IRS · Official form

Form 8889, Health Savings Accounts (HSAs)

Form 8889 reports contributions to and distributions from your health savings account and figures your HSA deduction. Fill in the official IRS PDF below and download it.

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What is 8889?

Form 8889, Health Savings Accounts (HSAs), is filed with your Form 1040 to report HSA contributions made by you, your employer, or anyone else, to figure your HSA deduction, and to report distributions from the account. It also figures any additional tax you may owe on distributions not used for qualified medical expenses or if you fail to stay eligible during a testing period.

You must file Form 8889 if you or someone on your behalf contributed to your HSA, if you took any distribution from it, or if you inherited an HSA. Contribution limits depend on whether you had self-only or family high-deductible health plan coverage, so check the current instructions for the amounts.

Who files 8889?

Anyone who made or received HSA contributions during the year, including employer contributions shown on Form W-2
Account holders who took distributions from an HSA, reported to them on Form 1099-SA
People who inherited an HSA as a beneficiary
Taxpayers who must pay additional tax because of nonqualified distributions or a failed testing period

How to fill out 8889

In Part I, enter your coverage type (self-only or family) and the contributions made to your HSA for the year.
Figure your contribution limit and your HSA deduction following the line instructions.
In Part II, report total distributions from Form 1099-SA and the amount spent on unreimbursed qualified medical expenses.
Figure any taxable distribution and the additional tax, and complete Part III if a testing-period rule applies to you.
Download the finished PDF and file it with your Form 1040.

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Page 1 27 fields

Name(s) shown on Form 1040, 1040-SR, or 1040-NR

Social security number of HSA beneficiary. If both spouses have HSAs, see instructions.

Self-only

Family

2. H S A contributions you made for 2025 (or those made on your behalf), including those made by the unextended due date of your tax return

3. If you were under age 55 at the end of 2025 and, on the first day of every month during 2025, you were, or were considered, an eligible

4. Enter the amount you and your employer contributed to your Archer M S As for 2025 from Form 8853, lines 1 and 2. If you or your spouse

5. Subtract line 4 from line 3. If zero or less, enter 0.

6. Enter the amount from line 5. But if you and your spouse each have separate H S As and had family coverage under an H D H P at any time

7. If you were age 55 or older at the end of 2025, married, and you or your spouse had family coverage under an H D H P at any time during

8. Add lines 6 and 7.

9. Employer contributions made to your H S As for 2025.

10. Qualified H S A funding distributions.

11. Add lines 9 and 10.

12. Subtract line 11 from line 8. If zero or less, enter 0.

13. H S A deduction (see instructions).

14a. Total distributions you received in 2025 from all H S As (see instructions).

14b. Distributions included on line 14a that you rolled over to another H S A. Also include any excess contributions (and the earnings on

14c. Subtract line 14b from line 14a.

15. Qualified medical expenses paid using H S A distributions (see instructions).

16. Taxable H S A distributions. Subtract line 15 from line 14c. If zero or less, enter 0. Also, include this amount in the total on

17a. If any of the distributions included on line 16 meet any of the Exceptions to the Additional 20% Tax (see instructions), check here.

17b. Additional 20% tax (see instructions). Enter 20% (0.20) of the distributions included on line 16 that are subject to the additional

18. Last-month rule.

19. Qualified H S A funding distribution.

20. Total income. Add lines 18 and 19. Include this amount on Schedule 1 (Form 1040), Part I, line 8f.

21. Additional tax. Multiply line 20 by 10% (0.10). Include this amount in the total on Schedule 2 (Form 1040), Part I I, line 17d.

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Frequently asked questions

Do I have to file Form 8889 if I only spent HSA money on medical bills?

Yes. Any distribution from an HSA must be reported on Form 8889, even if the entire amount was used for qualified medical expenses and none of it is taxable.

Are employer contributions to my HSA deductible by me?

No. Employer contributions are already excluded from your wages, so they are reported on Form 8889 but do not add to your personal deduction. Only contributions you made outside payroll can create a deduction.

What if I contributed more than the annual limit?

Excess contributions are generally subject to an excise tax reported on Form 5329 unless you withdraw the excess and its earnings by the deadline in the instructions.

Form 8889, Health Savings Accounts (HSAs)

What is 8889?

Who files 8889?

How to fill out 8889

Quick fill 8889 on this page

Frequently asked questions

Related forms

Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA

Form 5498-SA, HSA, Archer MSA, or Medicare Advantage MSA Information

Form 8853, Archer MSAs and Long-Term Care Insurance Contracts