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

File this form to report distributions made from a:

  • health savings account (HSA),
  • Archer Medical Savings Account (Archer MSA), or
  • Medicare Advantage Medical Savings Account (MA MSA).

The distribution may have been paid directly to a medical service provider or to the account holder. A separate return must be filed for each plan type.


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Page Last Reviewed or Updated: 30-Oct-2014