2024

Instructions for Forms 

1099-SA and 5498-SA

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

Archer MSA, or Medicare Advantage MSA Information

Department of the Treasury

Internal Revenue Service

Section references are to the Internal Revenue Code 

unless otherwise noted.

Future Developments

For the latest information about developments related to 

Forms 1099-SA and 5498-SA and their instructions, such 

as legislation enacted after they were published, go to 

IRS.gov/Form1099SA and IRS.gov/Form5498SA.

Reminders

In addition to these specific instructions, you should also 

use the 2024 General Instructions for Certain Information 

Returns. Those general instructions include information 

about the following topics.

• Who must file.

• When and where to file.

• Electronic reporting.

• Corrected and void returns.

• Statements to recipients.

• Taxpayer identification numbers (TINs).

• Backup withholding.

• Penalties.

• Other general topics.

You can get the general instructions from IRS.gov/

1099GeneralInstructions, IRS.gov/Form1099SA, and 

IRS.gov/Form5498SA.

Continuous-use form and instructions. Form 1099-SA 

and its instructions are continuous use. Both the form and 

instructions will be updated as needed. For the most 

recent version, go to IRS.gov/Form1099SA.

E-filing returns. The Taxpayer First Act of 2019 

authorized the Department of the Treasury and the IRS to 

issue regulations that reduce the 250-return e-file 

threshold. T.D. 9972, published February 23, 2023, 

lowered the e-file threshold to 10 (calculated by 

aggregating all information returns), effective for 

information returns required to be filed on or after January 

1, 2024. Go to IRS.gov/InfoReturn for e-file options.

Online fillable forms. Due to the very low volume of 

paper Forms 1099-SA and 5498-SA received and 

processed by the IRS each year, these forms have been 

converted to an online fillable format. You may fill out the 

forms, found online at IRS.gov/Form1099SA and IRS.gov/

Form5498SA, and send Copy B to the recipient.

For Forms 1099-SA and 5498-SA only, if due to 

a low volume of recipients, you are filing the 

form(s) on paper, you can send in the 

black-and-white Copy(ies) A with a Form 1096 that you 

also printed from the IRS website.

CAUTION

!

Specific Instructions for Form 

1099-SA

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

MSA, or Medicare Advantage MSA, to report distributions 

made from a health savings account (HSA), Archer 

medical savings account (Archer MSA), or Medicare 

Advantage MSA (MA MSA). The distribution may have 

been paid directly to a medical service provider or to the 

account holder. A separate return must be filed for each 

plan type.

Transfers

Do not report a trustee-to-trustee transfer from one Archer 

MSA or MA MSA to another Archer MSA or MA MSA, 

from an Archer MSA to an HSA, or from one HSA to 

another HSA. For reporting purposes, contributions and 

rollovers do not include transfers.

HSA Mistaken Distributions

If amounts were distributed during the year from an HSA 

because of a mistake of fact due to reasonable cause, the 

account beneficiary may repay the mistaken distribution 

no later than the due date of the tax return (not counting 

extensions) following the first year the account beneficiary 

knew or should have known the distribution was a 

mistake. For example, the account beneficiary reasonably, 

but mistakenly, believed that an expense was a qualified 

medical expense and was reimbursed for that expense 

from the HSA. The account beneficiary then repays the 

mistaken distribution to the HSA.

Under these circumstances, the mistaken distribution is 

not included in gross income, is not subject to the 

additional 20% tax, and the repayment is not subject to 

the excise tax on excess contributions. Do not treat the 

repayment as a contribution on Form 5498-SA, HSA, 

Archer MSA, or Medicare Advantage MSA Information.

As the trustee or custodian, you do not have to 

allow beneficiaries to return a mistaken 

distribution to the HSA. However, if you do allow 

the return of the mistaken distribution, you may rely on the 

account beneficiary's statement that the distribution was 

in fact a mistake. See Notice 2004-50, 2004-33 I.R.B. 196, 

Q&A 76, available at IRS.gov/irb/

2004-33_IRB#NOT-2004-50. Do not report the mistaken 

distribution on Form 1099-SA. Correct any filed Form 

1099-SA with the IRS and the account beneficiary as soon 

as you become aware of the error. See Corrected Returns 

TIP

Aug 14, 2023 Cat. No. 38470S
on Paper Forms in the current General Instructions for 

Certain Information Returns for more information.

HSA Closure Under the USA PATRIOT Act

If an HSA is closed at any time by the HSA trustee or 

custodian due to a failure of the participant to satisfy the 

Customer Identification Program requirements described 

in section 326 of the USA PATRIOT Act, the distribution 

from the HSA must be reported.

If a regular contribution is made to the HSA that is 

closed, and a distribution is made to the participant, enter 

the gross distribution in box 1. If no earnings are 

distributed, enter zero in box 2. If earnings are distributed, 

enter the amount of earnings in box 2. Enter code 2 in 

box 3. See the instructions for boxes 1 through 3, later.

In addition, Form 5498-SA must be filed to report any 

rollover (qualified HSA funding distributions 

(trustee-to-trustee transfers from an individual retirement 

arrangement (IRA) to an HSA under section 408(d)(9))) 

contributions to the HSA subsequently closed by the 

trustee or custodian. See the Specific Instructions for 

Form 5498-SA, later.

Death of Account Holder

Archer MSAs and MA MSAs. When the account holder 

dies and the designated beneficiary is the surviving 

spouse, the following apply.

• The spouse becomes the account holder of the Archer 

MSA.

• An MA MSA is treated as an Archer MSA of the spouse 

for distribution purposes.

• Distributions from these accounts are subject to the 

rules that apply to Archer MSAs.

If the designated beneficiary is not the spouse or there 

is no named beneficiary, the account ceases to be an 

MSA as of the date of death and the fair market value 

(FMV) on that date is reported.

If there is more than one recipient, the FMV should be 

allocated among them, as appropriate.

If the beneficiary is the estate, enter the estate's name 

and TIN in place of the recipient's on the form.

Distribution in year of death. If you learn of the 

account holder's death and make a distribution to the 

beneficiary in the year of death, issue a Form 1099-SA 

and enter in:

• Box 1, the gross distribution;

• Box 3, code 4 (see Box 3. Distribution Code, later); and

• Box 4, the FMV of the account on the date of death.

Distribution after year of death. If you learn of the 

death of the account holder and make a distribution after 

the year of death, issue a Form 1099-SA in the year you 

learned of the death of the account holder. Enter in:

• Box 1, the gross distribution;

• Box 3, one of the following codes (see Box 3. 

Distribution Code, later):

1—If the beneficiary is the spouse,

4—If the beneficiary is the estate, or

6—If the beneficiary is not the spouse or estate; and

• Box 4, the FMV of the account on the date of death, 

reduced by any payments from the HSA made for the 

decedent's qualified medical expenses, if paid within 1 

year after death.

HSAs. When the account holder dies, the following 

applies.

• If the designated beneficiary is the surviving spouse, 

the spouse becomes the account holder of the HSA.

• If the designated beneficiary is not the surviving 

spouse, the account ceases to be an HSA on the date of 

the account holder's death. The FMV of the account as of 

the date of death is required to be reported in box 4. 

Follow the rules and coding above under Distribution in 

year of death and Distribution after year of death.

Statements to Recipients

If you are required to file Form 1099-SA, you must provide 

a statement to the recipient. For more information about 

the requirement to furnish a Form 1099-SA or acceptable 

substitute statement to recipients, see part M in the 

current General Instructions for Certain Information 

Returns.

Truncating Recipient's TIN on Payee Statements

Pursuant to Regulations section 301.6109-4, all filers of 

this form may truncate a recipient’s TIN (social security 

number (SSN), individual taxpayer identification number 

(ITIN), adoption taxpayer identification number (ATIN), or 

employer identification number (EIN)) on payee 

statements. Truncation is not allowed on any documents 

the filer files with the IRS. A trustee's/payer's TIN may not 

be truncated on any form. See part J in the current 

General Instructions for Certain Information Returns.

Account Number

The account number is required if you have multiple 

accounts for a recipient for whom you are filing more than 

one Form 1099-SA. Additionally, the IRS encourages you 

to designate an account number for all Forms 1099-SA 

that you file. See part L in the current General Instructions 

for Certain Information Returns.

Box 1. Gross Distribution

Enter the total amount of the distribution. Include any 

earnings separately reported in box 2. You are not 

required to determine the taxable amount of a distribution. 

Do not report a negative amount in box 1. Do not report 

the withdrawal of excess employer contributions (and the 

earnings on them) returned to an employer as a 

distribution from an employee's HSA. Do not report 

excess MA MSA contributions returned to the Secretary of 

Health and Human Services or their representative.

Box 2. Earnings on Excess Contributions

Enter the total earnings distributed with any excess HSA 

or Archer MSA contributions returned by the due date of 

the account holder's tax return. Include this amount in 

box 1. Report earnings on other distributions only in box 1.

-2- Instructions for Forms 1099-SA and 5498-SA (2024)
For HSAs and Archer MSAs, if you are reporting 

earnings on a distribution of excess contributions, 

use the method under Regulations section 

1.408-11 for calculating the net income attributable to IRA 

contributions that are distributed as a returned 

contribution. If the amount in box 2 includes earnings on 

excess contributions, enter distribution code 2 in box 3.

TIP

Box 3. Distribution Code

Enter the appropriate distribution code from the following 

list that shows the type of distribution.

Distribution Codes for Distributions From HSAs, Archer MSAs, and Medicare Advantage MSAs

1—Normal distributions

Use this code for normal distributions to the account 

holder and any direct payments to a medical service 

provider. Use this code if no other code applies. Also, see 

Distribution after year of death, earlier.

2—Excess contributions Use this code for distributions of excess HSA or Archer 

MSA contributions to the account holder. 

3—Disability Use this code if you made distributions after the account 

holder was disabled (see section 72(m)(7)).

4—Death distribution other than code 6

Use this code for payments to a decedent's estate in the 

year of death. Also use this code for payments to an 

estate after the year of death. Do not use with code 6. See 

Death of Account Holder, earlier.

5—Prohibited transaction See sections 220(e)(2) and 223(e)(2).

6—Death distribution after year of death to a nonspouse 

beneficiary

Use this code for payments to a decedent's nonspouse 

beneficiary, other than an estate, after the year of death. 

Do not use with code 4.

Box 4. FMV on Date of Death

Enter the FMV of the account on the date of death. See 

Death of Account Holder, earlier.

Box 5. Checkbox

Check the box to indicate if this distribution was from an 

HSA, Archer MSA, or MA MSA.

Specific Instructions for Form 

5498-SA

File Form 5498-SA, HSA, Archer MSA, or Medicare 

Advantage MSA Information, with the IRS on or before 

June 2, 2025, for each person for whom you maintained a 

health savings account (HSA), Archer medical savings 

account (Archer MSA), or Medicare Advantage MSA (MA 

MSA) during 2024. You are required to file if you are the 

trustee or custodian of an HSA, Archer MSA, or MA MSA. 

A separate form is required for each type of plan.

For HSA or Archer MSA contributions made between 

January 1, 2025, and April 15, 2025, you should obtain 

the participant's designation of the year for which the 

contributions are made.

For repayment of a mistaken distribution amount, see 

HSA Mistaken Distributions, earlier. Do not treat the 

repayment as a contribution on Form 5498-SA.

Rollovers

You must report the receipt of a rollover from one Archer 

MSA to another Archer MSA, and the receipt of a rollover 

from an Archer MSA or an HSA to an HSA in box 4.

Transfers

Do not report a trustee-to-trustee transfer from one Archer 

MSA or MA MSA to another Archer MSA or MA MSA, 

from an Archer MSA to an HSA, or from one HSA to 

another HSA. For reporting purposes, contributions and 

rollovers do not include these transfers. However, see Box 

2, later, for the reporting of a trustee-to-trustee transfer 

from an IRA to an HSA.

Total Distribution, No Contributions

Generally, if a total distribution was made from an HSA or 

Archer MSA during the year and no contributions were 

made for that year, you need not file Form 5498-SA nor 

furnish a statement to the participant to reflect that the fair 

market value (FMV) on December 31 was zero.

Death of Account Holder

In the year an HSA, Archer MSA, or MA MSA owner dies, 

you must generally file a Form 5498-SA and furnish a 

statement for the decedent. If the designated beneficiary 

is the surviving spouse, the following apply.

• The spouse becomes the account holder of the HSA or 

Archer MSA.

• An MA MSA is treated as an Archer MSA of the spouse 

for distribution purposes, but no new contributions may be 

made to the account.

If the designated beneficiary is not the spouse or there 

is no designated beneficiary, the account ceases to be an 

HSA, Archer MSA, or MA MSA.

Instructions for Forms 1099-SA and 5498-SA (2024) -3-
Statements to Participants

If you are required to file Form 5498-SA, you must provide 

a statement to the participant (generally Copy B) by June 

2, 2025. You may, but you are not required to, provide the 

participant with a statement of the December 31, 2024, 

FMV of the participant's account by January 31, 2025. For 

more information about statements to participants, see 

part M in the 2024 General Instructions for Certain 

Information Returns.

If you furnished a statement of the FMV of the account 

to the participant by January 31, 2025, and no reportable 

contributions, including rollovers, were made for 2024, you 

need not furnish another statement (or Form 5498-SA) to 

the participant to report zero contributions. However, you 

must file Form 5498-SA with the IRS by June 2, 2025, to 

report the December 31, 2024, FMV of the account.

If you do not furnish another statement to the 

participant because no reportable contributions 

were made for the year, the statement of the FMV 

of the account must contain a legend designating which 

information is being furnished to the IRS.

Truncating Participant's TIN on Payee 

Statements

Pursuant to Regulations section 301.6109-4, all filers of 

this form may truncate a participant's TIN (social security 

number (SSN), individual taxpayer identification number 

(ITIN), adoption taxpayer identification number (ATIN), or 

employer identification number (EIN)) on payee 

statements. Truncation is not allowed on any documents 

the filer files with the IRS. A trustee's TIN may not be 

truncated on any form. See part J in the 2024 General 

Instructions for Certain Information Returns.

Account Number

The account number is required if you have multiple 

accounts for a recipient for whom you are filing more than 

one Form 5498-SA. Additionally, the IRS encourages you 

to designate an account number for all Forms 5498-SA 

that you file. See part L in the 2024 General Instructions 

for Certain Information Returns.

CAUTION

!

Box 1. Employee or Self-Employed Person's 

Archer MSA Contributions Made in 2024 and 

2025 for 2024

Enter the employee's or self-employed person's regular 

contributions to the Archer MSA made in 2024 and 

through April 15, 2025, for 2024. Report gross 

contributions, including any excess contributions, even if 

the excess contributions were withdrawn. No HSA 

information is to be reported in box 1.

Box 2. Total Contributions Made in 2024

Enter the total HSA or Archer MSA contributions made in 

2024. Include any contribution made in 2024 for 2023. 

Also include qualified HSA funding distributions 

(trustee-to-trustee transfers from an IRA to an HSA under 

section 408(d)(9)) received by you during 2024. Any 

excess employer contributions (and the earnings on them) 

withdrawn by the employer pursuant to Notice 2008-59, 

Q&A 24, available at IRS.gov/irb/

2008-29_IRB#NOT-2008-59, should not be reported as a 

contribution. You may, but you are not required to, report 

the total MA MSA contributions made in 2024 by the 

Secretary of Health and Human Services or their 

representative. Do not include amounts reported in box 4.

Box 3. Total HSA or Archer MSA Contributions 

Made in 2025 for 2024

Enter the total HSA or Archer MSA contributions made in 

2025 for 2024.

Box 4. Rollover Contributions

Enter rollover contributions to the HSA or Archer MSA 

received by you during 2024. These amounts are not to be 

included in box 2.

Box 5. Fair Market Value of HSA, Archer MSA, or 

MA MSA

Enter the FMV of the account on December 31, 2024.

Box 6. Checkbox

Check the box to indicate if this account is an HSA, Archer 

MSA, or MA MSA.

-4- Instructions for Forms 1099-SA and 5498-SA (2024)