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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.


Current Products

Form 1099-SA

Instructions for Form 1099-SA and 5498-SA (HTML)

General Instructions for Certain Information Returns (Forms 1097, 1098, 1099, 3921, 3922, 5498, and W-2G)


Other Items You May Find Useful:

All Form 1099-SA Revisions

Publication 542, Corporations

Form 5498-SA, HSA, Archer MSA, or Medicare Advantage MSA Information

Form 8851, Summary of Archer MSAs

Form 8853, Archer MSAs and Long-Term Care Insurance Contracts

Form 8889, Health Savings Accounts (HSAs)

Online Ordering for Information Returns and Employer Returns

Other Current Products


Comment on Form 1099-SA

Use the Comment on Tax Forms and Publications  web form to provide feedback on the content of this product. Although we cannot respond individually to each comment, we do appreciate your feedback and will consider all comments submitted.

CAUTION: We cannot respond to tax-related questions submitted using this page. Instead, please visit Tax Law Questions or call our toll-free number at 1-800-829-1040 (Individuals) or 1-800-829-4933 (Business).

Information reporting customer service site. If you have questions about reporting on forms 1096, 1097, 1098, 1099, 3921, 3922, 5498, W-2, W-2C, W-2G, W-3 and W-3C, you may call 1-866-455-7438 (toll-free) or 304-263-8700 (not toll free). Persons with a hearing or speech disability with access to TTY/TDD equipment can call 304-579-4827 (not toll free).

Page Last Reviewed or Updated: 05-Dec-2013