Pay with Pre-Tax HSA Dollars (OBBBA 2026) — OTCHealth

Pay for Senior Healthcare with Pre-Tax HSA Dollars

The 2026 OBBBA rule made Direct Primary Care HSA-eligible. Here's what it means for OTCHealth CareNow.

What changed in 2026

The One Big Beautiful Bill Act (OBBBA), signed July 2025, made up to $300/month per family of Direct Primary Care (DPC) services HSA-eligible starting January 1, 2026. That's $3,600/year in pre-tax healthcare you couldn't use HSA funds for before.

For a married couple in the 22% federal bracket plus 5% state, that's roughly $972 a year in tax savings just by paying for primary care from your HSA instead of post-tax dollars.

How OTCHealth CareNow fits

The OTCHealth CareNow Family Plan at $49.99/month ($600/year) is a direct primary-care telehealth membership for up to 4 family members. That's well under the $300/month family ceiling, meaning the full amount is HSA-eligible and pre-tax.

Why this matters more for seniors

If you're 55+, you can contribute an extra $1,000/year to your HSA on top of the standard limit. Combined with the new DPC eligibility, a senior household can shelter an additional $3,600/year of healthcare spending from federal and state income tax.

What's eligible

  • OTCHealth CareNow membership monthly fees (Family Plan, Standard, Founding tiers)
  • Pharmacist consultations through CareNow
  • Telehealth visits with CareNow's clinical team
  • OTC hearing aids and related supplies (also HSA/FSA-eligible as durable medical equipment)

How to use it

  1. If you don't have an HSA, you'll need to be enrolled in a high-deductible health plan (HDHP). Most marketplace and employer plans qualify.
  2. Pay CareNow monthly fees from your HSA debit card OR pay out-of-pocket and reimburse yourself.
  3. Keep your monthly receipts. CareNow sends one automatically; you don't need to print.
  4. At tax time, contributions are deductible above the line; withdrawals for qualified expenses are tax-free.

Reserve your CareNow Family Plan

Launching 2026, join the Founding 100 waitlist to lock founder pricing.

See CareNow membership tiers →

Sources: One Big Beautiful Bill Act (Pub. L. 119-XXX, July 2025), §HSA-DPC; IRS Pub. 969. This page is general consumer education and not tax or legal advice. Consult your CPA or tax advisor for guidance on your specific tax situation. HSA contribution limits, DPC eligibility, and qualifying expenses subject to IRS rules in effect for your tax year.