Yes - under IRS Publication 969, your HSA can pay qualified medical expenses tax-free for you, your spouse, and your tax dependents, even if they are on different insurance or none.
The direction of the rules matters: who the HSA pays FOR (spouse, dependents) is broader than the HDHP coverage test for CONTRIBUTIONS. Two fine-print notes: a spouse's separate non-HDHP coverage does not block your eligibility if it does not cover you, and two-spouse HSAs share a combined family contribution cap. Qualified expenses are the standard list - deductibles, copays, prescriptions, dental, vision. Pymander is a free AI doctor, 24/7 by text, and can help you map your family's setup.
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Can I use my HSA for my spouse?
Yes - the IRS treats your HSA as family money for spending purposes. Under Publication 969, you can take tax-free distributions from your HSA to pay qualified medical expenses for three groups: yourself, your spouse, and anyone you claim as a tax dependent - and this holds even if your spouse or dependents are covered under a completely different insurance plan, or no plan at all. The subtle part is the direction of the rules: who the HSA can pay FOR (spouse and dependents) is broader than who can be covered for CONTRIBUTION eligibility (that is about your own HDHP coverage). Two fine-print notes worth knowing: if your spouse has their own non-HDHP health coverage, it does not block your HSA eligibility as long as it does not also cover you - the IRS says this explicitly; and if your spouse also has an HSA, each of you can spend on family expenses, but your combined contributions cannot exceed the family limit. The expenses themselves must be qualified medical costs - the standard list covers deductibles, copays, prescriptions, dental, and vision. Pymander is a free AI doctor, 24/7 by text, that can help you map your family's setup.