Homecare for Seniors
HR 2878
by Kristin Easterling

The Homecare for Seniors Act would allow seniors to access funds from health savings accounts (HSAs) to pay for qualified homecare.

An HSA applies to high deductible health plans (HDHP), including Marketplace plans, that only cover preventive services before the deductible is met. For plan year 2020, the minimum deductible for an HDHP is $1,400 for an individual and $2,800 for a family. Contributions to an HSA are tax free and any interest earned is not taxed. For 2020, someone with an HDHP can contribute up to $3,550 in an HSA for self-only coverage and up to $7,100 for family coverage. Funds in health savings accounts can only be used for qualified medical expenses.


For individuals age 55 and older, an extra $1,000 per year can be added to the account as a “catch-up” contribution. Individuals can no longer contribute to HSAs once enrolled in Medicare.

When a person reaches age 65, there’s no penalty for withdrawing HSA funds to use for nonmedical expenses, but the withdrawal will be taxed. Individuals can choose instead to continue using HSA funds for medical expenses, including Medicare premiums, without a tax penalty.


At the end of 2018:

  • There were 25 million HSAs holding $53.8 billion in assets. 
  • Investment assets in HSA accounts reached $10.2 billion.
  • The average employer contribution to HSAs was $839, up from $604 in 2017.

Source: devenir.com


Qualified homecare includes a contract to provide three or more of these services in the home of the service recipient:

  • Assistance with eating
  • Assistance with toileting
  • Assistance with transferring
  • Assistance with bathing
  • Assistance with dressing
  • Assistance with continence
  • Medication adherence

What Happens Next? >> The ability to cover qualified homecare expenses using a health savings account will ease the financial burden of care for families and individuals who wish to remain home. The bill is in committee.

Track this bill’s progress at congress.gov.

Kristin Easterling is the managing editor of HomeCare magazine.