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Form 8853: Archer MSAs and Long-Term Care Insurance Contracts
IRS Form 8853 reports Archer MSA contributions, deductions, distributions and taxable long‑term care insurance payments, including accelerated death benefits. It is required for anyone who made or received contributions for 2025 or who acquired an Archer or Medicare Advantage MSA interest because of a death.
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IRS Form 8853 - Archer MSAs and Long-Term Care Insurance Contracts
IRS Form 8853 reports Archer MSA contributions, deductions, distributions and taxable long‑term care insurance payments, including accelerated death benefits. It is required for anyone who made or received contributions for 2025 or who acquired an Archer or Medicare Advantage MSA interest because of a death.
Risk Radar
Scan points- 1Entering a non‑zero amount on line 26 when only accelerated death benefits were received triggers a filing error.
- 2Fail to enter the Archer MSA fair market value on lines 6a and 6c for a beneficiary of a deceased account holder.
- 3Omit qualified medical expenses incurred before death that were paid within one year on line 7.
- 4Do not apply the special Part I instructions when employer contributions prevent a deduction, leading to incorrect lines.
- 5Combine totals from each spouse’s separate statement Forms incorrectly, or fail to add lines 1, 2, 5 for joint filing.
Plain English
Form 8853 tells the IRS how much you put into or took out of an Archer Medical Savings Account and any taxable long‑term care insurance payments. It also calculates any deduction you can claim. If you or your spouse contributed in 2025 or inherited an MSA after a death, you need to fill it out.
Submission Date
- Filing date: 2025-12-19 14:10:51
- 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 you made or your employer made Archer MSA contributions for 2025, when filing jointly and your spouse made contributions, or when you acquired an interest in an Archer or Medicare Advantage MSA because of the account holder’s death.
- Do not use it when you have no Archer MSA contributions, distributions, or long‑term care insurance contract payments for 2025.
- Check Form 1040 instead when you are filing a regular individual income tax return without Archer MSA activity.
Form selector
Use this form or another form?
You are a U.S. citizen filing a regular individual income tax return
Form 8853 is attached to the main return; the base form collects overall tax liability
✓ Verify you are using the 2025 edition of Form 1040
You are a senior taxpayer filing the simplified return for seniors
The senior version also requires attaching Form 8853 and ensures correct formatting
✓ Confirm the form version matches your filing year
You are a non‑resident alien filing a U.S. tax return
Non‑resident returns require the NR version; Archer MSA reporting is still attached
✓ Ensure you select the correct filing status on Form 1040‑NR
Deadline or filing window
Not stated in the official source
Checklist
What you need before filling it out
Line 1 – Total employer contributions to your Archer MSA(s) for 2025
Employer contribution statements or W‑2 Box 12 code · Form 8853, Part I, line 1
Line 13b – One‑half of line 6 amount
Calculated amount from line 6 on Form 1040 Schedule 1 · Instructions p.7
Section C – Per diem LTC payments
Statement of LTC insurance contract payments · Instructions p.9
Lines 20‑26 – Per diem limitation calculations
Per diem rate and days from insurance contract · Instructions p.10
Attachment sequence number
Form 8853 attachment number · Form p.1, Attachment Sequence No. 39
Before you submit
- 1Verify the form revision reads 20/25.
- 2Confirm all required lines (e.g., line 1, line 13b, line 15) are completed.
- 3Attach the required statement for Section C if you answered Yes on line 15.
- 4Sign and date the form.
- 5Attach Form 8853 to the appropriate individual income tax return (Form 1040, 1040‑SR, or 1040‑NR).
- 6Include the correct attachment sequence number (39) on the top of the return.
- 7Double‑check that employer contributions are reported accurately.
- 8Review per diem limitation calculations for accuracy.
- 9Keep a copy of the completed Form 8853 for your records.
- 10Mail the return to the IRS address for your filing location or e‑file if supported.
How to file this form
- 1Gather employer contribution statements, LTC insurance payment records, and any accelerated death benefit documents.
- 2Complete Part I of Form 8853, entering contributions, deductions, and required calculations.
- 3Fill Section C, attaching the required statement if you answered Yes on line 15.
- 4Sign and date the form.
- 5Attach Form 8853 to your 2025 Form 1040 (or 1040‑SR/1040‑NR) using attachment sequence number 39.
- 6Mail the combined return to the IRS address for your filing location or e‑file if available.
- 7Retain a copy of the filed return and attachment for at least three years.
Known limitations
- 1Does not apply to contributions made after Dec 31 2007 unless you were an active Archer MSA participant before that date or qualified under a high‑deductible health plan.
- 2Not applicable for Health Savings Accounts (HSAs) or other tax‑favored health plans that are not Archer MSAs.
- 3Not used for reporting qualified medical‑expense insurance premiums; only taxable LTC insurance premiums are reported.
- 4Not required if you have no Archer MSA contributions, distributions, or LTC contract payments for 2025.
- 5Not suitable for reporting non‑qualified accelerated death benefits that are not per‑diem.
Field map
Compact field-by-field guide
Entity Info
1 items
Name and taxpayer ID of the entity claiming the credit.
Credit Info
1 items
Type of credit or incentive being claimed.
Calculation
2 items
The base amount used to calculate the credit.
Calculated credit amount after applying formulas and limitations.
Certification
1 items
Detailed breakdown supporting the credit calculation.
Signatures
1 items
Sign and date the form.
Almost done reviewing the fields?
Fillable formOpen in Editor->The form shows revision 20/25 and the instructions direct users to IRS.gov/Form8853 for the latest information.
What changed or needs a fresh check
- Edition date — confirm the form shows revision 20/25
- Fee — Not stated in the official source
- Mailing address — Not stated in the official source
- Signature — Not stated in the official source
- OMB number — confirm it reads 1545-0074
Quick Facts
Downloads
After you file
- 1Keep a copy of the filed return and supporting documents for at least three years.
- 2Expect an IRS acknowledgment of return processing (e.g., acceptance notice).
- 3If an error is discovered, file an amended return using Form 1040‑X with a corrected Form 8853.
- 4Monitor for any IRS notice regarding per‑diem limitation allocation.
- 5Store all LTC insurance and MSA records with your tax files.
- 6Update records promptly if you receive additional LTC payments after filing.
Sources
- SRCInstructions p.1 — purpose of Form 8853 includes reporting Archer MSA contributions, deductions, distributions, and taxable LTC insurance payments.
- SRCInstructions p.1 — filing requirement: you must file if you (or employer) made contributions for 2025, if spouse made contributions, or if you acquired an interest due to death.
- SRCInstructions p.7 — line 13b requires entering one‑half of line 6.
- SRCInstructions p.8 — you may choose Contract Period or Equal Payment Rate method for LTC period.
- SRCInstructions p.9 — attach a statement duplicating lines 18‑26 when you answered Yes on line 15.
- SRCInstructions p.10 — per diem limitation amounts and allocation example for lines 20‑26.
- SRCForm p.1 — attachment sequence number is 39.
- SRCForm p.1 — OMB No. 1545-0074 appears on the form.
- SRCInstructions p.1 — contributions cannot be made after Dec 31 2007 unless active participant criteria are met.
- SRCInstructions p.1 — reference to Pub. 969 for more details on MSAs.
Common confusion points
Do I need to file Form 8853 if I only received employer contributions?
The form is required whenever any contributions are made, even if only the employer’s.
→ Check that any contribution appears on line 1.
Can I treat my LTC insurance premiums as qualified medical expenses?
Premiums are not qualified unless they meet specific criteria not listed in the instructions.
→ Confirm premiums are not listed as qualified in the instructions.
Which method should I use for the LTC period?
Two methods exist and special rules apply if multiple payees are involved.
→ Review Instructions p.8 and select the method that matches your contract.
What does line 13b represent?
It requires one‑half of line 6, but the source is easy to miss.
→ Calculate line 6 first, then divide by two for line 13b.
Do I attach a statement for Section C even if I answered No on line 15?
A statement is only required when Yes is checked.
→ Verify your answer on line 15 before attaching.
Is the attachment sequence number always 39?
The form shows 39, but other years may differ.
→ Confirm the number on the top of Form 8853 matches the current edition.
Workflow map
Related forms and next steps
Before
Current
After
Often used with
⚠ If something goes wrong
- Form 1040‑X — Amended return to correct errors on Form 8853.
Questions about IRS Form 8853
What is IRS Form 8853 used for?
Form 8853 tells the IRS how much you put into or took out of an Archer Medical Savings Account and any taxable long‑term care insurance payments. It also calculates any deduction you can claim. If you or your spouse contributed in 2025 or inherited an MSA after a death, you need to fill it out.
Who must file IRS Form 8853?
You must file IRS Form 8853 if you (or your employer) contributed to an Archer MSA for 2025, if you file jointly and your spouse (or their employer) contributed to a spouse’s Archer MSA for 2025, or if you or your spouse acquired an interest in an Archer or Medicare Advantage MSA because of the account holder’s death.
What information does IRS Form 8853 require?
The form collects contribution amounts, deduction calculations, and distribution totals in Part I and Part II, and it reports taxable payments from long‑term care contracts and accelerated death benefits on the appropriate lines.
How do I complete IRS Form 8853?
First, complete Part I by entering contributions on lines 1‑5, following the special rules for employer contributions or multiple MSAs. Next, fill Part II with distribution totals on line 6a, rollovers on line 6b, and any taxable LTC payments. If you are a beneficiary of a deceased account holder, enter the fair market value on lines 6a and 6c and qualified medical expenses on line 7, then skip Part I as instructed. Sign the form before mailing or e‑filing.
Do I need to file Form 8853 if I only received employer contributions?
The form is required whenever any contributions are made, even if only the employer’s. Check that any contribution appears on line 1.
Can I treat my LTC insurance premiums as qualified medical expenses?
Premiums are not qualified unless they meet specific criteria not listed in the instructions. Confirm premiums are not listed as qualified in the instructions.
Which method should I use for the LTC period?
Two methods exist and special rules apply if multiple payees are involved. Review Instructions p.8 and select the method that matches your contract.
What does line 13b represent?
It requires one‑half of line 6, but the source is easy to miss. Calculate line 6 first, then divide by two for line 13b.
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