since current law does not set a deadline for reimbursing a qualified expense incurred after the account was opened. After 65, non-medical withdrawals are taxed as ordinary income without the additional penalty, which makes the account behave much like a traditional IRA. State treatment is not uniform, and California and New Jersey do not follow the federal exclusion.

Moves to discuss with your advisor

• Whether a high deductible plan still makes sense once the employer's premium difference and expected medical costs are included, rather than judging on the tax break alone.
• How to handle the $1,000 catch-up when both spouses are 55 or older, since each spouse generally needs an account in his or her own name to make one.
• Whether a direct primary care membership fits under the $150 or $300 monthly fee caps.
• How HSA investments fit into overall asset location, given that the account can hold growth assets indefinitely.

What to watch

Open enrollment for 2027 begins at many employers in the fall, when the new deductible minimums will show up in plan designs. The direct primary care fee caps will begin adjusting for inflation after 2027, and further IRS guidance on how those arrangements are documented is expected.

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