Use Form 8853 to: Report Archer MSA contributions (including employer contributions. Figure your Archer MSA deduction. Report distributions from Archer MSAs or Medicare Advantage MSAs. Report taxable payments from long-term care (LTC) insurance contracts. Report taxable accelerated death benefits from a life insurance policy. Current revision Form 8853 PDF Instructions for Form 8853 (Print Version PDF) Recent developments None at this time. Other items you may find useful All Form 8853 Revisions About Publication 502, Medical and Dental Expenses About Publication 590-A, Contributions to Individual Retirement Arrangements (IRAs) About Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans Other Current Products Related About Form 1040, U.S. Individual Income Tax Return About Form 1040-NR, U.S. Nonresident Alien Income Tax Return About Form 1099-LTC, Long Term Care and Accelerated Death Benefits About Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA About Form 5329, Additional Taxes on Qualified Plans (including IRAs) and Other Tax-Favored Accounts About Form W-2, Wage and Tax Statement
