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    IRS Form 1099-SA

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

    Report distributions from Health Savings Accounts, Archer MSAs, and Medicare Advantage MSAs.

    Filing Deadline

    January 31 (to participant) / February 28 (paper) or March 31 (e-file) to IRS

    Common Account

    Health Savings Accounts (HSAs)

    Tax Treatment

    Tax-free if used for qualified medical expenses

    Overview

    Form 1099-SA reports distributions from Health Savings Accounts (HSAs), Archer Medical Savings Accounts (MSAs), and Medicare Advantage MSAs. HSAs are the most common type.

    Distributions used for qualified medical expenses are tax-free. Non-qualified distributions are taxable and may be subject to a 20% penalty (or 10% for Archer MSAs) unless an exception applies.

    Who Must File

    Required Filers

    • HSA trustees, custodians, and administrators
    • Archer MSA and Medicare Advantage MSA trustees
    • Required for any distribution, regardless of amount
    • Must report even if distribution is for qualified medical expenses

    Form Structure & Instructions

    Here's what information is required in each section:

    Distribution Information

    Amounts distributed from the account

    Box 1
    Gross Distribution
    Total amount distributed during the year
    Box 2
    Earnings on Excess Contributions
    Earnings distributed with returned excess contributions
    Box 3
    Distribution Code
    Code indicating type of account and reason for distribution
    Box 4
    FMV on Date of Death
    Fair market value if account holder died

    Important Filing Notes

    Qualified Medical Expenses

    Tax-free treatment applies only to qualified medical expenses defined in Section 213(d). This includes most medical, dental, and vision expenses not reimbursed by insurance.

    Distribution Codes

    Box 3 codes: 1 (Normal HSA distribution), 2 (Excess contributions), 3 (Disability), 4 (Death), 5 (Prohibited transaction), 6 (Normal Archer MSA). Code determines tax treatment.

    20% Penalty for HSAs

    Non-qualified HSA distributions are subject to income tax plus 20% penalty. Penalty doesn't apply after age 65, death, or disability. Keep receipts to prove qualified expenses.

    Over-the-Counter Medications

    Since 2020, over-the-counter medications and menstrual care products are qualified medical expenses for HSAs without requiring a prescription.

    HSA and MSA Distribution Reporting

    Simplify health savings account reporting with accurate Form 1099-SA filing. We help financial institutions stay compliant with IRS requirements.

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