Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA
Form 1099-SA reports money paid out of a health savings account or medical savings account during the year. Fill in the official IRS PDF below and download it.
This is the genuine IRS PDF, unmodified. Source: IRS official page.
What is 1099-SA?
Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA, is filed by the bank or trustee that administers the account whenever it pays out funds, whether the money went to the account holder or directly to a medical provider. A separate form is filed for each account type.
The distribution itself is not automatically taxable. Amounts spent on qualified medical expenses stay tax-free; anything else is income and may carry an additional tax. Account holders reconcile HSA distributions on Form 8889 and Archer MSA distributions on Form 8853.
Who files 1099-SA?
- Banks, credit unions, and other trustees administering health savings accounts
- Trustees of Archer MSAs and Medicare Advantage MSAs
- Custodians paying out an account after the holder’s death or closing an account
- Account holders receive the form and reconcile it on Form 8889 or 8853
How to fill out 1099-SA
- Enter the trustee’s or payer’s name, address, and TIN in the left-hand boxes.
- Add the recipient’s TIN, name, address, and account number.
- Report the gross distribution in box 1 and any earnings on excess contributions in box 2.
- Pick the correct distribution code for box 3, such as normal distribution, excess contributions, disability, or death, and check the account type box: HSA, Archer MSA, or MA MSA.
- Download the PDF, furnish the recipient copy, and file Copy A with the IRS electronically or on official scannable stock.
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Frequently asked questions
Is the amount on my 1099-SA taxable?
Not if you spent it all on qualified medical expenses. You show that on Form 8889 (HSA) or Form 8853 (Archer MSA). Distributions used for anything else are taxable and may owe an additional tax.
Do I need receipts for my HSA spending?
Yes, keep them. The trustee reports only the total distributed; it is up to you to substantiate that the money went to qualified medical expenses if the IRS asks.