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Official form guide
Form 1099-SA: Distributions From an HSA, Archer MSA, or Medicare Advantage MSA
IRS Form 1099‑SA is used to report distributions from Health Savings Accounts (HSA), Archer MSAs, or Medicare Advantage MSAs to the IRS and the account beneficiary. File using the April 2025 revision for 2026 information.
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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 Health Savings Accounts (HSA), Archer MSAs, or Medicare Advantage MSAs to the IRS and the account beneficiary. File using the April 2025 revision for 2026 information.
Risk Radar
Scan points- 1Do not report a mistaken distribution on Form 1099‑SA.
- 2Reporting a mistaken distribution on Form 1099‑SA instead of correcting it.
- 3Leaving the 4‑digit calendar year field blank.
- 4Omitting the required account number when multiple accounts exist for a recipient.
- 5Including a trustee‑to‑trustee transfer in Box 2 as a contribution.
Plain English
Form 1099‑SA tells the IRS how much money was taken out of an HSA, Archer MSA, or Medicare Advantage MSA. It also shows any rollovers, the account’s year‑end value, and the type of account. The trustee or custodian completes the form and provides a copy to the account holder.
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 made from a health savings account (HSA), Archer medical savings account (Archer MSA), or Medicare Advantage MSA (MA MSA).
- Do not use it when reporting trustee‑to‑trustee transfers between HSAs or MSAs.
- Check Form 5498‑SA instead when reporting contributions, rollovers, or account information.
Form selector
Use this form or another form?
Reporting a distribution from an HSA, Archer MSA, or MA MSA
Used to report the distribution amount to the IRS and beneficiary
✓ Confirm box 1 amount is correct
Filing paper copies with a low volume of recipients
Serves as the transmittal for paper Form 1099‑SA copies
✓ Ensure Form 1096 is completed and attached
Reporting contributions, rollovers, or account information
Holds contribution and rollover data, not reported on Form 1099‑SA
✓ Verify you are using the December 2026 revision of Form 5498‑SA
Deadline or filing window
Not stated in the official source.
Checklist
What you need before filling it out
Box 1 – Gross Distribution
Total distribution amount (including earnings) · Form 1099‑SA box 1
Box 2 – Earnings
Earnings portion of distribution · Form 1099‑SA box 2
Box 4 – Rollover
Amount received as rollover from another Archer MSA or HSA · Form 1099‑SA box 4
Trustee‑to‑trustee transfer
Transfer details (if any) · Not reported on Form 1099‑SA
Mistaken distribution repayment
Statement that distribution was a mistake and repaid · Not reported on Form 1099‑SA
Before you submit
- 1Use the April 2025 revision of Form 1099‑SA.
- 2Enter the total distribution amount in box 1.
- 3Enter any earnings separately in box 2.
- 4Report any rollover receipt in box 4 when applicable.
- 5Do not enter trustee‑to‑trustee transfers on the form.
- 6Do not report mistaken distribution repayments on the form.
- 7Attach a completed Form 1096 when filing paper copies.
- 8Sign the form before submission.
How to file this form
- 1Gather distribution totals and earnings for each HSA, Archer MSA, or MA MSA.
- 2Complete Form 1099‑SA (April 2025 revision) with amounts in boxes 1, 2, and 4 as applicable.
- 3Prepare a black‑and‑white copy A and attach Form 1096 if filing on paper.
- 4Submit the forms to the IRS in early 2027 and provide copy A to the account beneficiary.
- 5Retain the signed Form 1099‑SA and transmission proof for your records.
Known limitations
- 1Does not apply to trustee‑to‑trustee transfers between HSAs or MSAs.
- 2Does not apply to mistaken distribution repayments; these are not reported on Form 1099‑SA.
- 3Does not apply to contributions or rollovers; these are reported on Form 5498‑SA.
- 4Not for prior‑year information; use only the April 2025 revision for 2026 data.
- 5Requires a separate return for each plan type (HSA, Archer MSA, MA MSA).
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.
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Fillable formOpen in Editor->The form is the April 2025 revision, and the instructions direct users to the IRS.gov/Form1099SA page for the latest information; the newest change is the separation of address fields into individual boxes on Form 5498‑SA.
What changed or needs a fresh check
- Edition date — confirm the form revision is April 2025
- Related form edition — confirm Form 5498‑SA revision is December 2026
- Fee — Not stated in the official source
- Mailing address — Not stated in the official source
- Signature — Not stated in the official source
Quick Facts
Downloads
After you file
- 1Keep a copy of the signed Form 1099‑SA for your records.
- 2Provide the beneficiary with their copy of Form 1099‑SA.
- 3Monitor for any error notices from the IRS.
- 4Correct any filed Form 1099‑SA promptly by filing a corrected form and notifying the beneficiary.
Sources
- SRCInstructions p.1 — use the April 2025 revision of Form 1099‑SA for 2026 information.
- SRCInstructions p.1 — do not report trustee‑to‑trustee transfers on Form 1099‑SA.
- SRCInstructions p.2 — mistaken distribution repayments are not included in gross income and are not reported on Form 1099‑SA.
- SRCInstructions p.1 — a separate return must be filed for each plan type.
- SRCInstructions p.3 — report the receipt of a rollover in box 4.
- SRCInstructions p.1 — for low volume paper filing, send black‑and‑white Copy A with Form 1096.
- SRCInstructions p.1 — latest developments are at IRS.gov/Form1099SA.
- SRCInstructions p.1 — address fields were separated into individual entry boxes on Form 5498‑SA.
Common confusion points
Do I need to report a trustee‑to‑trustee transfer?
Transfers are not reportable on Form 1099‑SA.
→ Verify no transfer amounts are entered in any box.
Should I include a mistaken distribution repayment?
Repayments are excluded from gross income and not reported.
→ Confirm the repayment is omitted from the form.
Where do I report earnings on a distribution?
Earnings must be reported separately in box 2.
→ Ensure earnings are entered in box 2, not added to box 1.
Do I need to file a separate Form 1099‑SA for each plan type?
Each plan type requires its own return.
→ Check that you have a distinct form for each HSA, Archer MSA, and MA MSA.
Can I use the same form for prior years?
Instructions specify using the April 2025 revision only for 2026 information.
→ Confirm the form revision matches April 2025.
Is Form 5498‑SA needed for reporting rollovers?
Rollovers are reported on Form 1099‑SA box 4, while contributions are on Form 5498‑SA.
→ Verify rollovers are entered in box 4 and contributions are not placed on Form 1099‑SA.
Workflow map
Related forms and next steps
Before
Current
After
Often used with
⚠ If something goes wrong
- Form 1099‑SA (corrected) — file a corrected Form 1099‑SA and notify the beneficiary.
Questions about IRS Form 1099-SA
What is IRS Form 1099-SA used for?
Form 1099‑SA tells the IRS how much money was taken out of an HSA, Archer MSA, or Medicare Advantage MSA. It also shows any rollovers, the account’s year‑end value, and the type of account. The trustee or custodian completes the form and provides a copy to the account holder.
What information does IRS Form 1099-SA require?
The form collects the distribution amount, rollover contributions, fair market value, and account type in Boxes 1‑6, plus the 4‑digit calendar year and, if needed, an account number.
How do I complete IRS Form 1099-SA?
Enter the 4‑digit calendar year in the “For calendar year” space. Provide an account number when filing multiple accounts for the same recipient. Complete Boxes 1‑6 with the appropriate amounts and check the box indicating HSA, Archer MSA, or MA MSA. Truncate the recipient’s TIN on payee statements if desired, but not on any IRS‑filed document.
What happens if IRS Form 1099-SA is filed incorrectly?
Incorrect filing can result in penalties.
Do I need to report a trustee‑to‑trustee transfer?
Transfers are not reportable on Form 1099‑SA. Verify no transfer amounts are entered in any box.
Should I include a mistaken distribution repayment?
Repayments are excluded from gross income and not reported. Confirm the repayment is omitted from the form.
Where do I report earnings on a distribution?
Earnings must be reported separately in box 2. Ensure earnings are entered in box 2, not added to box 1.
Do I need to file a separate Form 1099‑SA for each plan type?
Each plan type requires its own return. Check that you have a distinct form for each HSA, Archer MSA, and MA MSA.
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