Insurance premiums. You can’t treat insurance premiums
as qualified medical expenses unless the premiums
4. Medicare and other health care coverage if you were
65 or older (other than premiums for a Medicare supplemental
policy, such as Medigap).
The layman in me would think Pub. 969 is forbidding only Medigap policies. Of course Pubs could be poorly written.
This seems quite similarly worded to your find…..how in the world did you find it?? The main factors seems to be age 65 and employer’s plan.
Q-43. May a retiree who is age 65 or older receive tax-free distributions from an HSA to pay the retiree’s contribution to an employer’s ……. retiree health coverage?
A-43. Yes. …….. the purchase of health insurance is generally not a qualified medical expense that can be paid or reimbursed by an HSA. …….However, …….. provides an exception for coverage for health insurance once an account beneficiary has attained age 65. The exception applies to both insured and self-insured plans.