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HSA Tax Resource Center
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Forms

IRS Form 1099-SA

This form provides you with the total distributions that were made from your health savings account. You will receive a separate 1099-SA for each type of distribution you had in that tax year. The five types of distributions are: normal, excess contribution removal, death, disability and prohibited transaction. If you did not have distributions during the tax year, you will not receive a 1099.

IRS Form 5498-SA

This form provides you with the contributions that you made to your health savings account in that tax year. Since account holders have the right to make contributions to their HSA for a tax year until April 15 of the next year, this form is sent out the following May.

IRS Form 8889

This form is the HSA contribution form and must be completed by the account holder and attached to the 1040 Form.

Find more information on tax forms and descriptions:

U.S. Treasury HSAs: IRS Forms and Publications
http://www.ustreas.gov/offices/public-affairs/hsa/forms/

U.S. Treasury HSA Frequently Asked Questions
http://www.ustreas.gov/offices/public-affairs/hsa/faq.shtml

Eligible and ineligible expenses
Get information on eligible and ineligible expenses, including a tax-subsidized medical expenses visit:

IRS Publication 502 - Qualified Medical and Dental Expenses


Health savings accounts are offered by OptumHealth Bank, Member FDIC, and are subject to eligibility. This communication is not intended as legal or tax advice. Please contact a competent legal or tax professional for personal advice on eligibility, tax treatment and restrictions. Federal and state regulations are subject to change. Please check your health benefit plan materials to determine whether your employer will make supplemental contributions to your HSA.