High-Deductible Health Plans: IRS Rules for 2026 and 2027

A high-deductible health plan, or HDHP, trades a lower monthly premium for a bigger deductible. Its real distinction, though, is tax-related: an HDHP that meets IRS rules is what lets you contribute to a health savings account (HSA).

That is why HealthCare.gov says HDHPs are more commonly called "HSA-eligible" plans. The rules changed for 2026, when a new federal law made Marketplace Bronze and Catastrophic plans count as HDHPs. This guide explains the IRS definition, the 2026 and 2027 figures, what can be covered before the deductible, and the trade-offs to weigh.

This is general information, not insurance, tax, legal or medical advice. For your own tax situation, IRS Publication 969 and a qualified tax professional are the places to go.

What makes a plan an HDHP

HealthCare.gov describes an HDHP as a plan with a higher deductible than a traditional plan, with a lower monthly premium but more costs paid by you before the insurer starts to pay. For HSA purposes, the IRS sets two numerical tests each year: a minimum deductible and a maximum on out-of-pocket expenses (deductibles, copayments and other amounts, but not premiums).

• For 2026, IRS Revenue Procedure 2025-19 sets the minimum deductible at $1,700 for self-only coverage or $3,400 for family coverage, and caps out-of-pocket expenses at $8,500 for self-only or $17,000 for family coverage.
• For 2027, IRS Revenue Procedure 2026-24 sets the minimum deductible at $1,750 for self-only or $3,500 for family coverage, and caps out-of-pocket expenses at $8,700 for self-only or $17,400 for family coverage.

Note that the HDHP out-of-pocket cap is lower than the general federal out-of-pocket limit; for 2026, HealthCare.gov lists the general Marketplace limit as $10,600 for an individual. IRS Publication 969 adds that, for a plan using a provider network, only in-network deductibles and out-of-pocket expenses are used to check the HDHP limit.

The 2026 change for Bronze and Catastrophic plans

The law known as the One, Big, Beautiful Bill Act, enacted July 4, 2025, expanded who can use HSAs. IRS Notice 2026-5 explains that for months beginning after December 31, 2025, a Bronze or Catastrophic plan available as individual coverage through a Marketplace is treated as an HDHP even if it doesn't meet the usual minimum deductible or out-of-pocket tests. The notice says the same plan bought directly from an insurer outside the Marketplace also qualifies, as long as it is available through the Marketplace.

HealthCare.gov now states that all Bronze and Catastrophic health plans work with HSAs, and that plans in other metal categories may also be eligible depending on their deductibles and out-of-pocket maximums. On HealthCare.gov you can filter plans with the "Eligible for an HSA" option.

Catastrophic plans have their own eligibility rules. HealthCare.gov's glossary says you must be under 30 or qualify for a hardship or affordability exemption, and that these plans cover three primary care visits per year before the deductible.

What an HDHP can cover before the deductible

To stay HSA-eligible, a plan generally can't cover most non-preventive services until you've met the deductible, according to HealthCare.gov. That means you pay the full allowed amount for things like doctor visits and prescriptions until then. There are exceptions:

• Preventive care. IRS Publication 969 says an HDHP may cover preventive care without a deductible, including periodic health evaluations, routine prenatal and well-child care, immunizations and many screening services.
• Telehealth. IRS Notice 2026-5 explains that the One, Big, Beautiful Bill Act made permanent a safe harbor letting HDHPs cover telehealth and other remote care before the deductible, for plan years beginning after December 31, 2024.
• Certain chronic-condition care. Publication 969 notes that preventive care can include treatment for certain chronic conditions listed in IRS Notice 2019-45.

Family plans need a closer look. Publication 969 explains that if a family plan has an individual deductible for each member that is lower than the family minimum, the plan doesn't qualify as an HDHP.

How the HSA fits in

The HSA is a separate account you own, usually opened at a bank or other financial institution. HealthCare.gov describes it as a way to set aside pre-tax money for qualified medical expenses like your deductible, copayments and coinsurance, though HSA funds generally can't be used to pay premiums. Balances roll over from year to year.

To contribute, Publication 969 says you must be covered by an HDHP on the first day of the month, have no other disqualifying health coverage, not be enrolled in Medicare, and not be claimable as a dependent on someone else's tax return. A general-purpose health FSA or HRA can also block eligibility.

For 2026, Revenue Procedure 2025-19 sets the contribution limit at $4,400 for self-only coverage or $8,750 for family coverage. For 2027, Revenue Procedure 2026-24 raises those limits to $4,500 and $9,000. Our Using Your Coverage section covers HSA rules in more detail.

Weighing the trade-offs

An HDHP isn't automatically a good or bad choice; it shifts more of the cost of care onto you in exchange for lower premiums and tax-advantaged savings. HealthCare.gov frames it this way: if you don't need many health care services, you may benefit from the lower premium, and if you need more care, you can use pre-tax HSA money to pay for it.

Consider a hypothetical person with a $2,000 deductible who needs an MRI in March. Until the deductible is met, they pay the plan's full allowed amount for the scan. If they have built up HSA savings, that payment comes from pre-tax money; if they haven't, it comes out of their monthly budget all at once.

Questions worth asking yourself:

1. Could you cover the full deductible if you needed to, in cash or HSA savings?
2. Do you take regular prescriptions or see specialists that you'd pay for in full until the deductible is met?
3. Would a large up-front cost make you put off care you need? If so, factor that in.
4. Will you actually contribute to the HSA? Much of the value depends on it.
5. Do you have other coverage, a general-purpose FSA, or Medicare that would make you ineligible to contribute?

Where to get personal help

For Marketplace plans, the Marketplace Call Center (1-800-318-2596) can tell you which plans are HSA-eligible, and your insurance company can confirm whether your specific plan qualifies. For tax questions, read IRS Publication 969 or talk with a qualified tax professional. Your state insurance department, listed in the NAIC directory, can help with problems involving an insurer.

Key takeaways

• An HDHP meets IRS minimum-deductible and maximum out-of-pocket tests that change every year and make you eligible for an HSA.
• For 2026, the IRS minimum deductible is $1,700 self-only and $3,400 family; for 2027, $1,750 and $3,500.
• Starting in 2026, Marketplace Bronze and Catastrophic plans count as HDHPs under IRS Notice 2026-5.
• HDHPs may cover preventive care, and now telehealth, before the deductible; most other care waits until the deductible is met.
• HSA contribution limits for 2026 are $4,400 self-only and $8,750 family, rising in 2027 to $4,500 and $9,000.

Sources

• HealthCare.gov, Understanding Health Savings Account-eligible plans
• HealthCare.gov, Glossary: High Deductible Health Plan (HDHP)
• HealthCare.gov, Glossary: Catastrophic health plan
• IRS, Revenue Procedure 2025-19 (2026 HSA and HDHP amounts)
• IRS, Revenue Procedure 2026-24 (2027 HSA and HDHP amounts)
• IRS, Notice 2026-5, Expanded Availability of Health Savings Accounts under the One, Big, Beautiful Bill Act
• IRS, Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans
• HealthCare.gov, Glossary: Out-of-pocket maximum/limit