IRS Form 1099-SA

2025 Printable Template

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Form last updated: 03/2024. Please verify this is the current version before use.

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What is a 1099-SA used for?

Form 1099-SA is used to report distributions from health savings accounts (HSAs), Archer medical savings accounts (MSAs), and Medicare Advantage MSAs. It is issued by financial institutions to account holders to report withdrawals and ensure accurate tax reporting.

Who needs to fill out a 1099-SA form

Financial institutions managing HSAs, Archer MSAs, and Medicare Advantage MSAs must complete this form for account holders.

How to fill out a 1099-SA online?

Follow these steps to complete your 1099-SA form online.

Step 1
Step 1
Identify the type of distribution: HSA, Archer MSA, or Medicare Advantage MSA.
Step 2
Step 2
Enter the total distribution amount in Box 1.
Step 3
Step 3
If applicable, report earnings on excess contributions in Box 2.
Step 4
Step 4
Fill in Box 3 with the distribution code to indicate the type of withdrawal.
Step 5
Step 5
Provide details for the account holder and financial institution.
Step 6
Step 6
If necessary, report fair market value for inherited accounts in Box 4.
Step 7
Step 7
Confirm the account type in Box 5.
IRS Form 1099-SA Instructions

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Frequently Asked Questions

Find quick answers to common questions about our PDF editor.

It is a tax form that reports distributions from health savings accounts and similar accounts.

The form must be provided to recipients by January 31 and filed with the IRS by the applicable deadline.

You should correct the form and provide the corrected version to the recipient and the IRS.

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