Health Savings Account (HSA) Overview – 2026
Montgomery County ESC offers a Health Savings Account (HSA) to any employee enrolled in the High Deductible Health Plan (HDHP) who meets IRS eligibility requirements.
An HSA is a pre-tax savings account that you can contribute to directly from your paycheck. Funds in your HSA can be used for eligible medical expenses or saved for future needs. Funds roll over year-to-year, and the account stays with you even if you change jobs or retire.
Important: You are responsible for tracking all receipts and expenses paid with your HSA funds for at least seven years. If audited by the IRS, you must provide proof that withdrawals were for qualified expenses. Non-qualified expenses are subject to taxes and a 20% penalty. Since 2020, IRS rules allow HSAs to cover over-the-counter items — such as menstrual care products, antacids, and anti-inflammatories — without a prescription.
HSA Eligibility
To be eligible for an HSA, you must:
- Be enrolled in a high deductible health plan
- Not have any first-dollar coverage
- Not be enrolled in Medicare, Medicaid, or Tricare
- Not be claimed as a dependent on another person’s tax return
For a complete list of qualified and non-qualified expenses, visit:
American Fidelity HSA Eligibility List
MCESC HSA Contributions – 2026
Montgomery County ESC contributes annually to your HSA account as follows:
- $1,700 for Employee Only coverage
- $2,500 for all other coverage tiers (Employee/Spouse, Employee/Child(ren), Family)
Contributions are distributed into your account twice a year:
- First Pay in January
- First Pay in July
Hardship Advances: Available upon approval — contact the Treasurer’s Office to request.
2026 IRS Maximum HSA Contributions
- $4,400 for Employee Only coverage
- $8,750 for all other coverage tiers
- $1,000 catch-up contribution for individuals age 55 and older
These maximum amounts include both employee and employer contributions.
How to Use Your HSA
At the Provider’s Office:
Attend your healthcare provider’s appointment — No copay required.
Your provider will submit the claim to UnitedHealthcare (UHC).
You will receive an Explanation of Benefits (EOB) from UHC, showing the amount you owe after the network discount is applied.
Your provider will bill you for the amount shown on your EOB. Verify that the billed amount matches your EOB.
Pay your bill using your HSA debit card, or visit AmericanFidelity.com to request that American Fidelity send a check directly to your provider.
At the Pharmacy:
Pay at the pharmacy when you pick up your prescription. The pharmacy network discount will be applied automatically when you present your pharmacy card.
Use your debit card to pay the remaining amount.
The amount you pay will be automatically applied toward your deductible.