Form 1099-SA: HSA Distributions and Distribution Codes
Form 1099-SA reports distributions from a health savings account (HSA), Archer MSA or Medicare Advantage MSA, and box 3 carries one of six distribution codes: 1 (normal distributions), 2 (excess contributions), 3 (disability), 4 (death distribution other than code 6), 5 (prohibited transaction) and 6 (death distribution after year of death to a nonspouse beneficiary). The recipient copy of Form 1099-SA (Rev. April 2025) says the payer isn’t required to compute the taxable amount, and says to file Form 8853 or Form 8889 with Form 1040 or 1040-SR to report a distribution even if the distribution isn’t taxable.
Maintained by Archie Chang · Sources checked against agency text on November 2, 2026 · Methodology & sources
Who files Form 1099-SA and who receives it
The IRS instructions and the IRS About page describe the form as the return for distributions from three kinds of account. The payer box on the form is labeled “TRUSTEE’S/PAYER’S name”, and the recipient receives Copy B.
“File Form 1099-SA to report distributions made from a:
Health savings account (HSA).
Archer Medical Savings Account (Archer MSA).
Medicare Advantage Medical Savings Account (MA MSA).”
“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.”
“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.”
“If you are required to file Form 1099-SA, you must provide a statement to the recipient.”
Form revision and tax year
Form 1099-SA (Rev. April 2025) and the Instructions for Forms 1099-SA and 5498-SA (Rev. December 2026) are the documents quoted here. The instructions say how the revisions are used:
“Use the April 2025 revision of Form 1099-SA, the December 2026 revision of Form 5498-SA, and these instructions to file and furnish 2026 information in early 2027. Continue to use these revisions for subsequent years until we issue a superseding revision. Do not use these revisions for prior years.”
Form 1099-SA box by box
The form has five boxes. The table puts the form’s label, the wording of the instructions for the payer and the wording of the instructions printed on the recipient copy side by side.
| Box | Label on the form | Instructions for Forms 1099-SA and 5498-SA (for the payer) | Instructions for Recipient (on the form) |
|---|---|---|---|
| Box 1 | 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. | Shows the amount received this year. The amount may have been a direct payment to the medical service provider or distributed to you. |
| Box 2 | 2 Earnings on excess cont. | 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. | Shows the earnings on any excess contributions you withdrew from an HSA or Archer MSA by the due date of your income tax return. |
| Box 3 | 3 Distribution code | Enter the appropriate distribution code from the following list that shows the type of distribution. | These codes identify the distribution you received: |
| Box 4 | 4 FMV on date of death | Enter the FMV of the account on the date of death. See Death of Account Holder, earlier. | If the account holder died, shows the FMV of the account on the date of death. |
| Box 5 | 5 HSA Archer MSA MA MSA | Check the box to indicate if this distribution was from an HSA, Archer MSA, or MA MSA. | Shows the type of account that is reported on this Form 1099-SA. |
“An excise tax of 6% for each tax year is imposed on you for excess individual and employer contributions that remain in the account.”
Box 3 distribution codes
Box 3 holds one distribution code. The instructions list six, shown here with the name and explanation exactly as printed. The same six codes are listed on the recipient copy of the form.
| Code | Name on the list | What the instructions say |
|---|---|---|
| 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. Don’t 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. Don’t use with code 4. |
Form 8889, Form 8853 and the taxable amount
The recipient copy of Form 1099-SA points to Form 8853 and Form 8889. See the Form 8889 page and the 2026 and 2027 HSA contribution limits for the contribution side.
“Distributions from a health savings account (HSA), Archer medical savings account (MSA), or Medicare Advantage (MA) MSA are reported to you on Form 1099-SA. File Form 8853 or Form 8889 with your Form 1040 or 1040-SR to report a distribution from these accounts even if the distribution isn’t taxable. The payer isn’t required to compute the taxable amount of any distribution.”
“An HSA or Archer MSA distribution isn’t taxable if you used it to pay qualified medical expenses of the account holder or eligible family member or you rolled it over. An HSA may be rolled over to another HSA; an Archer MSA may be rolled over to another Archer MSA or an HSA. An MA MSA isn’t taxable if you used it to pay qualified medical expenses of the account holder only. If you didn’t use the distribution from an HSA, Archer MSA, or MA MSA to pay for qualified medical expenses, or in the case of an HSA or Archer MSA, you didn’t roll it over, you must include the distribution in your income (see Form 8853 or Form 8889). Also, you may owe a penalty.”
“You may repay a mistaken distribution from an HSA no later than the due date of the tax return (not including extensions) following the first year you knew or should have known the distribution was a mistake, providing the trustee allows the repayment.”
After the account holder dies
The recipient copy has a paragraph for each kind of beneficiary:
“Spouse beneficiary. If you inherited an Archer MSA or MA MSA because of the death of your spouse, special rules apply. See the Instructions for Form 8853. If you inherited an HSA because of the death of your spouse, see the Instructions for Form 8889.”
“Estate beneficiary. If the HSA, Archer MSA, or MA MSA account holder dies and the estate is the beneficiary, the fair market value (FMV) of the account on the date of death is includible in the account holder’s gross income. Report the amount on the account holder’s final income tax return.”
“Nonspouse beneficiary. If you inherited the HSA, Archer MSA, or MA MSA from someone who wasn’t your spouse, you must report as income on your tax return the FMV of the account as of the date of death. Report the FMV on your tax return for the year the account owner died even if you received the distribution from the account in a later year.”
Due dates
Due dates for Form 1099-SA come from the Publication 1099 (2026) guide to information returns, the same publication the 1099 threshold page uses for Form 1099-NEC and Form 1099-MISC.
| Form | Publication 1099 (2026) row, as printed | Due to the IRS on paper | Due to the IRS if filed electronically | Due to the recipient |
|---|---|---|---|---|
| Form 1099-SA | All amounts February 28* January 31 | February 28 | March 31 | January 31 |
“* The due date is March 31 if filed electronically.”
“If any filing due date in these instructions falls on a Saturday, Sunday, or a legal holiday, you will be considered to have timely filed if you file by the next day that is not a Saturday, Sunday, or a legal holiday. Legal holidays for this purpose are legal holidays in the District of Columbia or a statewide legal holiday where the return is required to be filed.”
“File Form 5498-SA, HSA, Archer MSA, or Medicare Advantage MSA Information, with the IRS on or before May 31 of the subsequent year 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 the calendar year.”
Frequently asked questions
What is Form 1099-SA?
The IRS instructions say to file Form 1099-SA “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, and a separate return must be filed for each plan type.
What do the box 3 distribution codes on Form 1099-SA mean?
The instructions list six codes: 1—Normal distributions (“Use this code if no other code applies.”); 2—Excess contributions; 3—Disability; 4—Death distribution other than code 6; 5—Prohibited transaction; and 6—Death distribution after year of death to a nonspouse beneficiary.
Does Form 1099-SA show how much of a distribution is taxable?
The recipient copy says “The payer isn’t required to compute the taxable amount of any distribution.” It also says an HSA or Archer MSA distribution isn’t taxable if it was used to pay qualified medical expenses of the account holder or eligible family member or was rolled over, and that Form 8853 or Form 8889 is filed even if the distribution isn’t taxable. The recipient copy adds: “Also, you may owe a penalty.”
When is Form 1099-SA due?
Publication 1099 (2026) lists Form 1099-SA with a due date of February 28 to the IRS (March 31 if filed electronically) and January 31 to the recipient. It also says that if a filing due date falls on a Saturday, Sunday, or a legal holiday, a return filed by the next day that is not a Saturday, Sunday, or a legal holiday is considered timely.
How is Form 1099-SA different from Form 5498-SA?
Form 1099-SA reports distributions. The instructions say to file Form 5498-SA with the IRS “on or before May 31 of the subsequent year 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 the calendar year.” Publication 1099 (2026) lists Form 5498-SA as the form for HSA and Archer MSA contributions and for the FMV of the account.
What do codes 4 and 6 and box 4 mean after the account holder dies?
Code 4 is for payments to a decedent’s estate, and code 6 is for payments to a decedent’s nonspouse beneficiary, other than an estate, after the year of death; the instructions say not to use code 4 with code 6. For a distribution after the year of death, the instructions list code 1, 4 or 6 depending on whether the beneficiary is the spouse, the estate or neither, and describe box 4 as “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.”
Can a mistaken HSA distribution be repaid?
The recipient copy says: “You may repay a mistaken distribution from an HSA no later than the due date of the tax return (not including extensions) following the first year you knew or should have known the distribution was a mistake, providing the trustee allows the repayment.”