Form 5498-SA, HSA, Archer MSA, or Medicare Advantage MSA Information
Form 5498-SA is how HSA and MSA trustees report the contributions and year-end value of each health savings account they maintain. Fill in the official PDF online and download the copies you need.
This is the genuine IRS PDF, unmodified. Source: IRS official page.
What is 5498-SA?
Form 5498-SA reports contributions to a health savings account (HSA), Archer medical savings account (MSA), or Medicare Advantage MSA. The trustee or custodian of the account files a separate form for each person and each type of account it maintains, showing the year’s contributions, rollovers, and the fair market value at year end.
Account holders use their copy to double-check the contribution amounts they claim on Form 8889 for HSAs or Form 8853 for Archer MSAs, but the form itself is not attached to a tax return. Distributions from these accounts are reported separately on Form 1099-SA.
Who files 5498-SA?
- Banks, insurers, and other trustees or custodians of health savings accounts
- Trustees of Archer MSAs and Medicare Advantage MSAs
- Custodians reporting rollovers between health accounts during the year
- Institutions reporting the December 31 fair market value of each account they maintain
How to fill out 5498-SA
- Enter the trustee’s name, address, and TIN, along with the participant’s identifying information.
- Report the contributions for the year in the correct boxes, separating amounts made for the current year from those designated for the prior year.
- Enter any rollover amounts and the fair market value of the account, then mark the checkbox for the account type.
- Download the completed PDF and furnish the participant their copy by the deadline in the current instructions.
- File Copy A with the IRS electronically through IRIS or FIRE, or on official scannable paper stock if you qualify for paper filing.
Quick fill 5498-SA on this page
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Frequently asked questions
Do I need Form 5498-SA to file my taxes?
No. You report your HSA or MSA activity on Form 8889 or Form 8853 using your own records, and the 5498-SA copy that arrives later simply confirms what your custodian reported. Keep it with your tax records.
Why do employer contributions show up on my Form 5498-SA?
The form reports everything that went into the account, whether it came from you, your employer, or a rollover. Your W-2 and Form 8889 sort out which amounts were pre-tax versus deductible.