What's the connection between HSAs and health insurance premiums?

Premiums are not usually considered to be qualified medical expenses for your HSA.

There are a few exceptions:

  1. Long-term care insurance – check out IRS publication 502.
  2. Health care continuation (e.g., COBRA premiums).
  3. Coverage when receiving federal or state unemployment benefits.
  4. Medicare premiums (Part A and Part B) and other healthcare coverage if you are 65 or older (other than premiums for a Medicare supplemental policy, such as Medigap).

#2 and #3 can be applied to a spouse and/or dependents.

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