Table of Contents
A health savings account (HSA) is a tax-exempt trust or custodial account that you set up with a qualified HSA trustee to pay or reimburse certain medical expenses you incur. You must be an eligible individual to qualify for an HSA.
No permission or authorization from the IRS is necessary to establish an HSA. When you set up an HSA, you will need to work with a trustee. A qualified HSA trustee can be a bank, an insurance company, or anyone already approved by the IRS to be a trustee of individual retirement arrangements (IRAs) or Archer MSAs. The HSA can be established through a trustee that is different from your health plan provider.
Your employer may already have some information on HSA trustees in your area.

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You can claim a tax deduction for contributions you, or someone other than your employer, make to your HSA even if you do not itemize your deductions on Form 1040.
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Contributions to your HSA made by your employer (including contributions made through a cafeteria plan) may be excluded from your gross income.
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The contributions remain in your account from year to year until you use them.
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The interest or other earnings on the assets in the account are tax free.
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Distributions may be tax free if you pay qualified medical expenses. See Qualified medical expenses, later.
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An HSA is “portable” so it stays with you if you change employers or leave the work force.
To be an eligible individual and qualify for an HSA, you must meet the following requirements.
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You have a high deductible health plan (HDHP), described later, on the first day of the month.
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You have no other health coverage except what is permitted under Other health coverage, later.
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You are not enrolled in Medicare.
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You cannot be claimed as a dependent on someone else's 2007 tax return.

If you meet these requirements, you are an eligible individual even if your spouse has non-HDHP family coverage, provided your spouse's coverage does not cover you.


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A higher annual deductible than typical health plans, and
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A maximum limit on the sum of the annual deductible and out-of-pocket medical expenses that you must pay for covered expenses. Out-of-pocket expenses include copayments and other amounts, but do not include premiums.
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Periodic health evaluations, including tests and diagnostic procedures ordered in connection with routine examinations, such as annual physicals.
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Routine prenatal and well-child care.
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Child and adult immunizations.
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Tobacco cessation programs.
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Obesity weight-loss programs.
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Screening services. This includes screening services for the following:
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Cancer.
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Heart and vascular diseases.
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Infectious diseases.
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Mental health conditions.
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Substance abuse.
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Metabolic, nutritional, and endocrine conditions.
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Musculoskeletal disorders.
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Obstetric and gynecological conditions.
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Pediatric conditions.
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Vision and hearing disorders.
For more information on screening services, see Notice 2004-23, which is on page 725 of Internal Revenue Bulletin 2004-15 at
www.irs.gov/pub/irs-irbs/irb04-15.pdf. -
| Type of Coverage | Minimum
Annual Deductible |
Maximum
Annual Deductible and Other Out-of-Pocket Expenses * |
| Self-only | $1,100 | $5,500 |
| Family | $2,200 | $11,000 |
| * This limit does not apply to deductibles and expenses for out-of-network services if the plan uses a network of providers. Instead, only deductibles and out-of-pocket expenses for services within the network should be used to figure whether the limit applies. |
Example.
You have family health insurance coverage in 2007. The annual deductible for the family plan is $3,500. This plan also has an individual deductible of $1,500 for each family member. The plan does not qualify as an HDHP because the deductible for an individual family member is below the minimum annual deductible ($2,200) for family coverage.
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Liabilities incurred under workers' compensation laws, tort liabilities, or liabilities related to ownership or use of property.
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A specific disease or illness.
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A fixed amount per day (or other period) of hospitalization.
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Accidents.
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Disability.
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Dental care.
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Vision care.
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Long-term care.

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Limited-purpose health FSA or HRA. These arrangements can pay or reimburse the items listed earlier under Other health coverage, except long-term care. Also, these arrangements can pay or reimburse preventive care expenses because they can be paid without having to satisfy the deductible.
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Suspended HRA. Before the beginning of an HRA coverage period, you can elect to suspend the HRA. The HRA does not pay or reimburse, at any time, the medical expenses incurred during the suspension period except preventive care and items listed under Other health coverage. When the suspension period ends, you are no longer eligible to make contributions to an HSA.
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Post-deductible health FSA or HRA. These arrangements do not pay or reimburse any medical expenses incurred before the minimum annual deductible amount is met. The deductible for these arrangements does not have to be the same as the deductible for the HDHP, but benefits may not be provided before the minimum annual deductible amount is met.
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Retirement HRA. This arrangement pays or reimburses only those medical expenses incurred after retirement. After retirement you are no longer eligible to make contributions to an HSA.
Any eligible individual can contribute to an HSA. For an employee's HSA, the employee, the employee's employer, or both may contribute to the employee's HSA in the same year. For an HSA established by a self-employed (or unemployed) individual, the individual can contribute. Family members or any other person may also make contributions on behalf of an eligible individual.
Contributions to an HSA must be made in cash. Contributions of stock or property are not allowed.
The amount you or any other person can contribute to your HSA depends on the type of HDHP coverage you have, your age, the date you become an eligible individual, and the date you cease to be an eligible individual. For 2007, if you have self-only HDHP coverage, you can contribute up to $2,850. If you have family HDHP coverage, you can contribute up to $5,650.

If you were, or were considered (under the last-month rule, discussed later), an eligible individual for the entire year and did not change your type of coverage, you can contribute the full amount based on your type of coverage. However, if you were not an eligible individual for the entire year or changed your coverage during the year, your contribution limit is the greater of:
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The limitation shown on the last line of the Line 3 Limitation Chart and Worksheet in the Instructions for Form 8889, Health Savings Accounts (HSAs), or
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The maximum annual HSA contribution based on your HDHP coverage (self-only or family) on the first day of the last month of your tax year.

Example 1.
Chris, age 53, becomes an eligible individual on December 1, 2007. He has family HDHP coverage on that date. Under the last-month rule, he contributes $5,650 to his HSA.
Chris fails to be an eligible individual in June 2008. Because Chris did not remain an eligible individual during the testing period (December 1, 2007, through December 31, 2008), he must include in his 2008 income the contributions made in 2007 that would not have been made except for the last-month rule. Chris uses the worksheet for line 3 in the Form 8889 instructions to determine this amount.
| January | -0- |
| February | -0- |
| March | -0- |
| April | -0- |
| May | -0- |
| June | -0- |
| July | -0- |
| August | -0- |
| September | -0- |
| October | -0- |
| November | -0- |
| December | $5,650.00 |
| Total for all months | $5,650.00 |
| Limitation. Divide the total by 12 | $470.83 |
Chris would include $5,179.17 ($5,650.00 - $470.83) in his gross income on his 2008 tax return. Also, a 10% additional tax applies to this amount.
Example 2.
Erika, age 39, has self-only HDHP coverage on January 1, 2007. Erika changes to family HDHP coverage on November 1, 2007. Because Erika has family HDHP coverage on December 1, 2007, she contributes $5,650 for 2007.
Erika fails to be an eligible individual in March 2008. Because she did not remain an eligible individual during the testing period (December 1, 2007, through December 31, 2008), she must include in income the contribution made that would not have been made except for the last-month rule. Erika uses the worksheet for line 3 in the Form 8889 instructions to determine this amount.
| January | $2,850.00 |
| February | $2,850.00 |
| March | $2,850.00 |
| April | $2,850.00 |
| May | $2,850.00 |
| June | $2,850.00 |
| July | $2,850.00 |
| August | $2,850.00 |
| September | $2,850.00 |
| October | $2,850.00 |
| November | $5,650.00 |
| December | $5,650.00 |
| Total for all months | $39,800.00 |
| Limitation. Divide the total by 12 | $3,316.67 |
Erika would include $2,333.33 ($5,650 - $3,316.67) in her gross income on her 2008 tax return. Also, a 10% additional tax applies to this amount.



If both spouses are 55 or older and not enrolled in Medicare, each spouse's contribution limit is increased by the additional contribution. If both spouses meet the age requirement, the total contributions under family coverage cannot be more than $7,250.
Example.
For 2007, Mr. Auburn and his wife are both eligible individuals. They each have family coverage under separate HDHPs. Mr. Auburn is 58 years old and Mrs. Auburn is 53. Mr. and Mrs. Auburn can split the family contribution limit ($5,650) equally or they can agree on a different division. If they split it equally, Mr. Auburn can contribute $3,625 to an HSA (one-half the maximum contribution for family coverage ($2,825) + $800 additional contribution) and Mrs. Auburn can contribute $2,825 to an HSA.
Example.
You turned age 65 in July 2007 and enrolled in Medicare. You had an HDHP with self-only coverage and are eligible for an additional contribution of $800. Your contribution limit is $1,825 ($3,650 × 6 ÷ 12 ).
A rollover contribution is not included in your income, is not deductible, and does not reduce your contribution limit.
Note.
If you instruct the trustee of your HSA to transfer funds directly to the trustee of another HSA, the transfer is not considered a rollover. There is no limit on the number of these transfers. Do not include the amount transferred in income, deduct it as a contribution, or include it as a distribution on Form 8889, line 12a.
Contributions made by your employer are not included in your income. Contributions to an employee's account by an employer using the amount of an employee's salary reduction through a cafeteria plan are treated as employer contributions. You can claim contributions you made and contributions made by any other person, other than your employer, on your behalf, as an adjustment to income.
Contributions by a partnership to a bona fide partner's HSA are not contributions by an employer. The contributions are treated as a distribution of money and are not included in the partner's gross income. Contributions by a partnership to a partner's HSA for services rendered are treated as guaranteed payments that are deductible by the partnership and includible in the partner's gross income. In both situations, the partner can deduct the contribution made to the partner's HSA.
Contributions by an S corporation to a 2% shareholder-employee's HSA for services rendered are treated as guaranteed payments and are deductible by the S corporation and includible in the shareholder-employee's gross income. The shareholder-employee can deduct the contribution made to the shareholder-employee's HSA.
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You withdraw the excess contributions by the due date, including extensions, of your tax return for the year the contributions were made.
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You withdraw any income earned on the withdrawn contributions and include the earnings in “Other income” on your tax return for the year you withdraw the contributions and earnings.

You will generally pay medical expenses during the year without being reimbursed by your HDHP until you reach the annual deductible for the plan. When you pay medical expenses during the year that are not reimbursed by your HDHP, you can ask the trustee of your HSA to send you a distribution from your HSA.
You can receive tax-free distributions from your HSA to pay or be reimbursed for qualified medical expenses you incur after you establish the HSA. If you receive distributions for other reasons, the amount you withdraw will be subject to income tax and may be subject to an additional 10% tax. You do not have to make distributions from your HSA each year.

A distribution is money you get from your health savings account. The trustee will report any distribution to you and the IRS on Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA.
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You and your spouse.
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All dependents you claim on your tax return.
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Any person you could have claimed as a dependent on your return except that:
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The person filed a joint return,
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The person had gross income of $3,400 or more, or
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You, or your spouse if filing jointly, could be claimed as a dependent on someone else's 2007 return.
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You engaged in any transaction prohibited by section 4975 with respect to any of your HSAs, at any time in 2007. Your account ceases to be an HSA as of January 1, 2007, and you must include the fair market value of all assets in the account as of January 1, 2007, on Form 8889, line 14a.
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You used any portion of any of your HSAs as security for a loan at any time in 2007. You must include the fair market value of the assets used as security for the loan as income on Form 1040 or Form 1040NR, line 21.

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The distributions were exclusively to pay or reimburse qualified medical expenses,
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The qualified medical expenses had not been previously paid or reimbursed from another source, and
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The medical expenses had not been taken as an itemized deduction in any year.
Do not send these records with your tax return. Keep them with your tax records.
How you report your distributions depends on whether or not you use the distribution for qualified medical expenses (defined earlier).
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If you use a distribution from your HSA for qualified medical expenses, you do not pay tax on the distribution but you have to report the distribution on Form 8889. However, the distribution of an excess contribution taken out after the due date, including extensions, of your return is subject to tax even if used for qualified medical expenses. Follow the instructions for the form and file it with your Form 1040 or Form 1040NR.
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If you do not use a distribution from your HSA for qualified medical expenses, you must pay tax on the distribution. Report the amount on Form 8889 and file it with your Form 1040 or Form 1040NR. If you have a taxable HSA distribution, include it in the total on Form 1040 or Form 1040NR, line 21, and enter “HSA” and the amount on the dotted line next to line 21. You may have to pay an additional 10% tax on your taxable distribution.
An HSA is generally exempt from tax. You are permitted to take a distribution from your HSA at any time; however, only those amounts used exclusively to pay for qualified medical expenses are tax free. Amounts that remain at the end of the year are generally carried over to the next year (see Excess contributions, earlier). Earnings on amounts in an HSA are not included in your income while held in the HSA.
You should choose a beneficiary when you set up your HSA. What happens to that HSA when you die depends on whom you designate as the beneficiary.
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The account stops being an HSA, and
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The fair market value of the HSA becomes taxable to the beneficiary in the year in which you die.

You must file Form 8889 with your Form 1040 or Form 1040NR if you (or your spouse, if married filing a joint return) had any activity in your HSA during the year. You must file the form even if only your employer or your spouse's employer made contributions to the HSA.
This section contains the rules that employers must follow if they decide to make HSAs available to their employees. Unlike the previous discussions, “you” refers to the employer and not to the employee.
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The same amount, or
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The same percentage of the annual deductible limit under the HDHP covering the employees.
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Are covered by your HDHP and are eligible to establish an HSA,
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Have the same category of coverage (either self-only or family coverage), and
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Have the same category of employment (part-time, full-time, or former employees).
Note.
For purposes of making contributions to HSAs of non-highly compensated employees, highly compensated employees shall not be treated as comparable participating employees.
Archer MSAs were created to help self-employed individuals and employees of certain small employers meet the medical care costs of the account holder, the account holder's spouse, or the account holder's dependent(s).
A Medicare Advantage MSA is an Archer MSA designated by Medicare to be used solely to pay the qualified medical expenses of the account holder who is eligible for Medicare.
An Archer MSA is a tax-exempt trust or custodial account that you set up with a U.S. financial institution (such as a bank or an insurance company) in which you can save money exclusively for future medical expenses.
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You can claim a tax deduction for contributions you make even if you do not itemize your deductions on Form 1040 or Form 1040NR.
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The interest or other earnings on the assets in your Archer MSA are tax free.
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Distributions may be tax free if you pay qualified medical expenses. See Qualified medical expenses, later.
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The contributions remain in your Archer MSA from year to year until you use them.
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An Archer MSA is “portable” so it stays with you if you change employers or leave the work force.
To qualify for an Archer MSA, you must be either of the following.
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An employee (or the spouse of an employee) of a small employer (defined later) that maintains a self-only or family HDHP for you (or your spouse).
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A self-employed person (or the spouse of a self-employed person) who maintains a self-only or family HDHP.
You can have no other health or Medicare coverage except what is permitted under Other health coverage, later. You must be an eligible individual on the first day of a given month to get an Archer MSA deduction for that month.

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Had 50 or fewer employees when the Archer MSAs began,
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Made a contribution that was excludable or deductible as an Archer MSA for the last year he or she had 50 or fewer employees, and
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Had an average of 200 or fewer employees each year after 1996.
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A higher annual deductible than typical health plans, and
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A maximum limit on the annual out-of-pocket medical expenses that you must pay for covered expenses.
| Type of Coverage | Minimum
Annual Deductible |
Maximum
Annual Deductible |
Maximum
Annual Out-of-Pocket Expenses |
| Self-only | $1,900 | $2,850 | $3,750 |
| Family | $3,750 | $5,650 | $6,900 |







