Line 3 Limitation Chart and Worksheet

Line 3 Limitation Chart and Worksheet

Summary: This flowchart is used to determine the amount of deductible limitation for each month. After calculating the amount for each month in 2023, enter the amount on the line for that month in the worksheet, add them all together and divide by 12 to receive the limitation amount to be entered on line 3 of Form 8889.

Start

This is the starting of the flowchart.

Decision (1)

Were you enrolled in Medicare for the month?

IF Yes Continue To Process (a)
IF No Continue To Decision (2)

Process (a)

Enter 0 on the line below for the month.

Continue To End

Decision (2)

Were you an eligible individual (see page 1 of the instructions) on the first day of the month?

IF Yes Continue To Decision (3)
IF No Continue To Process (a)

Decision (3)

What type of coverage did your High Deductible Health Plan provide on the first day of the month (see the instructions for items (1) through (3) on this page)?

IF Self-only coverage Continue To Process (b)
IF Family coverage Continue To Process (c)

Process (b)

Enter $3,850 on the line below for the month. If you were age 55 or older at the end of 2023, enter $4,850 for the month.

Continue To End

Process (c)

Enter $7,750 on the line below for the month. If, at the end of 2023, you were unmarried and age 55 or older, enter $8,750 for the month.

Continue To End

End

This is the ending of the flowchart.