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Form 1099-SA: Distributions From an HSA, Archer MSA, or Medicare Advantage MSA
IRS Form 1099-SA is used to report Distributions From an HSA, Archer MSA, or Medicare Advantage MSA for the April 2025 revision; these instructions are for filing in early 2027.
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IRS Form 1099-SA - Distributions From an HSA, Archer MSA, or Medicare Advantage MSA
IRS Form 1099-SA is used to report Distributions From an HSA, Archer MSA, or Medicare Advantage MSA for the April 2025 revision; these instructions are for filing in early 2027.
Risk Radar
Scan points- 1Do not truncate a recipient’s TIN on documents filed with the IRS; truncation is only allowed on payee statements.
- 2Filing without entering the correct 4-digit calendar year on the form.
- 3Incorrectly treating a mistaken distribution as a contribution on Form 1099-SA.
- 4Not reporting trustee-to-trustee transfers when required (e.g., IRA to HSA).
- 5Failing to report gross contributions, even if excess amounts were withdrawn.
Plain English
This form tells the IRS how much money was taken out of your Health Savings Account (HSA), Archer Medical Savings Account (MSA), or Medicare Advantage MSA. It also tracks contributions and rollovers so the IRS knows exactly what happened with your retirement health savings during the year. Filing this helps confirm that distributions are not taxed incorrectly.
Submission Date
- Filing date: 2025-12-23 14:10:36
- Preparation window: collect IDs, supporting records, and signatures in advance.
- Final review: verify names, dates, and required fields before submission.
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What this form is for
- Use this form when reporting Distributions From an HSA, Archer MSA, or Medicare Advantage MSA.
- Do not use it when the distribution is a mistaken payment that you are repaying (rely on account beneficiary's statement).
- Check Form 5498-SA instead when reporting information related to the distributions.
Form selector
Use this form or another form?
Distribution was a mistake, but it was not reported on Form 1099-SA
The mistaken distribution is not included in gross income or subject to the additional 20% tax.
✓ Check Notice 2004-50.
The distribution amount includes earnings from excess contributions
This identifies that the distribution relates to excess HSA or Archer MSA contributions.
✓ Check Form 5329 for excise tax details.
You used the distribution to pay qualified medical expenses, but you did not roll it over (HSA/Archer MSA)
You may also owe a penalty if this condition is met.
✓ Check Form 8853 or Form 8889.
Must include the distribution in income
Deadline or filing window
The filing window requires furnishing information in early 2027 for the preceding calendar year. The source does not state a specific deadline date, but it directs users to file these revisions until a superseding revision is issued.
Checklist
What you need before filling it out
Box 1. Gross Distribution
Total amount of the distribution · Form 1099-SA
Box 3. Distribution Code
Appropriate code from list (1, 2, 3, or 4) · Form 1099-SA
Distribution Code 2
Distributions of excess HSA or Archer MSA contributions to account holder · Form 1099-SA Box 3
Box 4. Account Holder Death Value
FMV of the account on the date of death · Form 1099-SA
Box 5. Type of Account
HSA, Archer MSA, or Medicare Advantage MSA · Form 1099-SA
Repayment Deadline
No later than the due date of the tax return following the first year you knew/should have known it was a mistake · Form 1099-SA (Form p.3)
Before you submit
- 1Ensure Box 1 contains the total distribution amount, including any earnings reported in Box 2.
- 2Verify that if earnings are included in Box 2, Distribution Code 2 is used in Box 3 for excess contributions.
- 3Select the correct code (1-4) in Box 3 to identify the type of distribution received.
- 4Confirm Box 5 correctly identifies whether the account is an HSA, Archer MSA, or Medicare Advantage MSA.
- 5If the account holder died, verify that Box 4 shows the FMV on the date of death.
- 6Check if you must report the amount in your income because it was not used for qualified medical expenses (or rollover).
- 7Review the recipient's TIN section to ensure the issuer has reported the complete number to the IRS.
How to file this form
- 1Calculate and enter the total distribution amount into Box 1 on Form 1099-SA.
- 2Determine if earnings are present in Box 2, and if so, select Distribution Code 2 in Box 3 for excess contributions.
- 3Select the appropriate code (1 through 4) in Box 3 based on the distribution type (e.g., Normal, Disability).
- 4Fill out Boxes 4 and 5 to document the account value at death or the specific account type.
- 5Complete the recipient's Taxpayer Identification Number (TIN) section using the complete number reported by the issuer.
- 6Sign and date Form 1099-SA before mailing it to the IRS.
Known limitations
- 1A separate return must be filed for each plan type when using IRS Form 1099-SA to report distributions.
- 2The form does not report a trustee-to-trustee transfer from one Archer MSA or MA MSA to another Archer MSA or MA MSA, from an Archer MSA to an HSA, or from one HSA to another HSA for reporting purposes.
- 3Contributions and rollovers reported on IRS Form 1099-SA do not include transfers mentioned above.
- 4If a total distribution is made from an HSA or Archer MSA during the year and no contributions were made, filing IRS Form 5498-SA may not be necessary if the fair market value (FMV) on December 31 was zero.
Field map
Compact field-by-field guide
Payer Info
1 items
Identifying information of the business or person making the payment.
Recipient Info
1 items
Identifying information of the person or entity receiving the payment.
Amounts
1 items
The payment amount subject to reporting for the applicable box category.
Withholding
1 items
Backup withholding amount if applicable.
Signatures
1 items
Name and phone number of the person to contact about this return.
Almost done reviewing the fields?
Fillable formOpen in Editor->The current revision is the April 2025 version, and these instructions are for filing in early 2027; future developments regarding Form 1099-SA can be found at IRS.gov/Form1099SA.
What changed or needs a fresh check
- Edition date — confirm the revision reads April 2025.
- Instruction set — confirm instructions are for filing in early 2027.
- Mailing address — Not stated in the official source (verify on the agency site).
- Signature — The requirement to sign is not explicitly stated, but it is implied as a submission step.
Quick Facts
Downloads
After you file
- 1Keep a copy of the filed IRS Form 1099-SA.
- 2If a mistake occurs, correct the filed IRS Form 1099-SA with both the IRS and the account beneficiary as soon as the error is known.
- 3If a mistaken distribution from an HSA occurred, the account beneficiary must repay it no later than the due date of the tax return (not counting extensions) following the first year they knew or should have known about the mistake.
- 4If a mistaken distribution occurs under specific circumstances, do not report the repayment on IRS Form 1099-SA.
Sources
- SRCInstructions p.1 — IRS Form 1099-SA reports Distributions From an HSA, Archer MSA, or Medicare Advantage MSA.
- SRCInstructions p.1 — A separate return must be filed for each plan type when using IRS Form 1099-SA.
- SRCInstructions p.1 — Do not report a trustee-to-trustee transfer from one Archer MSA or MA MSA to another Archer MSA or MA MSA, from an Archer MSA to an HSA, or from one HSA to another HSA for reporting purposes.
- SRCInstructions p.2 — If amounts were distributed due to mistake of fact, the repayment must be made no later than the due date of the tax return (not counting extensions) following the first year the beneficiary knew or should have known.
- SRCInstructions p.2 — Do not report a mistaken distribution on IRS Form 1099-SA under these circumstances.
- SRCInstructions p.3 — Rollovers from one Archer MSA to another Archer MSA, and from an Archer MSA or HSA to an HSA must be reported in box 4 of IRS Form 1099-SA.
- SRCInstructions p.3 — Generally, if no contributions were made during the year, you need not file IRS Form 5498-SA nor furnish a statement if the FMV on December 31 was zero.
Common confusion points
What must be reported on Form 1099-SA?
The form reports distributions made from a health savings account (HSA), Archer medical savings account (Archer MSA), or Medicare Advantage MSA (MA MSA).
→ Ensure you file a separate return for each plan type if multiple types are involved.
How do I handle transfers between accounts on Form 1099-SA?
A trustee-to-trustee transfer from one Archer MSA or MA MSA to another, from an Archer MSA to an HSA, or from one HSA to another HSA does not need to be reported in box 1 (Gross Distribution).
→ Verify that the distribution amount itself is what you are reporting, as transfers do not count toward gross distributions for reporting purposes.
What about mistaken distributions?
If a distribution was made by mistake due to reasonable cause, the account beneficiary may repay it no later than the due date of the tax return following the first year they knew or should have known it was a mistake.
→ Do not report this repayment in box 1 on Form 1099-SA; instead, check instructions for how to handle that specific situation.
When must I file Form 1099-SA if there are no contributions?
Generally, you need not file Form 5498-SA nor furnish a statement if a total distribution was made from an HSA or Archer MSA during the year and no contributions were made for that year.
→ If filing on paper due to low volume, send in the black-and-white Copy(ies) A with a Form 1096.
Can I truncate a recipient's TIN when filing this form?
Yes, filers of Form 1099-SA may truncate a participant’s TIN (SSN, ITIN, ATIN, or EIN) on payee statements.
→ Truncation is not allowed on any documents filed with the IRS; a trustee’s TIN cannot be truncated on any form.
What is the deadline if May 31 falls on a weekend/holiday?
If May 31 falls on a Saturday, Sunday, or a legal holiday, filing must occur by the next day that is not a Saturday, Sunday, or a legal holiday.
→ Confirm this date when determining your final submission deadline for Form 1099-SA.
What should I do if I report a mistaken distribution?
Do not report the mistaken distribution on Form 1099-SA itself; instead, ensure you correct any filed Form 1099-SA with the IRS and the account beneficiary as soon as the error is known.
→ Remember that this repayment is not treated as a contribution when reporting on Form 5498-SA.
What if I am filing on paper due to low volume?
If filing on paper, you can send in the black-and-white Copy(ies) A along with a Form 1096 printed from the IRS website.
→ This applies specifically to Forms 1099-SA and 5498-SA.
Workflow map
Related forms and next steps
Before
Current
After
Often used with
⚠ If something goes wrong
- Correct any filed IRS Form 1099-SA with the IRS and the account beneficiary as soon as you become aware of the error.
Questions about IRS Form 1099-SA
What is IRS Form 1099-SA used for?
This form tells the IRS how much money was taken out of your Health Savings Account (HSA), Archer Medical Savings Account (MSA), or Medicare Advantage MSA. It also tracks contributions and rollovers so the IRS knows exactly what happened with your retirement health savings during the year. Filing this helps confirm that distributions are not taxed incorrectly.
Who must file IRS Form 1099-SA?
Filers include trustees, custodians, and payers who report these account activities to the IRS.
What information does IRS Form 1099-SA require?
The form collects details such as total contributions (Box 2), rollover amounts (Box 4), and the Fair Market Value of the account on December 31 (Box 5). Part J requires reporting the filer's TIN, while Box 6 specifies if the account is an HSA, Archer MSA, or MA MSA.
When is IRS Form 1099-SA due?
The form must be filed in early 2027 when reporting information for the calendar year.
Where do I file IRS Form 1099-SA?
The source does not specify a single service center address but confirms that electronic filing (e-filing) is available. General instructions are found at IRS.gov/1099GeneralInstructions.
How do I complete IRS Form 1099-SA?
First, enter the 4-digit calendar year in the designated space. Next, complete the relevant boxes detailing contributions and distributions (e.g., Box 2 for total contributions). Finally, ensure you sign the form before sending it to the IRS.
What happens if IRS Form 1099-SA is filed incorrectly?
If an error occurs, the filer must correct the filed Form 1099-SA with both the IRS and the account beneficiary as soon as the mistake becomes known.
What must be reported on Form 1099-SA?
The form reports distributions made from a health savings account (HSA), Archer medical savings account (Archer MSA), or Medicare Advantage MSA (MA MSA). Ensure you file a separate return for each plan type if multiple types are involved.
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