IRS
What you need to know
What if a spouse who has a health saving account dies?
IRS Section 223 (8) (a)—Treatment after death of account beneficiary
If the HSA account beneficiary’s surviving spouse acquires such HSA beneficiary’s interest in a health savings account by reason of being the designated beneficiary of such account at the death of the HSA account beneficiary, such health savings account shall be treated as if the spouse were the HSA account beneficiary.
If the surviving spouse has an HSA account, normal HSA spending rules would apply to any funds that are transferred to the surviving spouse. Otherwise, funds transferred to beneficiaries cease to be considered HSA monies, so they could be used however the recipient wished; however, estate taxes would apply. Please note that assigning a beneficiary is an important step in the establishment of a health savings account.
Coaches' Takeaway
If the spouse of a deceased person has an HSA account, then any funds are transferred from the deceased spouse to that of the living spouse, and normal HSA spending rules would apply to that surviving spouse.
It is critically important to have a beneficiary listed for your HSA account. The surviving spouse acquires their beneficiary interest, simply because they are the designated beneficiary on the HSA
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IRS
What you need to know