What You Should Know Before You Name an HSA Beneficiary

If you have an HSA, you will want to give some thought to what will happen to this account after your death. The rules are a little tricky and careful planning is important to minimize the tax bite.

HSA Beneficiaries

You should name a beneficiary for your HSA, just as you would for your IRA or company retirement plan. After your death, any funds remaining in your HSA are payable to the beneficiary you named on the account. You are not required to name a spouse or an individual who is eligible to make HSA contributions.

Naming Your Spouse

If you name your spouse as your HSA beneficiary, at your death the HSA will become your spouse’s own HSA. They can maintain the HSA in their own name and can continue to access the funds. Distributions for qualified medical expenses will be income tax free. Your spouse does not need to have HSA-eligible health insurance to continue to hold the HSA. However, if they do and they are eligible, they may make contributions to the HSA.

Naming Your Children

You may also name your children or another non-spouse beneficiary. However, you should be aware that non-spouse HSA beneficiaries do not fare very well! The account value of the HSA account becomes taxable to the non-spouse beneficiary in the year of your death. That means the entire account will be taxable in one year. That could be a significant tax hit!

The amount taxable to your beneficiary is reduced by any qualified medical expenses for the deceased HSA owner that are paid by the beneficiary within one year after the date of death.

Naming Your Estate

It is also possible for you to name your estate as your HSA beneficiary. There is a special rule that applies if the beneficiary of an HSA is the estate. If the estate is the beneficiary, then the total distribution is in included on the deceased HSA owner’s final tax return.


Naming a spouse may be a good strategy if you are married. If you name your spouse, he or she can continue to access the HSA tax-free for medical expenses after your death.

Things get more complicated if you are not married or do not want to name your spouse as beneficiary. For example, if you are thinking of naming your son or daughter as your HSA beneficiary, you will want to consider the tax impact of a lump sum distribution on their tax return. You might consider planning to use more of your HSA assets during your lifetime to pay for qualified medical expenses. You can even reimburse yourself for medical expenses in prior years, as long as those expenses were incurred after you established your HSA.

While it is usually not a good idea to name your estate as the beneficiary of your IRA or company retirement plan, that may not be the case with your HSA. There may be situations where naming the estate may make good sense as a strategy to minimize taxes.

For example, if you are in a low tax bracket and your child is in a high tax bracket, it may make sense for you to name your estate as the beneficiary instead of your child. The HSA distribution to the estate would be included on your final income tax return and taxed at your lower rate. If you leave it to your child outright it would be taxed at your child’s higher rate.

Don’t overlook your HSA beneficiary designation. Be sure to think it through carefully and remember that if your situation changes in the future, you can update your HSA beneficiary form at anytime.