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Guide to IRS Form 1099-SA: Distributions from Archer and Medicare MSAs and HSAs

The federal government provides a number of tax benefits that serve as incentive for you to put some money away for the cost of medical care, but if you already take advantage of them, you’ll probably receive a Form 1099-SA. There are a variety of ways to save since you can choose between a health savings account, or HSA, and one of the medical savings accounts, like an Archer MSA or Medicare MSA. When it comes time to use your account funds to pay some of your medical expenses, the organization that administers your HSA or MSA account will report all withdrawals on Form 1099-SA.

HSA & MSA Tax Benefits

If you contribute money to a health or medical savings account, you can reduce the amount of income tax you owe since contributions are deductible. You also save additional money in tax since you don’t have to report the earnings made by HSA and MSA accounts as income on your tax return each year.

Tax-Free Distributions

In addition, distributions you take from your HSA and MSA accounts are tax-free provided you use the money to pay qualified medical expenses. Despite being able to take distributions tax-free, you will always receive a Form 1099-SA that reports the annual distributions – which are reported in box 1 of the form. And provided you used the funds distributed from your HSA or MSA account to cover qualified medical expenses, Form 1099-SA should report distribution code number one, which is used to report distributions that are tax-free.

Qualified Medical Expenses

In order to avoid paying income tax on your distributions from your Archer MSA, Medicare MSA or HSA, you need to insure that the medical services you pay are for qualified expenses. The IRS doesn’t provide guidance on every possible qualified medical expense, but instead states that expenses are qualified if they’re of the type that taxpayers could normally deduct on Schedule A when itemizing. As a general rule, you should insure that the expense covers costs related to diagnosing, preventing, mitigating, curing and treating a disease. Also qualified is the cost of treatments that deal with any part of the human body. Otherwise, distribution code number five may be reported in box 3 of Form1099-SA. Distribution code five indicates that some or all of your Archer MSA, Medicare MSA and health savings account distributions were used for expenses other than qualified medical expenses. As a result, the amounts not spent on qualified medical expenses aren’t tax-free and must be reported on your tax return.

Health Savings Account Distributions

Any year you take a distribution from an HSA, the IRS will require Form 8889 to be attached to your tax return. However, if Form 1099-SA indicates that some of your distributions were used to pay for unqualified expenses, you’ll need to report the taxable amount of your HSA distributions on the “other income” line of your 1040.The purpose of Form 8889 is to calculate the additional 20-percent tax “penalty” that you will owe on the taxable portion of your HSA distribution.

Medical Savings Account Distributions

MSA distributions that aren’t used to pay qualified medical expenses are subject to the same tax treatment as your taxable has distributions. However, you report both the taxable and tax-free distribution amounts on Form 8853 rather than Form 8889, but for purposes of your 1040, the taxable MSA distribution is also included on the “other income” line.

Form 1099-SA