Department of the Treasury

Internal Revenue Service

Publication 969

Cat. No. 24216S

Health Savings 

Accounts

and Other 

Tax-Favored 

Health Plans

For use in preparing

2023 Returns

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Future Developments

Go to IRS.gov/Pub969 for the latest information about 

Pub. 969.

What’s New

Notice 2023-37 addresses the announced end of the 

COVID-19 public health emergency and the National 

Emergency Concerning the Novel Coronavirus Disease 

2019 Pandemic on May 11, 2023; it modifies prior guidance regarding benefits relating to testing for and treatment of COVID-19 that can be provided by a health plan 

that otherwise satisfies the requirements to be a high deductible health plan (HDHP) under section 223(c)(2)(A) of 

the Internal Revenue Code (Code). Specifically, the relief 

described in Notice 2020-15, 2020-14 IRB 559, applies 

only with respect to plan years ending on or before December 31, 2024.

Notice 2023-37 also clarifies whether certain items and 

services are treated as preventive care under section 

223(c)(2)(C). Specifically, the preventive care safe harbor 

as described in Notice 2004-23, 2004-15 IRB 725, does 

not include screening (for example, testing) for COVID-19, 

effective as of July 24, 2023. Notice 2023-37 also provides that items and services recommended with an “A” or 

“B” rating by the United States Preventive Services Task 

Force on or after March 23, 2010, are treated as preventive care for purposes of section 223(c)(2)(C), regardless 

of whether these items and services must be covered, 

without cost sharing, under Public Health Service Act section 2713.

For more information on Notice 2023-37, 2023-30 

I.R.B. 359, see IRS.gov/irb/2023-30_IRB#NOT-2023-37.

Reminders

Telehealth and other remote care services. Public 

Law 117-328, December 29, 2022, amended section 223 

to provide that an HDHP may have a $0 deductible for telehealth and other remote care services for plan years beginning before 2022; months beginning after March 2022 

and before 2023; and plan years beginning after 2022 and 

before 2025. Also, an “eligible individual” remains eligible 

to make contributions to its Health Savings Account (HSA) 

even if the individual has coverage outside of the HDHP 

during these periods for telehealth and other remote care 

services.

Health Flexible Spending Arrangement (FSA) contribution and carryover for 2023. Revenue Procedure 

2022-38, October 18, 2022, provides that for tax years beginning in 2023, the dollar limitation under section 125(i) 

on voluntary employee salary reductions for contributions 

to health flexible spending arrangements is $3,050. If the 

cafeteria plan permits the carryover of unused amounts, 

the maximum carryover amount is $610.

Jan 5, 2024
Insulin products. Public Law 117-169, August 16, 2022, 

amended section 223 to provide that an HDHP may have 

a $0 deductible for selected insulin products. The amendment applies to plan years beginning after 2022.

Health FSA contribution and carryover for 2022. Revenue Procedure 2021-45, November 10, 2021, provides 

that for tax years beginning in 2022, the dollar limitation 

under section 125(i) on voluntary employee salary reductions for contributions to health flexible spending arrangements is $2,850. If the cafeteria plan permits the carryover 

of unused amounts, the maximum carryover amount is 

$570.

Home testing for COVID-19 and personal protective 

equipment for preventing spread of COVID-19. News 

Release IR-2021-181, September 10, 2021, reminds that 

the cost of home testing for COVID-19 and the costs of 

personal protective equipment, such as masks, hand sanitizer and sanitizing wipes, for the primary purpose of preventing the spread of COVID-19 are eligible medical expenses that can be paid or reimbursed under health 

FSAs, HSAs, Health Reimbursement Arrangements 

(HRAs), or Archer Medical Savings Accounts (MSAs).

Surprise billing for emergency services or air ambulance services. Public Law 116-260, December 27, 

2020, amended section 223 to provide that an HDHP may 

provide benefits under federal and state anti-“surprise billing” laws with a $0 deductible. Also, an “eligible individual” 

remains eligible to make contributions to its HSA even if 

the individual receives anti-“surprise billing” benefits outside of the HDHP. The amendment applies to plan years 

beginning after 2021.

Note. Anti-“surprise billing” laws generally protect individuals from “surprise billing” for items like emergency 

medical services, some non-emergency medical services, 

and air ambulance services.

Ask your insurance provider whether your HDHP 

and any other coverage meet the requirements of 

section 223.

Ask your HSA trustee whether the HSA and 

trustee meet the requirements of section 223.

The Coronavirus Aid, Relief, and Economic Security 

Act (CARES Act, P.L. 116-136, March 27, 2020) made the 

following changes.

HSA. 

• Over-the-counter medicine (whether or not prescribed) and menstrual care products are treated as medical care for amounts paid after 2019.

Archer MSA. 

• Over-the-counter medicine (whether or not prescribed) and menstrual care products are treated as medical care for amounts paid after 2019.

Health FSA. 

• Over-the-counter medicine (whether or not prescribed) and menstrual care products are treated as medical care for amounts incurred after 2019.

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HRA. 

• Over-the-counter medicine (whether or not prescribed) and menstrual care products are treated as medical care for amounts incurred after 2019.

The IRS will provide any further updates as soon as 

they are available at IRS.gov/Coronavirus.

See also Notice 2020-29, 2020-22 I.R.B. 864, and 

Notice 2020-33, 2020-22 I.R.B. 868, available at 

IRS.gov/pub/irs-irbs/irb20-22.pdf, for additional 

information.

Affordable Care Act guidance. Notice 2013-54, 

2013-40 I.R.B. 287, available at IRS.gov/irb/2013-40_IRB/

ar11.html, as supplemented by Notice 2015-87, provides 

guidance for employers on the application of the Affordable Care Act (ACA) to FSAs and Health Reimbursement 

Arrangements (HRAs).

For more information on the ACA, go to IRS.gov/

Affordable-Care-Act.

Photographs of missing children. The Internal Revenue Service is a proud partner with the National Center for 

Missing & Exploited Children® (NCMEC). Photographs of 

missing children selected by the Center may appear in 

this publication on pages that would otherwise be blank. 

You can help bring these children home by looking at the 

photographs and calling 800-THE-LOST (800-843-5678) 

if you recognize a child.

Introduction

Various programs are designed to give individuals tax advantages to offset health care costs. This publication explains the following programs.

• Health Savings Accounts (HSAs).

• Medical Savings Accounts (Archer MSAs and Medicare Advantage MSAs).

• Health Flexible Spending Arrangements (FSAs).

• Health Reimbursement Arrangements (HRAs).

An HSA may receive contributions from an eligible individual or any other person, including an employer or a 

family member, on behalf of an eligible individual. Contributions, other than employer contributions, are deductible 

on the eligible individual’s return whether or not the individual itemizes deductions. Employer contributions aren’t 

included in income. Distributions from an HSA that are 

used to pay qualified medical expenses aren’t taxed.

An Archer MSA may receive contributions from an eligible individual and the eligible individual’s employer, but 

not both in the same year. Contributions by the individual 

are deductible whether or not the individual itemizes deductions. Employer contributions aren’t included in income. Distributions from an Archer MSA that are used to 

pay qualified medical expenses aren’t taxed.

A Medicare Advantage MSA is an Archer MSA designated by Medicare to be used solely to pay the qualified 

medical expenses of the account holder who is enrolled in 

Medicare. Contributions can be made only by Medicare. 

2 Publication 969 (2023)
The contributions aren’t included in your income. Distributions from a Medicare Advantage MSA that are used to 

pay qualified medical expenses aren’t taxed.

A health FSA may receive contributions from an eligible 

individual. Employers may also contribute. Contributions 

aren’t includible in income. Reimbursements from an FSA 

that are used to pay qualified medical expenses aren’t 

taxed.

An HRA must receive contributions from the employer 

only. Employees may not contribute. Contributions aren’t 

includible in income. Reimbursements from an HRA that 

are used to pay qualified medical expenses aren’t taxed.

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Health Savings Accounts 

(HSAs)

An HSA is a tax-exempt trust or custodial account you set 

up with a qualified HSA trustee to pay or reimburse certain 

medical expenses you incur. You must be an eligible individual to contribute to an HSA.

No permission or authorization from the IRS is necessary to establish an HSA. You set up an HSA with a 

trustee. A qualified HSA trustee can be a bank, an insurance company, or anyone already approved by the IRS to 

be a trustee of individual retirement arrangements (IRAs) 

or Archer MSAs. The HSA can be established through a 

trustee that is different from your health plan provider.

Your employer may already have some information on 

HSA trustees in your area.

If you have an Archer MSA, you can generally roll 

it over into an HSA tax free. See Rollovers, later.

What are the benefits of an HSA? You may enjoy several benefits from having an HSA.

• You can claim a tax deduction for contributions you, or 

someone other than your employer, make to your HSA 

even if you don’t itemize your deductions on Schedule A (Form 1040).

• Contributions to your HSA made by your employer (including contributions made through a cafeteria plan) 

may be excluded from your gross income.

• The contributions remain in your account until you use 

them.

• The interest or other earnings on the assets in the account are tax free.

• Distributions may be tax free if you pay qualified medical expenses. See Qualified medical expenses, later.

• An HSA is “portable.” It stays with you if you change 

employers or leave the work force.

Qualifying for an HSA Contribution

To be an eligible individual and qualify for an HSA contribution, you must meet the following requirements.

• You are covered under a high deductible health plan 

(HDHP), described later, on the first day of the month.

• You have no other health coverage except what is permitted under Other health coverage, later.

• You aren’t enrolled in Medicare.

• You can’t be claimed as a dependent on someone 

else’s 2023 tax return.

Under the last-month rule, you are considered to 

be an eligible individual for the entire year if you 

are an eligible individual on the first day of the last 

month of your tax year (December 1 for most taxpayers) 

and you meet certain other requirements.

If you meet these requirements, you are an eligible individual even if your spouse has non-HDHP family coverage, provided your spouse’s coverage doesn’t cover you.

Also, you may be an eligible individual even if you receive hospital care or medical services under any law administered by the Secretary of Veterans Affairs for a service-connected disability.

If another taxpayer is entitled to claim you as a dependent, you can’t claim a deduction for an HSA 

contribution. This is true even if the other person 

doesn’t receive an exemption deduction for you because 

the exemption amount is zero for tax years 2018 through 

2025.

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Publication 969 (2023) 3
Each spouse who is an eligible individual who 

wants an HSA must open a separate HSA. You 

can’t have a joint HSA.

High deductible health plan (HDHP). An HDHP has:

• A higher annual deductible than typical health plans, 

and

• A maximum limit on the sum of the annual deductible 

and out-of-pocket medical expenses that you must 

pay for covered expenses. Out-of-pocket expenses include copayments and other amounts, but don’t include premiums.

An HDHP may provide preventive care benefits without 

a deductible or with a deductible less than the minimum 

annual deductible. Preventive care includes, but isn’t limited to, the following.

1. Periodic health evaluations, including tests and diagnostic procedures ordered in connection with routine 

examinations, such as annual physicals.

2. Routine prenatal and well-child care.

3. Child and adult immunizations.

4. Tobacco cessation programs.

5. Obesity weight-loss programs.

6. Screening services. This includes screening services 

for the following.

a. Cancer.

b. Heart and vascular diseases.

c. Infectious diseases.

d. Mental health conditions.

e. Substance abuse.

f. Metabolic, nutritional, and endocrine conditions.

g. Musculoskeletal disorders.

h. Obstetric and gynecological conditions.

i. Pediatric conditions.

j. Vision and hearing disorders.

For more information on screening services, see 

Notice 2004-23, 2004-15 I.R.B. 725, available at 

IRS.gov/irb/2004-15_IRB#NOT-2004-23.

For additional guidance on preventive care, see 

Notice 2004-50, 2004-2 C.B. 196, Q&A 26 and 27, 

available at IRS.gov/irb/2004-33_IRB#NOT-2004-50; 

and Notice 2013-57, 2013-40 I.R.B. 293, available at 

IRS.gov/pub/irs-drop/n-13-57.pdf. Preventive care 

can also include coverage for treatment of individuals 

with certain chronic conditions listed in the Appendix 

of Notice 2019-45, 2019-32 I.R.B. 593, if such services were received or items were incurred on or after 

July 17, 2019. For information on preventive care for 

chronic conditions, see Notice 2019-45, 2019-32 

I.R.B. 593, available at IRS.gov/pub/irs-drop/

n-19-45.pdf.

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The following table shows the minimum annual deductible and maximum annual deductible and other 

out-of-pocket expenses for HDHPs for 2023.

Self-only coverage Family coverage

Minimum annual 

deductible $1,500 $3,000

Maximum annual 

deductible and other 

out-of-pocket 

expenses* $7,500 $15,000

* This limit doesn’t apply to deductibles and expenses for out-of-network 

services if the plan uses a network of providers. Instead, only deductibles 

and out-of-pocket expenses for services within the network should be used 

to figure whether the limit applies.

The following table shows the minimum annual 

deductible and maximum annual deductible and 

other out-of-pocket expenses for HDHPs for 

2024.

Self-only coverage Family coverage

Minimum annual 

deductible $1,600 $3,200

Maximum annual 

deductible and other 

out-of-pocket 

expenses* $8,050 $16,100

* This limit doesn’t apply to deductibles and expenses for out-of-network 

services if the plan uses a network of providers. Instead, only deductibles 

and out-of-pocket expenses for services within the network should be used 

to figure whether the limit applies.

Self-only HDHP coverage is HDHP coverage for only 

an eligible individual. Family HDHP coverage is HDHP 

coverage for an eligible individual and at least one other 

individual (whether or not that individual is an eligible individual).

Example. You, an eligible individual, and your dependent child are covered under an “employee plus one” 

HDHP offered by your employer. This is family HDHP coverage.

Family plans that don’t meet the high deductible 

rules. There are some family plans that have deductibles 

for both the family as a whole and for individual family 

members. Under these plans, if you meet the individual 

deductible for one family member, you don’t have to meet 

the higher annual deductible amount for the family. If either the deductible for the family as a whole or the deductible for an individual family member is less than the minimum annual deductible for family coverage, the plan 

doesn’t qualify as an HDHP.

Other health coverage. If you (and your spouse, if 

you have family coverage) have HDHP coverage, you 

can’t generally have any other health coverage. However, 

you can still be an eligible individual even if your spouse 

has non-HDHP coverage, provided you aren’t covered by 

that plan.

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You can have additional insurance that provides benefits only for the following items.

• Liabilities incurred under workers’ compensation laws, 

tort liabilities, or liabilities related to ownership or use 

of property.

• A specific disease or illness.

• A fixed amount per day (or other period) of hospitalization.

You can also have coverage (whether provided through 

insurance or otherwise) for the following items.

• Accidents.

• Disability.

• Dental care.

• Vision care.

• Long-term care.

• Telehealth and other remote care.

Plans in which substantially all of the coverage is 

through the items listed earlier aren’t HDHPs. For 

example, if your plan provides coverage substantially all of which is for a specific disease or illness, the 

plan isn’t an HDHP for purposes of establishing an HSA.

Prescription drug plans. You can have a prescription drug plan, either as part of your HDHP or a separate 

plan (or rider), and qualify as an eligible individual if the 

plan doesn’t provide benefits until the minimum annual deductible of the HDHP has been met. If you can receive 

benefits before that deductible is met, you aren’t an eligible individual.

Other employee health plans. An employee covered by an HDHP and a health FSA or an HRA that pays 

or reimburses qualified medical expenses can’t generally 

make contributions to an HSA. FSAs and HRAs are discussed later.

However, an employee can make contributions to an 

HSA while covered under an HDHP and one or more of 

the following arrangements.

• Limited-purpose health FSA or HRA. These arrangements can pay or reimburse the items listed earlier under Other health coverage except long-term care. 

Also, these arrangements can pay or reimburse preventive care expenses because they can be paid without having to satisfy the deductible.

• Suspended HRA. Before the beginning of an HRA 

coverage period, you can elect to suspend the HRA. 

The HRA doesn’t pay or reimburse, at any time, the 

medical expenses incurred during the suspension period except preventive care and items listed under 

Other health coverage, earlier. When the suspension 

period ends, you are no longer eligible to make contributions to an HSA.

• Post-deductible health FSA or HRA. These arrangements don’t pay or reimburse any medical expenses 

incurred before the minimum annual deductible 

amount is met. The deductible for these arrangements 

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doesn’t have to be the same as the deductible for the 

HDHP, but benefits may not be provided before the 

minimum annual deductible amount is met.

• Retirement HRA. This arrangement pays or reimburses only those medical expenses incurred after retirement. After retirement, you are no longer eligible to 

make contributions to an HSA.

Health FSA—grace period. Coverage during a grace 

period by a general purpose health FSA is allowed if the 

balance in the health FSA at the end of its prior year plan 

is zero. See Flexible Spending Arrangements (FSAs), 

later.

Contributions to an HSA

Any eligible individual can contribute to an HSA. For an 

employee’s HSA, the employee, the employee’s employer, 

or both may contribute to the employee’s HSA in the same 

year. For an HSA established by a self-employed (or unemployed) individual, the individual can contribute. Family 

members or any other person may also make contributions on behalf of an eligible individual.

Contributions to an HSA must be made in cash. Contributions of stock or property aren’t allowed.

Limit on Contributions

The amount you or any other person can contribute to 

your HSA depends on the type of HDHP coverage you 

have, your age, the date you become an eligible individual, and the date you cease to be an eligible individual. 

For 2023, if you have self-only HDHP coverage, you can 

contribute up to $3,850. If you have family HDHP coverage, you can contribute up to $7,750.

For 2024, if you have self-only HDHP coverage, 

you can contribute up to $4,150. If you have family 

HDHP coverage, you can contribute up to $8,300.

If you are, or were considered (under the last-month 

rule, discussed later), an eligible individual for the entire 

year and didn’t change your type of coverage, you can 

contribute the full amount based on your type of coverage. 

However, if you weren’t an eligible individual for the entire 

year or changed your coverage during the year, your contribution limit is the greater of:

1. The limitation shown on the Line 3 Limitation Chart 

and Worksheet in the Instructions for Form 8889, 

Health Savings Accounts (HSAs); or

2. The maximum annual HSA contribution based on 

your HDHP coverage (self-only or family) on the first 

day of the last month of your tax year.

If you had family HDHP coverage on the first day 

of the last month of your tax year, your contribution limit for 2023 is $7,750 even if you changed 

coverage during the year.

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Last-month rule. Under the last-month rule, if you are an 

eligible individual on the first day of the last month of your 

tax year (December 1 for most taxpayers), you are considered an eligible individual for the entire year. You are treated as having the same HDHP coverage for the entire year 

as you had on the first day of the last month if you didn’t 

otherwise have coverage.

Testing period. If contributions were made to your 

HSA based on you being an eligible individual for the entire year under the last-month rule, you must remain an eligible individual during the testing period. For the 

last-month rule, the testing period begins with the last 

month of your tax year and ends on the last day of the 

12th month following that month (for example, December 

1, 2023, through December 31, 2024).

If you fail to remain an eligible individual during the testing period, for reasons other than death or becoming disabled, you will have to include in income the total contributions made to your HSA that wouldn’t have been made 

except for the last-month rule. You include this amount in 

your income in the year in which you fail to be an eligible 

individual. This amount is also subject to a 10% additional 

tax. The income and additional tax are calculated on Form 

8889, Part III.

Example 1. You, age 53, become an eligible individual on December 1, 2023. You have family HDHP coverage on that date. Under the last-month rule, you contribute 

$7,750 to your HSA.

You fail to be an eligible individual in June 2024. Because you didn’t remain an eligible individual during the 

testing period (December 1, 2023, through December 31, 

2024), you must include in your 2024 income the contributions made in 2023 that wouldn’t have been made except 

for the last-month rule. You use the worksheet in the Form 

8889 instructions to determine this amount.

January ................ -0-

February ................ -0-

March .................. -0-

April ................... -0-

May ................... -0-

June .................. -0-

July ................... -0-

August ................. -0-

September .............. -0-

October ................ -0-

November ............... -0-

December ............... $7,750.00

Total for all months ........ $7,750.00

Limitation. Divide the total by 12 $645.83

You would include $7,104.17 ($7,750.00 − $645.83) in 

your gross income on your 2024 tax return. Also, a 10% 

additional tax applies to this amount.

Example 2. You, age 39, have self-only HDHP coverage on January 1, 2023. You change to family HDHP coverage on November 1, 2023. Because you have family 

HDHP coverage on December 1, 2023, you contribute 

$7,750 for 2023.

You fail to be an eligible individual in March 2024. Because you didn’t remain an eligible individual during the 

testing period (December 1, 2023, through December 31, 

2024), you must include in income the contribution made 

that wouldn’t have been made except for the last-month 

rule. You use the worksheet in the Form 8889 instructions 

to determine this amount.

January ................ $3,850.00

February ................ $3,850.00

March .................. $3,850.00

April ................... $3,850.00

May ................... $3,850.00

June .................. $3,850.00

July ................... $3,850.00

August ................. $3,850.00

September .............. $3,850.00

October ................ $3,850.00

November ............... $7,750.00

December ............... $7,750.00

Total for all months ........ $54,000.00

Limitation. Divide the total by 12 $4,500.00

You would include $3,250.00 ($7,750.00 − $4,500.00) in 

your gross income on your 2024 tax return. Also, a 10% 

additional tax applies to this amount.

Additional contribution. If you are an eligible individual 

who is age 55 or older at the end of your tax year, your 

contribution limit is increased by $1,000. For example, if 

you have self-only coverage, you can contribute up to 

$4,850 (the contribution limit for self-only coverage 

($3,850) plus the additional contribution of $1,000). However, see Enrolled in Medicare, later.

If you have more than one HSA in 2023, your total 

contributions to all the HSAs can’t be more than 

the limits discussed earlier.

Reduction of contribution limit. You must reduce the 

amount that can be contributed (including any additional 

contribution) to your HSA by the amount of any contribution made to your Archer MSA (including employer contributions) for the year. A special rule applies to married people, discussed next, if each spouse has family coverage 

under an HDHP.

Rules for married people. If either spouse has family 

HDHP coverage, both spouses are treated as having family HDHP coverage. If each spouse has family coverage 

under a separate plan, the contribution limit for 2023 is 

$7,750. You must reduce the limit on contributions, before 

taking into account any additional contributions, by the 

amount contributed to both spouses’ Archer MSAs. After 

that reduction, the contribution limit is split equally between the spouses unless you agree on a different division.

The rules for married people apply only if both 

spouses are eligible individuals.

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6 Publication 969 (2023)
If both spouses are 55 or older and not enrolled in Medicare, each spouse’s contribution limit is increased by the 

additional contribution. If both spouses meet the age requirement, the total contributions under family coverage 

can’t be more than $9,750. Each spouse must make the 

additional contribution to its own HSA.

Example. For 2023, you and your spouse are both eligible individuals. You each have family coverage under 

separate HDHPs. You are 58 years old and your spouse is 

53. You and your spouse can split the family contribution 

limit ($7,750) equally or you can agree on a different division. If you split it equally, you can contribute $4,875 to an 

HSA (one-half the maximum contribution for family coverage ($3,875) + $1,000 additional contribution) and your 

spouse can contribute $3,875 to an HSA.

Employer contributions. You must reduce the 

amount you, or any other person, can contribute to your 

HSA by the amount of any contributions made by your employer that are excludable from your income. This includes 

amounts contributed to your account by your employer 

through a cafeteria plan.

Enrolled in Medicare. Beginning with the first month 

you are enrolled in Medicare, your contribution limit is 

zero. This rule applies to periods of retroactive Medicare 

coverage. So, if you delayed applying for Medicare and 

later your enrollment is backdated, any contributions to 

your HSA made during the period of retroactive coverage 

are considered excess. See Excess contributions, later.

Example. You turned age 65 in July 2023 and enrolled in Medicare. You had an HDHP with self-only coverage 

and are eligible for an additional contribution of $1,000. 

Your contribution limit is $2,425 ($4,850 × 6 ÷ 12).

Qualified HSA funding distribution. A qualified HSA 

funding distribution may be made from your traditional IRA 

or Roth IRA to your HSA. This distribution can’t be made 

from an ongoing SEP IRA or SIMPLE IRA. For this purpose, a SEP IRA or SIMPLE IRA is ongoing if an employer 

contribution is made for the plan year ending with or within 

the tax year in which the distribution would be made.

The maximum qualified HSA funding distribution depends on the HDHP coverage (self-only or family) you 

have on the first day of the month in which the contribution 

is made and your age as of the end of the tax year. The 

distribution must be made directly by the trustee of the 

IRA to the trustee of the HSA. The distribution isn’t included in your income, isn’t deductible, and reduces the 

amount that can be contributed to your HSA. The qualified 

HSA funding distribution is shown on Form 8889 for the 

year in which the distribution is made.

You can generally make only one qualified HSA funding 

distribution during your lifetime. However, if you make a 

distribution during a month when you have self-only HDHP 

coverage, you can make another qualified HSA funding 

distribution in a later month in that tax year if you change 

to family HDHP coverage. The total qualified HSA funding 

distribution can’t be more than the contribution limit for 

family HDHP coverage plus any additional contribution to 

which you are entitled.

Example. In 2023, you are an eligible individual, age 

57, with self-only HDHP coverage. You can make a qualified HSA funding distribution of $4,850 ($3,850 plus 

$1,000 additional contribution).

Funding distribution—testing period. You must remain an eligible individual during the testing period. For a 

qualified HSA funding distribution, the testing period begins with the month in which the qualified HSA funding 

distribution is contributed and ends on the last day of the 

12th month following that month. For example, if a qualified HSA funding distribution is contributed to your HSA 

on August 10, 2023, your testing period begins in August 

2023, and ends on August 31, 2024.

If you fail to remain an eligible individual during the testing period, for reasons other than death or becoming disabled, you will have to include in income the qualified HSA 

funding distribution. You include this amount in income in 

the year in which you fail to be an eligible individual. This 

amount is also subject to a 10% additional tax. The income and the additional tax are calculated on Form 8889, 

Part III.

Each qualified HSA funding distribution allowed has its 

own testing period. For example, you are an eligible individual, age 45, with self-only HDHP coverage. On June 

18, 2023, you make a qualified HSA funding distribution. 

On July 27, 2023, you enroll in family HDHP coverage and 

on August 17, 2023, you make a qualified HSA funding 

distribution. Your testing period for the first distribution begins in June 2023 and ends on June 30, 2024. Your testing period for the second distribution begins in August 

2023 and ends on August 31, 2024.

The testing period rule that applies under the 

last-month rule (discussed earlier) doesn’t apply to 

amounts contributed to an HSA through a qualified HSA 

funding distribution. If you remain an eligible individual 

during the entire funding distribution testing period, then 

no amount of that distribution is included in income and 

won’t be subject to the additional tax for failing to meet the 

last-month rule testing period.

Rollovers

A rollover contribution isn’t included in your income, isn’t 

deductible, and doesn’t reduce your contribution limit.

Archer MSAs and other HSAs. You can roll over 

amounts from Archer MSAs and other HSAs into an HSA. 

You don’t have to be an eligible individual to make a rollover contribution from your existing HSA to a new HSA. 

Rollover contributions don’t need to be in cash. Rollovers 

aren’t subject to the annual contribution limits.

You must roll over the amount within 60 days after the 

date of receipt. You can make only one rollover contribution to an HSA during a 1-year period.

Note. If you instruct the trustee of your HSA to transfer 

funds directly to the trustee of another of your HSAs, the 

transfer isn’t considered a rollover. There is no limit on the 

number of these transfers. Don’t include the amount transferred in income, deduct it as a contribution, or include it 

as a distribution on Form 8889.

Publication 969 (2023) 7
When To Contribute

You can make contributions to your HSA for 2023 through 

April 15, 2024. If you fail to be an eligible individual during 

2023, you can still make contributions through April 15, 

2024, for the months you were an eligible individual.

Your employer can make contributions to your HSA 

from January 1, 2024, through April 15, 2024, that are allocated to 2023. Your employer must notify you and the 

trustee of your HSA that the contribution is for 2023. The 

contribution will be reported on your 2024 Form W-2, 

Wage and Tax Statement.

Reporting Contributions on Your Return

Contributions made by your employer aren’t included in 

your income. Contributions to an employee’s account by 

an employer using the amount of an employee’s salary reduction through a cafeteria plan are treated as employer 

contributions. Generally, you can claim contributions you 

made and contributions made by any other person, other 

than your employer, on your behalf, as a deduction.

Contributions by a partnership to a bona fide partner’s 

HSA aren’t contributions by an employer. The contributions are treated as a distribution of money and aren’t included in the partner’s gross income. Contributions by a 

partnership to a partner’s HSA for services rendered are 

treated as guaranteed payments that are deductible by 

the partnership and includible in the partner’s gross income. In both situations, the partner can deduct the contribution made to the partner’s HSA.

Contributions by an S corporation to a 2% shareholder-employee’s HSA for services rendered are treated 

as guaranteed payments and are deductible by the S corporation and includible in the shareholder-employee’s 

gross income. The shareholder-employee can deduct the 

contribution made to the shareholder-employee’s HSA.

Form 8889. Report all contributions to your HSA on 

Form 8889 and file it with your Form 1040, 1040-SR, or 

1040-NR. You should include all contributions made for 

2023, including those made from January 1, 2024, 

through April 15, 2024, that are designated for 2023. Contributions made by your employer and qualified HSA funding distributions are also shown on the form.

You should receive Form 5498-SA, HSA, Archer MSA, 

or Medicare Advantage MSA Information, from the trustee 

showing the amount contributed to your HSA during the 

year. Your employer’s contributions will also be shown on 

Form W-2, box 12, code W. Follow the Instructions for 

Form 8889. Report your HSA deduction on Form 1040, 

1040-SR, or 1040-NR.

Excess contributions. You will have excess contributions if the contributions to your HSA for the year are 

greater than the limits discussed earlier. Excess contributions aren’t deductible. Excess contributions made by your 

employer are included in your gross income. If the excess 

contribution isn’t included in box 1 of Form W-2, you must 

report the excess as “Other income” on your tax return.

Generally, you must pay a 6% excise tax on excess 

contributions. See Form 5329, Additional Taxes on Qualified Plans (Including IRAs) and Other Tax-Favored Accounts, to figure the excise tax. The excise tax applies to 

each tax year the excess contribution remains in the account.

You may withdraw some or all of the excess contributions and avoid paying the excise tax on the amount withdrawn if you meet the following conditions.

• You withdraw the excess contributions by the due 

date, including extensions, of your tax return for the 

year the contributions were made.

• You withdraw any income earned on the withdrawn 

contributions and include the earnings in “Other income” on your tax return for the year you withdraw the 

contributions and earnings.

If you fail to remain an eligible individual during 

any of the testing periods, discussed earlier, the 

amount you have to include in income isn’t an excess contribution. If you withdraw any of those amounts, 

the amount is treated the same as any other distribution 

from an HSA, discussed later.

Deducting an excess contribution in a later year. You 

may be able to deduct excess contributions for previous 

years that are still in your HSA. The excess contribution 

you can deduct for the current year is the lesser of the following two amounts.

• Your maximum HSA contribution limit for the year minus any amounts contributed to your HSA for the year.

• The total excess contributions in your HSA at the beginning of the year.

Amounts contributed for the year include contributions 

by you, your employer, and any other person. They also 

include any qualified HSA funding distribution made to 

your HSA. Any excess contribution remaining at the end of 

a tax year is subject to the excise tax. See Form 5329.

Distributions From an HSA

You will generally pay medical expenses during the year 

without being reimbursed by your HDHP until you reach 

the annual deductible for the plan. When you pay medical 

expenses during the year that aren’t reimbursed by your 

HDHP, you can ask the trustee of your HSA to send you a 

distribution from your HSA.

You can receive tax-free distributions from your HSA to 

pay or be reimbursed for qualified medical expenses you 

incur after you establish the HSA. If you receive distributions for other reasons, the amount you withdraw will be 

subject to income tax and may be subject to an additional 

20% tax. You don’t have to make withdrawals from your 

HSA each year.

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8 Publication 969 (2023)
If you are no longer an eligible individual, you can 

still receive tax-free distributions to pay or reimburse your qualified medical expenses.

Generally, a distribution is money you get from your 

HSA. Your total distributions include amounts paid with a 

debit card and amounts withdrawn from the HSA by other 

individuals that you have designated. The trustee will report any distribution to you and the IRS on Form 1099-SA, 

Distributions From an HSA, Archer MSA, or Medicare Advantage MSA.

Qualified medical expenses. Qualified medical expenses are those expenses that would generally qualify for 

the medical and dental expenses deduction. These are 

explained in Pub. 502, Medical and Dental Expenses.

Amounts paid after 2019 for over-the-counter medicine 

(whether or not prescribed) and menstrual care products 

are considered medical care and are considered a covered expense.

For HSA purposes, expenses incurred before you establish your HSA aren’t qualified medical expenses. State 

law determines when an HSA is established. An HSA that 

is funded by amounts rolled over from an Archer MSA or 

another HSA is established on the date the prior account 

was established.

If, under the last-month rule, you are considered to be 

an eligible individual for the entire year for determining the 

contribution amount, only those expenses incurred after 

you actually establish your HSA are qualified medical expenses.

Qualified medical expenses are those incurred by the 

following persons.

1. You and your spouse.

2. All dependents you claim on your tax return.

3. Any person you could have claimed as a dependent 

on your return except that:

a. The person filed a joint return;

b. The person had gross income of $4,700 or more; 

or

c. You, or your spouse if filing jointly, could be 

claimed as a dependent on someone else’s 2023 

return.

For this purpose, a child of parents that are divorced, separated, or living apart for the last 6 

months of the calendar year is treated as the dependent of both parents whether or not the custodial parent releases the claim to the child’s exemption.

You can’t deduct qualified medical expenses as 

an itemized deduction on Schedule A (Form 

1040) that are equal to the tax-free distribution 

from your HSA.

Insurance premiums. You can’t treat insurance premiums as qualified medical expenses unless the premiums are for any of the following.

1. Long-term care insurance.

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2. Health care continuation coverage (such as coverage 

under COBRA).

3. Health care coverage while receiving unemployment 

compensation under federal or state law.

4. Medicare and other health care coverage if you were 

65 or older (other than premiums for a Medicare supplemental policy, such as Medigap).

The premiums for long-term care insurance (item (1)) 

that you can treat as qualified medical expenses are subject to limits based on age and are adjusted annually. See 

Limit on long-term care premiums you can deduct in the 

Instructions for Schedule A (Form 1040).

Items (2) and (3) can be for your spouse or a dependent meeting the requirement for that type of coverage. For 

item (4), if you, the account beneficiary, aren’t 65 or older, 

Medicare premiums for coverage of your spouse or a dependent (who is 65 or older) aren’t generally qualified 

medical expenses.

Health coverage tax credit. You can’t claim this 

credit for premiums that you pay with a tax-free distribution 

from your HSA. See Pub. 502 for more information on this 

credit.

Deemed distributions from HSAs. The following situations result in deemed taxable distributions from your 

HSA.

• You engaged in any transaction prohibited by section 

4975 with respect to any of your HSAs at any time in 

2023. Your account ceases to be an HSA as of January 1, 2023, and you must include the fair market 

value of all assets in the account as of January 1, 

2023, on Form 8889.

• You used any portion of any of your HSAs as security 

for a loan at any time in 2023. You must include the fair 

market value of the assets used as security for the 

loan as income on Form 1040, 1040-SR, or 1040-NR.

Examples of prohibited transactions include the direct 

or indirect:

• Sale, exchange, or leasing of property between you 

and the HSA;

• Lending of money between you and the HSA;

• Furnishing goods, services, or facilities between you 

and the HSA; and

• Transfer to or use by you, or for your benefit, of any assets of the HSA.

Any deemed distributions won’t be treated as used to 

pay qualified medical expenses. These distributions are 

included in your income and are subject to the additional 

20% tax, discussed later.

Publication 969 (2023) 9
Recordkeeping. You must keep records sufficient to show that:

• The distributions were exclusively to pay or reimburse 

qualified medical expenses,

• The qualified medical expenses hadn’t been previously paid or reimbursed from another source, and

• The medical expenses hadn’t been taken as an itemized deduction in any year.

Don’t send these records with your tax return. Keep them 

with your tax records.

Reporting Distributions on Your Return

How you report your distributions depends on whether or 

not you use the distribution for qualified medical expenses 

(defined earlier).

• If you use a distribution from your HSA for qualified 

medical expenses, you don’t pay tax on the distribution but you have to report the distribution on Form 

8889. However, the distribution of an excess contribution taken out after the due date, including extensions, 

of your return is subject to tax even if used for qualified 

medical expenses. Follow the instructions for the form 

and file it with your Form 1040, 1040-SR, or 1040-NR.

• If you don’t use a distribution from your HSA for qualified medical expenses, you must pay tax on the distribution. Report the amount on Form 8889 and file it 

with your Form 1040, 1040-SR, or 1040-NR. You may 

have to pay an additional 20% tax on your taxable distribution.

HSA administration and maintenance fees withdrawn by the trustee aren’t reported as distributions from the HSA.

Additional tax. There is an additional 20% tax on the 

part of your distributions not used for qualified medical expenses. Figure the tax on Form 8889 and file it with your 

Form 1040, 1040-SR, or 1040-NR.

Exceptions. There is no additional tax on distributions made after the date you are disabled, reach age 65, 

or die.

Balance in an HSA

An HSA is generally exempt from tax. You are permitted to 

take a distribution from your HSA at any time; however, 

only those amounts used exclusively to pay for qualified 

medical expenses are tax free. Amounts that remain at the 

end of the year are generally carried over to the next year 

(see Excess contributions, earlier). Earnings on amounts 

in an HSA aren’t included in your income while held in the 

HSA.

RECORDS

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Death of HSA Holder

You should choose a beneficiary when you set up your 

HSA. What happens to that HSA when you die depends 

on whom you designate as the beneficiary.

Spouse is the designated beneficiary. If your spouse 

is the designated beneficiary of your HSA, it will be treated 

as your spouse’s HSA after your death.

Spouse isn’t the designated beneficiary. If your 

spouse isn’t the designated beneficiary of your HSA:

• The account stops being an HSA, and

• The fair market value of the HSA becomes taxable to 

the beneficiary in the year in which you die.

If your estate is the beneficiary, the value is included on 

your final income tax return. The amount taxable to a beneficiary other than the estate is reduced by any qualified 

medical expenses for the decedent that are paid by the 

beneficiary within 1 year after the date of death.

Filing Form 8889

You must file Form 8889 with your Form 1040, 1040-SR, 

or 1040-NR if you (or your spouse, if married filing jointly) 

had any activity in your HSA during the year. You must file 

the form even if only your employer or your spouse’s employer made contributions to the HSA.

If, during the tax year, you are the beneficiary of two or 

more HSAs or you are a beneficiary of an HSA and you 

have your own HSA, you must complete a separate Form 

8889 for each HSA. Enter “statement” at the top of each 

Form 8889 and complete the form as instructed. Next, 

complete a controlling Form 8889 combining the amounts 

shown on each of the statement Forms 8889. Attach the 

statements to your tax return after the controlling Form 

8889.

Employer Participation

This section contains the rules that employers must follow 

if they decide to make HSAs available to their employees. 

Unlike the previous discussions, “you” refers to the employer and not to the employee.

Health plan. If you want your employees to be able to 

have HSAs, they must have an HDHP. You can provide no 

additional coverage other than those exceptions listed 

earlier under Other health coverage.

Contributions. You can make contributions to your employees’ HSAs. You deduct the contributions on your business income tax return for the year in which you make the 

contributions. If the contribution is allocated to the prior 

year, you still deduct it in the year in which you made the 

contribution.

For more information on employer contributions, see 

Notice 2008-59, 2008-29 I.R.B. 123, questions 23 through 

27, available at IRS.gov/irb/2008-29_IRB/ar11.html.

10 Publication 969 (2023)
Comparable contributions. If you decide to make contributions, you must make comparable contributions to all 

comparable participating employees’ HSAs. Your contributions are comparable if they are either:

• The same amount, or

• The same percentage of the annual deductible limit 

under the HDHP covering the employees.

The comparability rules don’t apply to contributions made 

through a cafeteria plan.

Comparable participating employees. Comparable 

participating employees:

• Are covered by your HDHP and are eligible to establish an HSA,

• Have the same category of coverage (either self-only 

or family coverage), and

• Have the same category of employment (part-time, 

full-time, or former employees).

To meet the comparability requirements for eligible employees who have neither established an HSA by December 31 nor notified you that they have an HSA, you must 

meet a notice requirement and a contribution requirement.

You will meet the notice requirement if by January 15 of 

the following calendar year you provide a written notice to 

all such employees. The notice must state that each eligible employee who, by the last day of February, establishes 

an HSA and notifies you that the eligible employee has established an HSA will receive a comparable contribution to 

the HSA for the prior year. For a sample of the notice, see 

Regulations section 54.4980G-4 A-14(c). You will meet 

the contribution requirement for these employees if by 

April 15, 2024, you contribute comparable amounts plus 

reasonable interest to the employees’ HSAs for the prior 

year.

Note. For purposes of making contributions to HSAs 

of non-highly compensated employees, highly compensated employees may not be treated as comparable participating employees.

Excise tax. If you made contributions to your employees’ 

HSAs that weren’t comparable, you must pay an excise 

tax of 35% of the amount you contributed.

Employment taxes. Amounts you contribute to your employees’ HSAs aren’t generally subject to employment 

taxes. You must report the contributions in box 12 of the 

Form W-2 you file for each employee. This includes the 

amounts the employee elected to contribute through a cafeteria plan. Enter code W in box 12. 

Medical Savings Accounts 

(MSAs)

Archer MSAs were created to help self-employed individuals and employees of certain small employers meet the 

medical care costs of the account holder, the account 

holder’s spouse, or the account holder’s dependent(s).

After 2007, you can’t be treated as an eligible individual for Archer MSA purposes unless:

1. You were an active participant for any tax year ending 

before 2008, or

2. You became an active participant for a tax year ending 

after 2007 by reason of coverage under a high deductible health plan (HDHP) of an Archer MSA participating employer.

A Medicare Advantage MSA is an Archer MSA designated by Medicare to be used solely to pay the qualified 

medical expenses of the account holder who is eligible for 

Medicare.

Archer MSAs

An Archer MSA is a tax-exempt trust or custodial account 

that you set up with a U.S. financial institution (such as a 

bank or an insurance company) in which you can save 

money exclusively for future medical expenses.

What are the benefits of an Archer MSA? You may 

enjoy several benefits from having an Archer MSA.

• You can claim a tax deduction for contributions you 

make even if you don’t itemize your deductions on 

Schedule A (Form 1040) or Schedule A (Form 

1040-NR).

• The interest or other earnings on the assets in your 

Archer MSA are tax free.

• Distributions may be tax free if you pay qualified medical expenses. See Qualified medical expenses, later.

• The contributions remain in your Archer MSA from 

year to year until you use them.

• An Archer MSA is “portable,” so it stays with you if you 

change employers or leave the work force.

Qualifying for an Archer MSA

To qualify for an Archer MSA, you must be either of the following.

• An employee (or the spouse of an employee) of a 

small employer (defined later) that maintains a 

self-only or family HDHP for you (or your spouse).

• A self-employed person (or the spouse of a self-employed person) who maintains a self-only or family 

HDHP.

You can have no other health or Medicare coverage except what is permitted under Other health coverage, later. 

You must be an eligible individual on the first day of a 

given month to get an Archer MSA deduction for that 

month.

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Publication 969 (2023) 11
If another taxpayer is entitled to claim you as a dependent, you can’t claim a deduction for an 

Archer MSA contribution. This is true even if the 

other person doesn’t receive an exemption deduction for 

you because the exemption amount is zero for tax years 

2018 through 2025.

Small employer. A small employer is generally an employer who had an average of 50 or fewer employees during either of the last 2 calendar years. The definition of 

small employer is modified for new employers and growing employers.

Growing employer. A small employer may begin 

HDHPs and Archer MSAs for its employees and then grow 

beyond 50 employees. The employer will continue to meet 

the requirement for small employers if the employer:

• Had 50 or fewer employees when the Archer MSAs 

began,

• Made a contribution that was excludable or deductible 

as an Archer MSA for the last year the employer had 

50 or fewer employees, and

• Had an average of 200 or fewer employees each year 

after 1996.

Changing employers. If you change employers, your 

Archer MSA moves with you. However, you may not make 

additional contributions unless you are otherwise eligible.

High deductible health plan (HDHP). To be eligible to 

contribute to an Archer MSA, you must be covered under 

an HDHP. An HDHP has:

• A higher annual deductible than typical health plans, 

and

• A maximum limit on the annual out-of-pocket medical 

expenses that you must pay for covered expenses.

Limits. The following table shows the limits for annual 

deductibles and the maximum out-of-pocket expenses for 

HDHPs for 2023.

Self-only coverage Family coverage

Minimum annual 

deductible $2,650 $5,300

Maximum annual 

deductible $3,950 $7,900

Maximum annual 

out-of-pocket 

expenses $5,300 $9,650

Family plans that don’t meet the high deductible 

rules. There are some family plans that have deductibles 

for both the family as a whole and for individual family 

members. Under these plans, if you meet the individual 

deductible for one family member, you don’t have to meet 

CAUTION

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the higher annual deductible amount for the family. If either the deductible for the family as a whole or the deductible for an individual family member is less than the minimum annual deductible for family coverage, the plan 

doesn’t qualify as an HDHP.

Other health coverage. If you (and your spouse, if you 

have family coverage) have HDHP coverage, you can’t 

generally have any other health coverage. However, you 

can still be an eligible individual even if your spouse has 

non-HDHP coverage, provided you aren’t covered by that 

plan. However, you can have additional insurance that 

provides benefits only for the following items.

• Liabilities incurred under workers’ compensation laws, 

torts, or ownership or use of property.

• A specific disease or illness.

• A fixed amount per day (or other period) of hospitalization.

You can also have coverage (whether provided through insurance or otherwise) for the following items.

• Accidents.

• Disability.

• Dental care.

• Vision care.

• Long-term care.

Contributions to an MSA

Contributions to an Archer MSA must be made in cash. 

You can’t contribute stock or other property to an Archer 

MSA.

Who can contribute to my Archer MSA? If you are an 

employee, your employer may make contributions to your 

Archer MSA. (You don’t pay tax on these contributions.) If 

your employer doesn’t make contributions to your Archer 

MSA, or you are self-employed, you can make your own 

contributions to your Archer MSA. You and your employer 

can’t make contributions to your Archer MSA in the same 

year. You don’t have to make contributions to your Archer 

MSA every year.

If your spouse is covered by your HDHP and an 

excludable amount is contributed by your spouse’s employer to an Archer MSA belonging to your 

spouse, you can’t make contributions to your own Archer 

MSA that year.

Limits

There are two limits on the amount you or your employer 

can contribute to your Archer MSA.

• The annual deductible limit.

• An income limit.

Annual deductible limit. You or your employer can contribute up to 75% of the annual deductible of your HDHP 

(65% if you have a self-only plan) to your Archer MSA. You 

CAUTION

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12 Publication 969 (2023)
must have the HDHP all year to contribute the full amount. 

If you don’t qualify to contribute the full amount for the 

year, determine your annual deductible limit by using the 

Line 3 Limitation Chart and Worksheet in the Instructions 

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

Example 1. You have an HDHP for your family all year 

in 2023. The annual deductible is $6,000. You can contribute up to $4,500 ($6,000 × 75% (0.75)) to your Archer 

MSA for the year.

Example 2. You have an HDHP for your family for the 

entire period of July through December 2023 (6 months). 

The annual deductible is $6,000. You can contribute up to 

$2,250 ($6,000 × 75% (0.75) ÷ 12 × 6) to your Archer 

MSA for the year.

If you and your spouse each have a family plan, 

you are treated as having family coverage with the 

lower annual deductible of the two health plans. 

The contribution limit is split equally between the two of 

you unless you agree on a different division.

Income limit. You can’t contribute more than you earned 

for the year from the employer through whom you have 

your HDHP.

If you are self-employed, you can’t contribute more than 

your net self-employment income. This is your income 

from self-employment minus expenses (including the deductible part of self-employment tax).

Example 1. You earned $25,000 from TR Company in 

2023. Through TR, you had an HDHP for your family for 

the entire year. The annual deductible was $6,000. You 

can contribute up to $4,500 to your Archer MSA (75% 

(0.75) × $6,000). You can contribute the full amount because you earned more than $4,500 at TR.

Example 2. You are self-employed. You had an HDHP 

for your family for the entire year in 2023. The annual deductible was $6,000. Based on the annual deductible, the 

maximum contribution to your Archer MSA would have 

been $4,500 (75% (0.75) × $6,000). However, after deducting your business expenses, your net self-employment income is $2,500 for the year. Therefore, you are 

limited to a contribution of $2,500.

Individuals enrolled in Medicare. Beginning with the 

first month you are enrolled in Medicare, you can’t contribute to an Archer MSA. However, you may be eligible for a 

Medicare Advantage MSA, discussed later.

When To Contribute

You can make contributions to your Archer MSA for 2023 

through April 15, 2024.

Reporting Contributions on Your Return

Report all contributions to your Archer MSA on Form 8853 

and file it with your Form 1040, 1040-SR, or 1040-NR. You 

should include all contributions you or your employer 

TIP

made for 2023, including those made from January 1, 

2024, through April 15, 2024, that are designated for 

2023.

You should receive Form 5498-SA, HSA, Archer MSA, 

or Medicare Advantage MSA Information, from the trustee 

showing the amount you or your employer contributed during the year. Your employer’s contributions should be 

shown on Form W-2, box 12, code R. Follow the Instructions for Form 8853 and complete the Line 3 Limitation 

Chart and Worksheet in the instructions. Report your 

Archer MSA deduction on Form 1040, 1040-SR, or 

1040-NR.

Excess contributions. You will have excess contributions if the contributions to your Archer MSA for the year 

are greater than the limits discussed earlier. Excess contributions aren’t deductible. Excess contributions made by 

your employer are included in your gross income. If the excess contribution isn’t included in Form W-2, box 1, you 

must report the excess as “Other income” on your tax return.

Generally, you must pay a 6% excise tax on excess 

contributions. See Form 5329, Additional Taxes on Qualified Plans (Including IRAs) and Other Tax-Favored Accounts, to figure the excise tax. The excise tax applies to 

each tax year the excess contribution remains in the account.

You may withdraw some or all of the excess contributions and avoid paying the excise tax on the amount withdrawn if you meet the following conditions.

• You withdraw the excess contributions by the due 

date, including extensions, of your tax return.

• You withdraw any income earned on the withdrawn 

contributions and include the earnings in “Other income” on your tax return for the year you withdraw the 

contributions and earnings.

Deducting an excess contribution in a later year. You 

may be able to deduct excess contributions for previous 

years that are still in your Archer MSA. The excess contribution you can deduct in the current year is the lesser of 

the following two amounts.

• Your maximum Archer MSA contribution limit for the 

year minus any amounts contributed to your Archer 

MSA for the year.

• The total excess contributions in your Archer MSA at 

the beginning of the year.

Any excess contributions remaining at the end of a tax 

year are subject to the excise tax. See Form 5329.

Distributions From an MSA

You will generally pay medical expenses during the year 

without being reimbursed by your HDHP until you reach 

the annual deductible for the plan. When you pay medical 

expenses during the year that aren’t reimbursed by your 

HDHP, you can ask the trustee of your Archer MSA to 

send you a distribution from your Archer MSA.

Publication 969 (2023) 13
You can receive tax-free distributions from your Archer 

MSA to pay for qualified medical expenses (discussed 

later). If you receive distributions for other reasons, the 

amount will be subject to income tax and may be subject 

to an additional 20% tax as well. You don’t have to make 

withdrawals from your Archer MSA each year.

If you no longer qualify to make contributions, you 

can still receive tax-free distributions to pay or reimburse your qualified medical expenses.

A distribution is money you get from your Archer MSA. 

The trustee will report any distribution to you and the IRS 

on Form 1099-SA, Distributions From an HSA, Archer 

MSA, or Medicare Advantage MSA.

Qualified medical expenses. Qualified medical expenses are those expenses that would generally qualify for 

the medical and dental expenses deduction. These are 

explained in Pub. 502.

Amounts paid after 2019 for over-the-counter medicine 

(whether or not prescribed) and menstrual care products 

are considered medical care and are considered a covered expense.

Qualified medical expenses are those incurred by the 

following persons.

1. You and your spouse.

2. All dependents you claim on your tax return.

3. Any person you could have claimed as a dependent 

on your return except that:

a. The person filed a joint return;

b. The person had gross income of $4,700 or more; 

or

c. You, or your spouse if filing jointly, could be 

claimed as a dependent on someone else’s 2023 

return.

For this purpose, a child of parents that are divorced, separated, or living apart for the last 6 

months of the calendar year is treated as the dependent of both parents whether or not the custodial parent releases the claim to the child’s exemption.

You can’t deduct qualified medical expenses as 

an itemized deduction on Schedule A (Form 

1040) that are equal to the tax-free distribution 

from your Archer MSA.

Special rules for insurance premiums. Generally, 

you can’t treat insurance premiums as qualified medical 

expenses for Archer MSAs. You can, however, treat premiums for long-term care coverage, health care coverage 

while you receive unemployment benefits, or health care 

continuation coverage required under any federal law as 

qualified medical expenses for Archer MSAs.

Health coverage tax credit. You can’t claim this 

credit for premiums that you pay with a tax-free distribution 

from your Archer MSA. See Pub. 502 for information on 

this credit.

TIP TIP

CAUTION

!

Deemed distributions from Archer MSAs. The following situations result in deemed taxable distributions from 

your Archer MSA.

• You engaged in any transaction prohibited by section 

4975 with respect to any of your Archer MSAs at any 

time in 2023. Your account ceases to be an Archer 

MSA as of January 1, 2023, and you must include the 

fair market value of all assets in the account as of January 1, 2023, on Form 8853.

• You used any portion of any of your Archer MSAs as 

security for a loan at any time in 2023. You must include the fair market value of the assets used as security for the loan as income on Form 1040, 1040-SR, 

or 1040-NR.

Examples of prohibited transactions include the direct 

or indirect:

• Sale, exchange, or leasing of property between you 

and the Archer MSA;

• Lending of money between you and the Archer MSA;

• Furnishing goods, services, or facilities between you 

and the Archer MSA; and

• Transfer to or use by you, or for your benefit, of any assets of the Archer MSA.

Any deemed distribution won’t be treated as used to 

pay qualified medical expenses. These distributions are 

included in your income and are subject to the additional 

20% tax, discussed later.

Recordkeeping. You must keep records sufficient to show that:

• The distributions were exclusively to pay or reimburse 

qualified medical expenses,

• The qualified medical expenses hadn’t been previously paid or reimbursed from another source, and

• The medical expenses hadn’t been taken as an itemized deduction in any year.

Don’t send these records with your tax return. Keep them 

with your tax records.

Reporting Distributions on Your Return

How you report your distributions depends on whether or 

not you use the distribution for qualified medical expenses, defined earlier.

• If you use a distribution from your Archer MSA for 

qualified medical expenses, you don’t pay tax on the 

distribution but you have to report the distribution on 

Form 8853. Follow the instructions for the form and file 

it with your Form 1040, 1040-SR, or 1040-NR.

• If you don’t use a distribution from your Archer MSA 

for qualified medical expenses, you must pay tax on 

the distribution. Report the amount on Form 8853 and 

file it with your Form 1040, 1040-SR, or 1040-NR. You 

may have to pay an additional 20% tax, discussed 

later, on your taxable distribution.

RECORDS

14 Publication 969 (2023)
If an amount (other than a rollover) is contributed 

to your Archer MSA this year (by you or your employer), you must also report and pay tax on a distribution you receive from your Archer MSA this year that 

is used to pay medical expenses of someone who isn’t 

covered by an HDHP, or is also covered by another health 

plan that isn’t an HDHP, at the time the expenses are incurred.

Rollovers. Generally, any distribution from an Archer 

MSA that you roll over into another Archer MSA or an HSA 

isn’t taxable if you complete the rollover within 60 days. An 

Archer MSA and an HSA can receive only one rollover 

contribution during a 1-year period. See the Form 8853 instructions for more information.

Additional tax. There is a 20% additional tax on the part 

of your distributions not used for qualified medical expenses. Figure the tax on Form 8853 and file it with your Form 

1040, 1040-SR, or 1040-NR. Report the additional tax in 

the total on Form 1040, 1040-SR, or 1040-NR.

Exceptions. There is no additional tax on distributions made after the date you are disabled, reach age 65, 

or die.

Balance in an Archer MSA

An Archer MSA is generally exempt from tax. You are permitted to take a distribution from your Archer MSA at any 

time; however, only those amounts used exclusively to pay 

for qualified medical expenses are tax free. Amounts that 

remain at the end of the year are generally carried over to 

the next year (see Excess contributions, earlier). Earnings 

on amounts in an Archer MSA aren’t included in your income while held in the Archer MSA.

Death of the Archer MSA Holder

You should choose a beneficiary when you set up your 

Archer MSA. What happens to that Archer MSA when you 

die depends on whom you designate as the beneficiary.

Spouse is the designated beneficiary. If your spouse 

is the designated beneficiary of your Archer MSA, it will be 

treated as your spouse’s Archer MSA after your death.

Spouse isn’t the designated beneficiary. If your 

spouse isn’t the designated beneficiary of your Archer 

MSA:

• The account stops being an Archer MSA, and

• The fair market value of the Archer MSA becomes taxable to the beneficiary in the year in which you die.

If your estate is the beneficiary, the fair market value of 

the Archer MSA will be included on your final income tax 

return.

The amount taxable to a beneficiary other than 

the estate is reduced by any qualified medical expenses for the decedent that are paid by the beneficiary within 1 year after the date of death.

CAUTION

!

TIP

Filing Form 8853

You must file Form 8853 with your Form 1040, 1040-SR, 

or 1040-NR if you (or your spouse, if married filing a joint 

return) had any activity in your Archer MSA during the 

year. You must file the form even if only your employer or 

your spouse’s employer made contributions to the Archer 

MSA.

If, during the tax year, you are the beneficiary of two or 

more Archer MSAs or you are a beneficiary of an Archer 

MSA and you have your own Archer MSA, you must complete a separate Form 8853 for each MSA. Enter “statement” at the top of each Form 8853 and complete the form 

as instructed. Next, complete a controlling Form 8853 

combining the amounts shown on each of the statement 

Forms 8853. Attach the statements to your tax return after 

the controlling Form 8853.

Employer Participation

This section contains the rules that employers must follow 

if they decide to make Archer MSAs available to their employees. Unlike the previous discussions, “you” refers to 

the employer and not to the employee.

Health plan. If you want your employees to be able to 

have Archer MSAs, you must make an HDHP available to 

them. You can provide no additional coverage other than 

those exceptions listed earlier under Other health coverage.

Contributions. You can make contributions to your employees’ Archer MSAs and deduct them for the year in 

which you make them.

Comparable contributions. If you decide to make contributions, you must make comparable contributions to all 

comparable participating employees’ Archer MSAs. Your 

contributions are comparable if they are either:

• The same amount, or

• The same percentage of the annual deductible limit 

under the HDHP covering the employees.

Comparable participating employees. Comparable 

participating employees:

• Are covered by your HDHP and are eligible to establish an Archer MSA,

• Have the same category of coverage (either self-only 

or family coverage), and

• Have the same category of employment (either 

part-time or full-time).

Excise tax. If you made contributions to your employees’ 

Archer MSAs that weren’t comparable, you must pay an 

excise tax of 35% of the amount you contributed.

Employment taxes. Amounts you contribute to your employees’ Archer MSAs aren’t generally subject to employment taxes. You must report the contributions on Form 

W-2, box 12, code R.

Publication 969 (2023) 15
Medicare Advantage MSAs

A Medicare Advantage MSA is an Archer MSA designated 

by Medicare to be used solely to pay the qualified medical 

expenses of the account holder. To be eligible for a Medicare Advantage MSA, you must be enrolled in Medicare 

and have an HDHP that meets the Medicare guidelines.

A Medicare Advantage MSA is a tax-exempt trust or 

custodial savings account that you set up with a financial 

institution (such as a bank or an insurance company) in 

which the Medicare program can deposit money for qualified medical expenses. The money in your account isn’t 

taxed if it is used for qualified medical expenses, and it 

may earn interest or dividends.

An HDHP is a special health insurance policy that has a 

high deductible. You choose the policy you want to use as 

part of your Medicare Advantage MSA plan. However, the 

policy must be approved by the Medicare program.

Medicare Advantage MSAs are administered through 

the federal Medicare program. You can get information by 

calling 800-MEDICARE (800-633-4227) or through the Internet at Medicare.gov.

Note. You must file Form 8853, Archer MSAs and 

Long-Term Care Insurance Contracts, with your tax return 

if you have a Medicare Advantage MSA.

Flexible Spending 

Arrangements (FSAs)

A health FSA allows employees to be reimbursed for medical expenses. FSAs are usually funded through voluntary 

salary reduction agreements with your employer. No employment or federal income taxes are deducted from your 

contribution. The employer may also contribute.

Note. Unlike HSAs or Archer MSAs, which must be 

reported on Form 1040, 1040-SR, or 1040-NR, there are 

no reporting requirements for FSAs on your income tax return.

For information on the interaction between a health 

FSA and an HSA, see Other employee health plans under 

Qualifying for an HSA, earlier.

What are the benefits of an FSA? You may enjoy several benefits from having an FSA.

• Contributions made by your employer can be excluded from your gross income.

• No employment or federal income taxes are deducted 

from the contributions.

• Reimbursements may be tax free if you pay qualified 

medical expenses. See Qualified medical expenses, 

later.

• You can use an FSA to pay qualified medical expenses even if you haven’t yet placed the funds in the account.

Qualifying for an FSA

Health FSAs are employer-established benefit plans. 

These may be offered in conjunction with other employer-provided benefits as part of a cafeteria plan. Employers have flexibility to offer various combinations of 

benefits in designing their plans.

Self-employed persons aren’t eligible for FSAs.

Certain limitations may apply if you are a highly 

compensated participant or a key employee.

Contributions to an FSA

You contribute to your FSA by electing an amount to be 

voluntarily withheld from your pay by your employer. This 

is sometimes called a “salary reduction agreement.” The 

employer may also contribute to your FSA if specified in 

the plan.

You don’t pay federal income tax or employment taxes 

on the salary you contribute or the amounts your employer 

contributes to the FSA. However, contributions made by 

your employer to provide coverage for long-term care insurance must be included in income.

When To Contribute

At the beginning of the plan year, you must designate how 

much you want to contribute. Then, your employer will deduct amounts periodically (generally, every payday) in accordance with your annual election. You can change or revoke your election only if specifically allowed by law and 

the plan.

Amount of Contribution

For 2023, salary reduction contributions to a health FSA 

can’t be more than $3,050 a year (or any lower amount set 

by the plan). This amount is indexed for inflation and may 

change from year to year.

Generally, contributed amounts that aren’t spent by the 

end of the plan year are forfeited. However, see Balance in 

an FSA, later, for possible exceptions. For this reason, it is 

important to base your contribution on an estimate of the 

qualifying expenses you will have during the year.

Distributions From an FSA

Generally, distributions from a health FSA must be paid 

only to reimburse you for qualified medical expenses you 

incurred during the period of coverage. You must be able 

to receive the maximum amount of reimbursement (the 

amount you have elected to contribute for the year) at any 

time during the coverage period, regardless of the amount 

you have actually contributed. The maximum amount you 

can receive tax free is the total amount you elected to contribute to the health FSA for the year.

CAUTION

!

16 Publication 969 (2023)
You must provide the health FSA with a written statement from an independent third party stating that the medical expense has been incurred and the amount of the expense. You must also provide a written statement that the 

expense hasn’t been paid or reimbursed under any other 

health plan coverage. The FSA can’t make advance reimbursements of future or projected expenses.

Debit cards, credit cards, and stored value cards given 

to you by your employer can be used to reimburse participants in a health FSA. If the use of these cards meets certain substantiation methods, you may not have to provide 

additional information to the health FSA. For information 

on these methods, see Revenue Ruling 2003-43, 2003-21 

I.R.B. 935, available at IRS.gov/pub/irs-drop/rr-03-43.pdf; 

Notice 2006-69, 2006-31 I.R.B. 107, available at 

IRS.gov/irb/2006-31_IRB/ar10.html; and Notice 2007-2, 

2007-2 I.R.B. 254, available at IRS.gov/irb/2007-02_IRB/

ar09.html.

Qualified medical expenses. Qualified medical expenses are those specified in the plan that would generally 

qualify for the medical and dental expenses deduction. 

These are explained in Pub. 502.

Expenses incurred after December 31, 2019, for 

over-the-counter medicine (whether or not prescribed) 

and menstrual care products are considered medical care 

and are considered a covered expense.

Qualified medical expenses are those incurred by the 

following persons.

1. You and your spouse.

2. All dependents you claim on your tax return.

3. Any person you could have claimed as a dependent 

on your return except that:

a. The person filed a joint return;

b. The person had gross income of $4,700 or more; 

or

c. You, or your spouse if filing jointly, could be 

claimed as a dependent on someone else’s 2023 

return.

4. Your child under age 27 at the end of your tax year.

You can’t receive distributions from your FSA for the following expenses.

• Amounts paid for health insurance premiums.

• Amounts paid for long-term care coverage or expenses.

• Amounts that are covered under another health plan.

If you are covered under both a health FSA and an HRA, 

see Notice 2002-45, Part V, 2002-28 I.R.B. 93, available at 

IRS.gov/pub/irs-drop/n-02-45.pdf.

You can’t deduct qualified medical expenses as 

an itemized deduction on Schedule A (Form 

1040) that are equal to the reimbursement you receive from the FSA.

CAUTION

!

Qualified reservist distribution. A special rule allows 

amounts in a health FSA to be distributed to reservists ordered or called to active duty. This rule applies to distributions made after June 17, 2008, if the plan has been 

amended to allow these distributions. Your employer must 

report the distribution as wages on your Form W-2 for the 

year in which the distribution is made. The distribution is 

subject to employment taxes and is included in your gross 

income.

A qualified reservist distribution is allowed if you were 

(because you were in the reserves) ordered or called to 

active duty for a period of more than 179 days or for an indefinite period, and the distribution is made during the period beginning on the date of the order or call and ending 

on the last date that reimbursements could otherwise be 

made for the plan year that includes the date of the order 

or call.

Balance in an FSA

FSAs are generally "use-it-or-lose-it" plans. This means 

that amounts in the account at the end of the plan year 

can't generally be carried over to the next year. However, 

the plan can provide for either a grace period or a carryover.

The plan can provide for a grace period of up to 2 1/2 

months after the end of the plan year. If there is a grace 

period, any qualified medical expenses incurred in that 

period can be paid from any amounts left in the account at 

the end of the previous year. Your employer isn't permitted 

to refund any part of the balance to you. See Qualified reservist distributions, earlier.

Plans may allow up to $610 of unused amounts remaining at the end of the plan year to be paid or reimbursed for 

qualified medical expenses you incur in the following plan 

year. The plan may specify a lower dollar amount as the 

maximum carryover amount. If the plan permits a carryover, any unused amounts in excess of the carryover 

amount are forfeited. The carryover doesn't affect the 

maximum amount of salary reduction contributions that 

you are permitted to make.

A plan may allow either the grace period or a carryover, 

but it may not allow both.

Employer Participation

For the health FSA to maintain tax-qualified status, employers must comply with certain requirements that apply 

to cafeteria plans. For example, there are restrictions for 

plans that cover highly compensated employees and key 

employees. The plans must also comply with rules applicable to other accident and health plans. Pub. 15-B, Employer’s Tax Guide to Fringe Benefits, explains these requirements.

Publication 969 (2023) 17
Health Reimbursement 

Arrangements (HRAs)

An HRA must be funded solely by an employer. The contribution can’t be paid through a voluntary salary reduction 

agreement on the part of an employee. Employees are reimbursed tax free for qualified medical expenses up to a 

maximum dollar amount for a coverage period. An HRA 

may be offered with other health plans, including FSAs.

Note. Unlike HSAs or Archer MSAs, which must be 

reported on Form 1040, 1040-SR, or 1040-NR, there are 

no reporting requirements for HRAs on your income tax 

return.

For information on the interaction between an HRA and 

an HSA, see Other employee health plans under Qualifying for an HSA, earlier.

What are the benefits of an HRA? You may enjoy several benefits from having an HRA.

• Contributions made by your employer can be excluded from your gross income.

• Reimbursements may be tax free if you pay qualified 

medical expenses. See Qualified medical expenses, 

later.

• Any unused amounts in the HRA can be carried forward for reimbursements in later years.

Qualifying for an HRA

HRAs are employer-established benefit plans. These may 

be offered in conjunction with other employer-provided 

health benefits. Employers have complete flexibility to offer various combinations of benefits in designing their 

plans.

Self-employed persons aren’t eligible for HRAs.

Certain limitations may apply if you are a highly 

compensated participant.

Contributions to an HRA

HRAs are funded solely through employer contributions 

and may not be funded through employee salary reductions under a cafeteria plan. These contributions aren’t included in the employee’s income. You don’t pay federal income tax or employment taxes on amounts your employer 

contributes to the HRA.

Amount of Contribution

There is no limit on the amount of money your employer 

can contribute to the accounts. Additionally, the maximum 

reimbursement amount credited under the HRA in the future may be increased or decreased by amounts not previously used. See Balance in an HRA, later.

CAUTION

!

Distributions From an HRA

Generally, distributions from an HRA must be paid to reimburse you for qualified medical expenses you have incurred. The expense must have been incurred on or after the 

date you are enrolled in the HRA.

Debit cards, credit cards, and stored value cards given 

to you by your employer can be used to reimburse participants in an HRA. If the use of these cards meets certain 

substantiation methods, you may not have to provide additional information to the HRA. For information on these 

methods, see Revenue Ruling 2003-43, 2003-21 I.R.B. 

935, available at IRS.gov/pub/irs-drop/rr-03-43.pdf; Notice 

2006-69, 2006-31 I.R.B. 107, available at IRS.gov/irb/

2006-31_IRB/ar10.html; and Notice 2007-2, 2007-2 I.R.B. 

254, available at IRS.gov/irb/2007-02_IRB/ar09.html.

If any distribution is, or can be, made for other than the 

reimbursement of qualified medical expenses, any distribution (including reimbursement of qualified medical expenses) made in the current tax year is included in gross 

income. For example, if an unused reimbursement is payable to you in cash at the end of the year, or upon termination of your employment, any distribution from the HRA is 

included in your income. This also applies if any unused 

amount upon your death is payable in cash to your beneficiary or estate, or if the HRA provides an option for you to 

transfer any unused reimbursement at the end of the year 

to a retirement plan.

If the plan permits amounts to be paid as medical benefits to a designated beneficiary (other than the employee’s 

spouse or dependents), any distribution from the HRA is 

included in income.

Reimbursements under an HRA can be made to the following persons.

1. Current and former employees.

2. Spouses and dependents of those employees.

3. Any person you could have claimed as a dependent 

on your return except that:

a. The person filed a joint return;

b. The person had gross income of $4,700 or more; 

or

c. You, or your spouse if filing jointly, could be 

claimed as a dependent on someone else’s 2023 

return.

4. Your child under age 27 at the end of your tax year.

5. Spouses and dependents of deceased employees.

For this purpose, a child of parents that are divorced, separated, or living apart for the last 6 

months of the calendar year is treated as the dependent of both parents whether or not the custodial parent releases the claim to the child’s exemption.

Qualified medical expenses. Qualified medical expenses are those specified in the plan that would generally 

TIP

18 Publication 969 (2023)
qualify for the medical and dental expenses deduction. 

These are explained in Pub. 502.

Expenses incurred after December 31, 2019, for 

over-the-counter medicine (whether or nor prescribed) 

and menstrual care products are considered medical care 

and are considered a covered expense.

Qualified medical expenses from your HRA include the 

following.

• Amounts paid for health insurance premiums.

• Amounts paid for long-term care coverage.

• Amounts that aren’t covered under another health 

plan.

If you are covered under both an HRA and a health FSA, 

see Notice 2002-45, Part V, which is available at 

IRS.gov/pub/irs-drop/n-02-45.pdf.

You can’t deduct qualified medical expenses as 

an itemized deduction on Schedule A (Form 

1040) that are equal to the distribution from the 

HRA.

Balance in an HRA

Some, but not all, HRAs permit amounts that remain at the 

end of the year to be carried to the next year. Your employer isn’t permitted to refund any part of the balance to 

you. These amounts may never be used for anything but 

reimbursements for qualified medical expenses.

Employer Participation

For an HRA to maintain tax-qualified status, employers 

must comply with certain requirements that apply to other 

accident and health plans. Pub. 15-B, Employer’s Tax 

Guide to Fringe Benefits, explains these requirements.

How To Get Tax Help

If you have questions about a tax issue; need help preparing your tax return; or want to download free publications, 

forms, or instructions, go to IRS.gov to find resources that 

can help you right away.

Preparing and filing your tax return. After receiving all 

your wage and earnings statements (Forms W-2, W-2G, 

1099-R, 1099-MISC, 1099-NEC, etc.); unemployment 

compensation statements (by mail or in a digital format) or 

other government payment statements (Form 1099-G); 

and interest, dividend, and retirement statements from 

banks and investment firms (Forms 1099), you have several options to choose from to prepare and file your tax return. You can prepare the tax return yourself, see if you 

qualify for free tax preparation, or hire a tax professional to 

prepare your return.

CAUTION

!

Free options for tax preparation. Your options for preparing and filing your return online or in your local community, if you qualify, include the following.

• Free File. This program lets you prepare and file your 

federal individual income tax return for free using software or Free File Fillable Forms. However, state tax 

preparation may not be available through Free File. Go 

to IRS.gov/FreeFile to see if you qualify for free online 

federal tax preparation, e-filing, and direct deposit or 

payment options.

• VITA. The Volunteer Income Tax Assistance (VITA) 

program offers free tax help to people with 

low-to-moderate incomes, persons with disabilities, 

and limited-English-speaking taxpayers who need 

help preparing their own tax returns. Go to IRS.gov/

VITA, download the free IRS2Go app, or call 

800-906-9887 for information on free tax return preparation.

• TCE. The Tax Counseling for the Elderly (TCE) program offers free tax help for all taxpayers, particularly 

those who are 60 years of age and older. TCE volunteers specialize in answering questions about pensions and retirement-related issues unique to seniors. 

Go to IRS.gov/TCE or download the free IRS2Go app 

for information on free tax return preparation.

• MilTax. Members of the U.S. Armed Forces and qualified veterans may use MilTax, a free tax service offered by the Department of Defense through Military 

OneSource. For more information, go to 

MilitaryOneSource (MilitaryOneSource.mil/MilTax).

Also, the IRS offers Free Fillable Forms, which can 

be completed online and then e-filed regardless of income.

Using online tools to help prepare your return. Go to 

IRS.gov/Tools for the following.

• The Earned Income Tax Credit Assistant (IRS.gov/

EITCAssistant) determines if you’re eligible for the 

earned income credit (EIC).

• The Online EIN Application (IRS.gov/EIN) helps you 

get an employer identification number (EIN) at no 

cost.

• The Tax Withholding Estimator (IRS.gov/W4App) 

makes it easier for you to estimate the federal income 

tax you want your employer to withhold from your paycheck. This is tax withholding. See how your withholding affects your refund, take-home pay, or tax due.

• The First-Time Homebuyer Credit Account Look-up 

(IRS.gov/HomeBuyer) tool provides information on 

your repayments and account balance.

• The Sales Tax Deduction Calculator (IRS.gov/

SalesTax) figures the amount you can claim if you 

itemize deductions on Schedule A (Form 1040).

Getting answers to your tax questions. On 

IRS.gov, you can get up-to-date information on 

current events and changes in tax law.

Publication 969 (2023) 19
• IRS.gov/Help: A variety of tools to help you get answers to some of the most common tax questions.

• IRS.gov/ITA: The Interactive Tax Assistant, a tool that 

will ask you questions and, based on your input, provide answers on a number of tax topics.

• IRS.gov/Forms: Find forms, instructions, and publications. You will find details on the most recent tax 

changes and interactive links to help you find answers 

to your questions.

• You may also be able to access tax information in your 

e-filing software.

Need someone to prepare your tax return? There are 

various types of tax return preparers, including enrolled 

agents, certified public accountants (CPAs), accountants, 

and many others who don’t have professional credentials. 

If you choose to have someone prepare your tax return, 

choose that preparer wisely. A paid tax preparer is:

• Primarily responsible for the overall substantive accuracy of your return,

• Required to sign the return, and

• Required to include their preparer tax identification 

number (PTIN).

Although the tax preparer always signs the return, 

you're ultimately responsible for providing all the 

information required for the preparer to accurately 

prepare your return and for the accuracy of every item reported on the return. Anyone paid to prepare tax returns 

for others should have a thorough understanding of tax 

matters. For more information on how to choose a tax preparer, go to Tips for Choosing a Tax Preparer on IRS.gov.

Employers can register to use Business Services Online. The Social Security Administration (SSA) offers online service at SSA.gov/employer for fast, free, and secure 

W-2 filing options to CPAs, accountants, enrolled agents, 

and individuals who process Form W-2, Wage and Tax 

Statement, and Form W-2c, Corrected Wage and Tax 

Statement.

IRS social media. Go to IRS.gov/SocialMedia to see the 

various social media tools the IRS uses to share the latest 

information on tax changes, scam alerts, initiatives, products, and services. At the IRS, privacy and security are our 

highest priority. We use these tools to share public information with you. Don’t post your social security number 

(SSN) or other confidential information on social media 

sites. Always protect your identity when using any social 

networking site.

The following IRS YouTube channels provide short, informative videos on various tax-related topics in English, 

Spanish, and ASL.

• Youtube.com/irsvideos.

• Youtube.com/irsvideosmultilingua.

• Youtube.com/irsvideosASL.

CAUTION

!

Watching IRS videos. The IRS Video portal 

(IRSVideos.gov) contains video and audio presentations 

for individuals, small businesses, and tax professionals.

Online tax information in other languages. You can 

find information on IRS.gov/MyLanguage if English isn’t 

your native language.

Free Over-the-Phone Interpreter (OPI) Service. The 

IRS is committed to serving taxpayers with limited-English 

proficiency (LEP) by offering OPI services. The OPI Service is a federally funded program and is available at Taxpayer Assistance Centers (TACs), most IRS offices, and 

every VITA/TCE tax return site. The OPI Service is accessible in more than 350 languages.

Accessibility Helpline available for taxpayers with 

disabilities. Taxpayers who need information about accessibility services can call 833-690-0598. The Accessibility Helpline can answer questions related to current and 

future accessibility products and services available in alternative media formats (for example, braille, large print, 

audio, etc.). The Accessibility Helpline does not have access to your IRS account. For help with tax law, refunds, or 

account-related issues, go to IRS.gov/LetUsHelp.

Note. Form 9000, Alternative Media Preference, or 

Form 9000(SP) allows you to elect to receive certain types 

of written correspondence in the following formats.

• Standard Print.

• Large Print.

• Braille.

• Audio (MP3).

• Plain Text File (TXT).

• Braille Ready File (BRF).

Disasters. Go to IRS.gov/DisasterRelief to review the 

available disaster tax relief.

Getting tax forms and publications. Go to IRS.gov/

Forms to view, download, or print all the forms, instructions, and publications you may need. Or, you can go to 

IRS.gov/OrderForms to place an order.

Getting tax publications and instructions in eBook 

format. Download and view most tax publications and 

instructions (including the Instructions for Form 1040) on 

mobile devices as eBooks at IRS.gov/eBooks.

IRS eBooks have been tested using Apple's iBooks for 

iPad. Our eBooks haven’t been tested on other dedicated 

eBook readers, and eBook functionality may not operate 

as intended.

Access your online account (individual taxpayers 

only). Go to IRS.gov/Account to securely access information about your federal tax account.

• View the amount you owe and a breakdown by tax 

year.

• See payment plan details or apply for a new payment 

plan.

20 Publication 969 (2023)
• Make a payment or view 5 years of payment history 

and any pending or scheduled payments.

• Access your tax records, including key data from your 

most recent tax return, and transcripts.

• View digital copies of select notices from the IRS.

• Approve or reject authorization requests from tax professionals.

• View your address on file or manage your communication preferences.

Get a transcript of your return. With an online account, you can access a variety of information to help you 

during the filing season. You can get a transcript, review 

your most recently filed tax return, and get your adjusted 

gross income. Create or access your online account at 

IRS.gov/Account.

Tax Pro Account. This tool lets your tax professional 

submit an authorization request to access your individual 

taxpayer IRS online account. For more information, go to 

IRS.gov/TaxProAccount.

Using direct deposit. The safest and easiest way to receive a tax refund is to e-file and choose direct deposit, 

which securely and electronically transfers your refund directly into your financial account. Direct deposit also 

avoids the possibility that your check could be lost, stolen, 

destroyed, or returned undeliverable to the IRS. Eight in 

10 taxpayers use direct deposit to receive their refunds. If 

you don’t have a bank account, go to IRS.gov/

DirectDeposit for more information on where to find a bank 

or credit union that can open an account online.

Reporting and resolving your tax-related identity 

theft issues. 

• Tax-related identity theft happens when someone 

steals your personal information to commit tax fraud. 

Your taxes can be affected if your SSN is used to file a 

fraudulent return or to claim a refund or credit.

• The IRS doesn’t initiate contact with taxpayers by 

email, text messages (including shortened links), telephone calls, or social media channels to request or 

verify personal or financial information. This includes 

requests for personal identification numbers (PINs), 

passwords, or similar information for credit cards, 

banks, or other financial accounts.

• Go to IRS.gov/IdentityTheft, the IRS Identity Theft 

Central webpage, for information on identity theft and 

data security protection for taxpayers, tax professionals, and businesses. If your SSN has been lost or 

stolen or you suspect you’re a victim of tax-related 

identity theft, you can learn what steps you should 

take.

• Get an Identity Protection PIN (IP PIN). IP PINs are 

six-digit numbers assigned to taxpayers to help prevent the misuse of their SSNs on fraudulent federal income tax returns. When you have an IP PIN, it prevents someone else from filing a tax return with your 

SSN. To learn more, go to IRS.gov/IPPIN.

Ways to check on the status of your refund. 

• Go to IRS.gov/Refunds.

• Download the official IRS2Go app to your mobile device to check your refund status.

• Call the automated refund hotline at 800-829-1954.

The IRS can’t issue refunds before mid-February 

for returns that claimed the EIC or the additional 

child tax credit (ACTC). This applies to the entire 

refund, not just the portion associated with these credits.

Making a tax payment. Payments of U.S. tax must be 

remitted to the IRS in U.S. dollars. Digital assets are not 

accepted. Go to IRS.gov/Payments for information on how 

to make a payment using any of the following options.

• IRS Direct Pay: Pay your individual tax bill or estimated 

tax payment directly from your checking or savings account at no cost to you.

• Debit Card, Credit Card, or Digital Wallet: Choose an 

approved payment processor to pay online or by 

phone.

• Electronic Funds Withdrawal: Schedule a payment 

when filing your federal taxes using tax return preparation software or through a tax professional.

• Electronic Federal Tax Payment System: Best option 

for businesses. Enrollment is required.

• Check or Money Order: Mail your payment to the address listed on the notice or instructions.

• Cash: You may be able to pay your taxes with cash at 

a participating retail store.

• Same-Day Wire: You may be able to do same-day 

wire from your financial institution. Contact your financial institution for availability, cost, and time frames.

Note. The IRS uses the latest encryption technology 

to ensure that the electronic payments you make online, 

by phone, or from a mobile device using the IRS2Go app 

are safe and secure. Paying electronically is quick, easy, 

and faster than mailing in a check or money order.

What if I can’t pay now? Go to IRS.gov/Payments for 

more information about your options.

• Apply for an online payment agreement (IRS.gov/

OPA) to meet your tax obligation in monthly installments if you can’t pay your taxes in full today. Once 

you complete the online process, you will receive immediate notification of whether your agreement has 

been approved.

• Use the Offer in Compromise Pre-Qualifier to see if 

you can settle your tax debt for less than the full 

amount you owe. For more information on the Offer in 

Compromise program, go to IRS.gov/OIC.

Filing an amended return. Go to IRS.gov/Form1040X 

for information and updates.

CAUTION

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Publication 969 (2023) 21
Checking the status of your amended return. Go to 

IRS.gov/WMAR to track the status of Form 1040-X amended returns.

It can take up to 3 weeks from the date you filed 

your amended return for it to show up in our system, and processing it can take up to 16 weeks.

Understanding an IRS notice or letter you’ve received. Go to IRS.gov/Notices to find additional information about responding to an IRS notice or letter.

Responding to an IRS notice or letter. You can now 

upload responses to all notices and letters using the 

Document Upload Tool. For notices that require additional 

action, taxpayers will be redirected appropriately on 

IRS.gov to take further action. To learn more about the 

tool, go to IRS.gov/Upload.

Note. You can use Schedule LEP (Form 1040), Request for Change in Language Preference, to state a preference to receive notices, letters, or other written communications from the IRS in an alternative language. You may 

not immediately receive written communications in the requested language. The IRS’s commitment to LEP taxpayers is part of a multi-year timeline that began providing 

translations in 2023. You will continue to receive communications, including notices and letters, in English until they 

are translated to your preferred language.

Contacting your local TAC. Keep in mind, many questions can be answered on IRS.gov without visiting a TAC. 

Go to IRS.gov/LetUsHelp for the topics people ask about 

most. If you still need help, TACs provide tax help when a 

tax issue can’t be handled online or by phone. All TACs 

now provide service by appointment, so you’ll know in advance that you can get the service you need without long 

wait times. Before you visit, go to IRS.gov/TACLocator to 

find the nearest TAC and to check hours, available services, and appointment options. Or, on the IRS2Go app, 

under the Stay Connected tab, choose the Contact Us option and click on “Local Offices.”

The Taxpayer Advocate Service (TAS) 

Is Here To Help You

What Is TAS?

TAS is an independent organization within the IRS that 

helps taxpayers and protects taxpayer rights. TAS strives 

to ensure that every taxpayer is treated fairly and that you 

know and understand your rights under the Taxpayer Bill 

of Rights.

How Can You Learn About Your Taxpayer 

Rights?

The Taxpayer Bill of Rights describes 10 basic rights that 

all taxpayers have when dealing with the IRS. Go to 

TaxpayerAdvocate.IRS.gov to help you understand what 

CAUTION

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these rights mean to you and how they apply. These are 

your rights. Know them. Use them.

What Can TAS Do for You?

TAS can help you resolve problems that you can’t resolve 

with the IRS. And their service is free. If you qualify for 

their assistance, you will be assigned to one advocate 

who will work with you throughout the process and will do 

everything possible to resolve your issue. TAS can help 

you if:

• Your problem is causing financial difficulty for you, 

your family, or your business;

• You face (or your business is facing) an immediate 

threat of adverse action; or

• You’ve tried repeatedly to contact the IRS but no one 

has responded, or the IRS hasn’t responded by the 

date promised.

How Can You Reach TAS?

TAS has offices in every state, the District of Columbia, 

and Puerto Rico. To find your advocate’s number:

• Go to TaxpayerAdvocate.IRS.gov/Contact-Us;

• Download Pub. 1546, The Taxpayer Advocate Service 

Is Your Voice at the IRS, available at IRS.gov/pub/irspdf/p1546.pdf;

• Call the IRS toll free at 800-TAX-FORM 

(800-829-3676) to order a copy of Pub. 1546;

• Check your local directory; or

• Call TAS toll free at 877-777-4778.

How Else Does TAS Help Taxpayers?

TAS works to resolve large-scale problems that affect 

many taxpayers. If you know of one of these broad issues, 

report it to TAS at IRS.gov/SAMS. Be sure to not include 

any personal taxpayer information.

Low Income Taxpayer Clinics (LITCs)

LITCs are independent from the IRS and TAS. LITCs represent individuals whose income is below a certain level 

and who need to resolve tax problems with the IRS. LITCs 

can represent taxpayers in audits, appeals, and tax collection disputes before the IRS and in court. In addition, 

LITCs can provide information about taxpayer rights and 

responsibilities in different languages for individuals who 

speak English as a second language. Services are offered 

for free or a small fee. For more information or to find an 

LITC near you, go to the LITC page at 

TaxpayerAdvocate.IRS.gov/LITC or see IRS Pub. 4134, 

Low Income Taxpayer Clinic List, at IRS.gov/pub/irs-pdf/

p4134.pdf.

22 Publication 969 (2023)
To help us develop a more useful index, please let us know if you have ideas for index entries.

Index See “Comments and Suggestions” in the “Introduction” for the ways you can reach us.

A

Archer MSAs 11-15

Assistance (See Tax help)

C

Contributions to:

FSA 16

HRA 18

HSA 5

MSA 12

D

Death of:

HSA holder 10

MSA holder 15

Distributions from:

FSA 16

HRA 18

HSA 8

MSA 13

E

Employer participation:

FSA 17

HRA 19

HSA 10

MSA 15

F

Flexible spending 

arrangements 16, 17

Balance in 17

Contributions to 16

Distributions from 16

Grace period 17

Qualifying for 16

When to contribute 16

Form:

5329 8, 13

5498–SA 8, 13

8853 15

8889 8, 10

H

Health plans, high deductible 4, 12

Health reimbursement 

arrangements 18, 19

Balance in 19

Contributions to 18

Distributions from 18

Qualifying for 18

Health savings accounts 3-11

Balance in 10

Contributions to 5

Deemed distributions 9

Distributions from 8

Last-month rule 6

Partnerships 8

Qualifying for 3

Rollovers 7

S corporations 8

When to contribute 8

High deductible health plan 4, 12

M

Medical expenses, qualified 9, 14, 

17, 18

Medical savings accounts 11-16

Balance in 15

Contributions to 12

Deemed distributions 14

Distributions from 13

Medicare Advantage MSAs 16

Qualifying for 11

When to contribute 13

Medicare Advantage MSAs 16

P

Preventive care 4

Publications (See Tax help)

Q

Qualified HSA funding 

distribution 7

T

Tax help 19

Testing period:

Last-month rule 6

Qualified HSA funding distribution 7

Publication 969 (2023) 23