How to Use Your HSA as a Couple or Family in Canada

By Frontier Team•February 10, 2026•3 min read

Most people set up a Health Spending Account thinking it only covers their own medical expenses. But one of the biggest advantages of an HSA is that it covers your entire family -- your spouse, your kids, and in some cases even your parents. One plan, one balance, no need for separate coverage for each person.

Who Counts as a Dependent?

Under CRA rules, your HSA can reimburse eligible medical expenses for the following family members:

  • Your spouse or common-law partner -- includes married spouses and partners you've lived with for at least 12 consecutive months
  • Your children under 18
  • Your children under 25 -- if they are enrolled as full-time students at a qualifying educational institution
  • Your parents or grandparents -- if they are financially dependent on you

That's a much wider circle than most people expect. If you're supporting aging parents or putting a child through university, their medical expenses can all flow through your HSA.

How Family Coverage Works

There is no need for a separate plan for each family member. Your HSA has one balance, and any eligible expense for any covered dependent can be claimed against it. Dental for your kids, glasses for your spouse, prescriptions for everyone -- it all comes from the same pool.

Your corporation sets an annual HSA limit -- say $3,000 per year. That entire amount is available for your whole family's health expenses. You don't need to divide it up or assign portions to each person. You just submit receipts as expenses come up, and the balance draws down accordingly.

A Real Example: Family of Four

Mark runs a small incorporated business. He sets up an HSA with a $3,000 annual limit. Here's how his family of four uses it over the year:

  • Kids' dental cleanings and a filling: $900
  • New glasses for his spouse: $500
  • Physiotherapy for Mark's back: $600
  • Prescriptions for the whole family: $500
  • Daughter's orthodontist consultation: $500
  • Total: $3,000

Without the HSA, Mark would need roughly $4,500 to $5,000 in pre-tax personal income to cover those same costs. With the HSA, his corporation deducts the full $3,000 as a business expense, and the family receives every dollar tax-free.

Why This Matters

A comparable family insurance plan would typically cost $300 to $500 per month in premiums -- whether the family uses it or not. That's $3,600 to $6,000 per year, often with co-pays, coverage limits, and categories that don't even apply to your family.

With an HSA, you only pay when there's an actual expense. No wasted premiums. No renewal increases. And the coverage is broader -- anything the CRA recognizes as an eligible medical expense qualifies, from dental and vision to massage therapy, mental health, fertility treatments, and more.

Get Started with Frontier Health

Setting up family coverage through an HSA takes minutes. At Frontier Health, you choose your monthly budget, and your whole family is covered from day one. Submit receipts through the app and get reimbursed within 48 hours. No forms, no call centres, no paperwork.

Simplify Your Business Health Benefits

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