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Form 5498-SA: HSA, Archer MSA, or Medicare Advantage MSA Information
IRS Form 5498-SA is HSA, Archer MSA, or Medicare Advantage MSA Information used to report account details to the IRS. It reports contributions for calendar year 2727.
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IRS Form 5498-SA - HSA, Archer MSA, or Medicare Advantage MSA Information
IRS Form 5498-SA is HSA, Archer MSA, or Medicare Advantage MSA Information used to report account details to the IRS. It reports contributions for calendar year 2727.
Risk Radar
Scan points- 1Do not attach Form 5498-SA to your income tax return; keep it for your records instead.
- 2Failing to keep a copy of Form 5498-SA for personal records after submission.
- 3Reporting contributions in Box 1 without verifying they were made through April 15 of the subsequent year.
- 4Omitting the Fair market value from Box 5 at the end of the calendar year shown.
- 5Failing to report any rollover contribution in Box 4 when one occurred.
Plain English
This form tells the IRS about your Health Savings Account (HSA), Archer Medical Savings Account (MSA), or Medicare Advantage MSA (MA MSA). It documents how much money was put into the account, any rollovers, and what the account was worth at year-end. The trustee submits this information to report it correctly for tax purposes.
Submission Date
- Filing date: 2025-12-22 15:10:46
- 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 a trustee furnishes information about your Health Savings Account (HSA), Archer Medical Savings Account (MSA), or Medicare Advantage MSA (MA MSA) to the Internal Revenue Service.
- Do not use this form when you are reporting distributions from an IRA to fund your HSA, as that specific detail is included within Box 1 of Form 5498-SA itself.
- Check Form 8853 or Form 8889 instead when reporting specific details about contributions or distributions.
Form selector
Use this form or another form?
Employer contributes to your HSA
Employer contributions are shown in Box 12 of Form W-2 for the year.
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You contribute to an Archer MSA while spouse's employer contributed to their MA MSA
You cannot deduct your contribution if your spouse is covered under a high deductible health plan that also covers you.
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Not stated in the official source
Contributions made by Social Security Administration to MA MSA
These contributions are not includible in gross income nor are they deductible for the participant or employer.
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Form 8853/8889 (for distribution context)
Deadline or filing window
The form relates to a specific calendar year shown on the document. For instance, Copy B is furnished for the calendar year listed there. The instructions do not specify an end date, but the information pertains to that reporting period.
Checklist
What you need before filling it out
Trustee's Name
The name of the account trustee · Form 5498-SA (Copy A/B)
Participant's TIN
The taxpayer identification number of the participant · Form 5498-SA (Copy A/B)
Box 1: Employee’s or self-employed person’s Archer MSA contributions made in calendar year & subsequent year for the calendar year
Dollar amount contribution figures · Form 5498-SA (p.1/2)
Box 3: Total HSA or Archer MSA contributions made in the subsequent year for the calendar year
Dollar amount total from prior year's reporting · Form 5498-SA (p.2)
Box 6: Type of account reported
HSA, Archer MSA, or MA MSA designation · Form 5498-SA (p.1/2)
Account Number
The specific identifying number for the account · Form 5498-SA (Copy A/B)
Before you submit
- 1Verify that Copy A is completed for the Internal Revenue Service filing.
- 2Confirm that Box 6 correctly identifies whether the account is HSA, Archer MSA, or MA MSA on each line item.
- 3Check if Box 2 reflects the total contributions made in the current calendar year.
- 4Ensure Box 4 accurately reports any rollover contribution into this account for the stated calendar year.
- 5Confirm that the Trustee's TIN and Participant's TIN are correctly entered on both Copy A and Copy B.
- 6Verify that you retain a copy of the completed Form 5498-SA for your records, as instructed.
- 7Check if the form is dated for calendar year 2727 (or the relevant year indicated).
How to file this form
- 1Complete Copy A by filling in Trustee information, Participant details, and all required contribution/value boxes for the specified calendar year.
- 2Complete Copy B using the same data as Copy A to furnish this information to the IRS.
- 3Sign or have the trustee sign both Copy A and Copy B (implied by structure) before sending the forms.
- 4Keep a copy of the completed Form 5498-SA for your records, separate from what is submitted to the IRS.
Known limitations
- 1Contributions made to a Medicare Advantage MSA are not includible in gross income nor are they deductible.
- 2Neither the participant nor their employer can make contributions directly to a MA MSA.
- 3Employer contributions to an HSA may be excluded from your income and are not deductible by you.
- 4The information on Form 5498-SA is provided for IRS use only (Boxes 2 and 3).
- 5Do not attach Form 5498-SA to your income tax return.
Field map
Compact field-by-field guide
General Info
2 items
Full legal name and taxpayer identification number (SSN or EIN).
Current mailing address.
Details
2 items
Complete all applicable sections of this form according to the official IRS instructions.
Enter the relevant dollar amount if this form involves tax calculation.
Certification
1 items
Read and acknowledge any certifications required by this form.
Signatures
1 items
Sign and date. Unsigned forms cannot be processed.
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Fillable formOpen in Editor->The current edition of IRS Form 5498-SA is dated December 2026, and the form directs users to www.irs.gov/Form5498SA for the latest information regarding future developments.
What changed or needs a fresh check
- Edition date — confirm the revision date reads December 2026.
- OMB Number — confirm the OMB No. is 1545-1518.
- Filing address/submission method — confirmation of mailing address is not stated, but it is furnished to the IRS.
- Signature — a signature field for the trustee is present on Copy A and Copy B, though specific signing instructions are not detailed.
Quick Facts
Downloads
After you file
- 1Keep a copy of the completed Form 5498-SA for personal records.
- 2The trustee may provide other account information on this form that is not explicitly listed in the boxes.
- 3If corrections are made, check the 'CORRECTED' box on Copy B and ensure the date reflects the correction.
- 4For the latest updates regarding Form 5498-SA, visit www.irs.gov/Form5498SA.
Sources
- SRCInstructions p.1 — The form is titled HSA, Archer MSA, or Medicare Advantage MSA Information and has Cat. No. 38467V.
- SRCInstructions p.1 — Copy A is for the Internal Revenue Service; Copy B is for the Participant.
- SRCInstructions p.2 — Box 1 shows Employee’s or self-employed person’s Archer MSA contributions made in the calendar year and subsequent year for the calendar year.
- SRCInstructions p.3 — Contributions made to a MA MSA are not includible in gross income nor deductible, and neither you nor your employer can make them.
- SRCInstructions p.3 — Employer contributions to an Archer MSA are shown on Form W-2 in box 12 (code R).
- SRCInstructions p.3 — Box 4 shows any rollover contribution from an Archer MSA to this Archer MSA in the calendar year shown on this form or any rollover from an HSA or Archer MSA to this HSA.
Common confusion points
What is Box 1?
Box 1 shows contributions made in the calendar year and through April 15 of the subsequent year to your Archer MSA.
Safe check: Verify if this amount can be deducted on Form 1040 or 1040-SR.
Workflow map
Related forms and next steps
Before
Current
After
Often used with
⚠ If something goes wrong
- Visit www.irs.gov/Form5498SA for future developments concerning Form 5498-SA.
Questions about IRS Form 5498-SA
What is IRS Form 5498-SA used for?
This form tells the IRS about your Health Savings Account (HSA), Archer Medical Savings Account (MSA), or Medicare Advantage MSA (MA MSA). It documents how much money was put into the account, any rollovers, and what the account was worth at year-end. The trustee submits this information to report it correctly for tax purposes.
Who must file IRS Form 5498-SA?
The trustee of your health savings account (HSA), Archer medical savings account (MSA), or Medicare Advantage MSA (MA MSA) must submit Form 5498-SA to the IRS.
What information does IRS Form 5498-SA require?
Copy A provides details identifying the Trustee and Participant, while Copy B repeats this information. The form collects specific figures such as contributions made in the calendar year (Box 2), rollover amounts (Box 4), and the fair market value at year-end (Box 5).
When is IRS Form 5498-SA due?
The source does not state a specific filing deadline, but it is used for information related to the calendar year shown on the form.
Where do I file IRS Form 5498-SA?
This information is furnished directly to the IRS by the trustee. The instructions direct users to keep a copy for their records instead of attaching it to an income tax return.
How do I complete IRS Form 5498-SA?
The trustee must complete the form (either Copy A for internal use or Copy B) by filling in the account details and contribution amounts. The Trustee's TIN and the Participant's TIN are required fields on both copies. Finally, the trustee provides other information about the account as needed.
What happens if IRS Form 5498-SA is filed incorrectly?
While the source does not list specific penalties, failure to accurately report the figures may result in incorrect reporting to the IRS, which could affect tax liability or eligibility.
Source transparency
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