Health Savings Accounts (HSAs), Direct Primary Care, and Open Enrollment: What You Need to Know for 2026

Navigating health insurance options can be daunting, especially with new laws and regulations being introduced. As we approach 2026, significant changes to Health Savings Accounts (HSAs) and Direct Primary Care (DPC) practices are coming into play. The One Big Beautiful Bill Act, passed in July 2025, will allow individuals to use HSA funds for DPC membership fees tax-free, effective January 1, 2026. Here’s what you need to know.

Understanding HSAs and Their Benefits

Health Savings Accounts are tax-advantaged accounts owned by individuals that allow them to save money for qualified medical expenses. Contributions to HSAs are tax-deductible, and funds grow tax-free. This makes HSAs a powerful financial tool for managing healthcare costs.

You might wonder, “What are qualified medical expenses?” Typically, these are costs related to:

• Doctor visits

• Prescription medications

• Dental care

• Vision care

  
  

Starting in 2026, DPC membership fees will qualify as medical expenses, allowing members to use their HSA funds without losing eligibility or tax benefits. This is a game changer for patients seeking preventive care.

Health Savings Account benefits overview

What is Direct Primary Care?

Direct Primary Care is a model where patients pay a monthly fee directly to their healthcare provider for a range of services. This approach emphasizes quality of care, preventive services, and a strong patient-provider relationship. Patients often find they can spend more time with their doctors, leading to better health outcomes, especially for chronic conditions.

DPC can lead to reduced healthcare costs overall. For instance, membership fees for DPC practices like Hall Health will be capped at $150 per month for individuals and $300 per month for families, making quality care more accessible.

Direct Primary Care consultation

New DPC Benefits for HSA Holders

With the implementation of the new law in 2026, patients with HSA-eligible high-deductible health plans (HDHPs) will be able to use their HSA funds to cover the costs associated with DPC membership. This means more flexibility and savings for individuals and families.

For example, consider a family that pays a DPC membership fee of $300 a month. With the ability to use HSA funds, they can benefit from this arrangement without worrying about losing their HSA eligibility or tax benefits. This arrangement encourages families to take advantage of preventive healthcare services that they may have previously avoided due to cost concerns.

The Importance of Open Enrollment

Open enrollment is the perfect time to review your health plan options. If you’re currently on a traditional insurance plan, consider switching to an HSA-eligible HDHP (high deductible health plan). These plans not only provide the flexibility to use HSA funds for DPC but often come with lower monthly premiums, making them an attractive option.

To make informed decisions during open enrollment, ask yourself:

• What are my health needs?

• How often do I visit my primary care physician?

• Am I managing any chronic conditions?

• How much can I contribute to an HSA?

  
  

By analyzing your health care usage and considering your future needs, you can determine whether an HDHP with HSA eligibility is right for you.

Reviewing health insurance plans during open enrollment

Employer Adoption of DPC

As more employers become aware of the benefits of DPC, many are beginning to offer DPC membership options alongside HSA-eligible HDHPs for their employees. This not only improves access to healthcare services for employees but also helps reduce overall healthcare costs for companies.

Employers are recognizing that investing in preventive health care translates to fewer sick days, higher employee productivity, and overall healthier staff. In the long term, implementing a DPC model can also lead to lower insurance premiums for companies, resulting in savings that can be passed on to employees.

State Regulations and Compliance

While the changes at a federal level provide broad support for DPC and HSAs, it’s essential to remain aware of state-specific regulations that may impact DPC practices. Some states might have additional restrictions concerning subscriptions and billing for DPC services.

Hall Health, for example, is committed to ensuring compliance with all relevant regulations while maintaining a high standard of care. As you consider switching to DPC, it’s crucial to confirm the practice's legitimacy and compliance in your state.

Taking Action for Future Health

As you prepare for 2026, start planning how to leverage these new benefits to enhance your healthcare experience. Here are some actionable steps to get you started:

1. Evaluate your current health insurance plan: Review your coverage and consider switching to an HSA-eligible HDHP during open enrollment.

   
   

2. Research DPC options: Investigate DPC practices in your area, such as Hall Health, to understand their services and membership costs.

   
   

3. Calculate potential savings: Use a simple budget calculator to determine how much you could save by using HSA funds for DPC membership fees.

   
   

4. Consult with a financial advisor: If you're unsure how these changes will affect your financial planning, seek professional advice to make informed decisions.

   
   

Having access to proactive, patient-centered healthcare can lead to better health outcomes and significant savings for individuals and families. The ability to use HSA funds for DPC memberships marks a significant step toward making healthcare more accessible and affordable.

By following these recommendations and understanding the landscape of HSAs, DPC, and open enrollment, you can make beneficial choices that enhance your healthcare journey and financial well-being. Be proactive and utilize these changes to ensure a healthier future.