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Home » Form 5498-SA
Form 5498-SA is an IRS form used to report contributions to a Health Savings Account (HSA), Archer Medical Savings Account (Archer MSA), or Medicare Advantage MSA (MA MSA) over a tax year.
HSAs are tax-advantaged savings accounts designed for taxpayers with high-deductible health plans. It allows for tax-deductible contributions, growth, and withdrawals for qualified medical expenses. Accurate reporting is crucial to avoid a 6% excise tax on excess contributions.
Archer MSAs is designed for self-employed individuals and small businesses with HDHPs. The contribution limits are based on a percentage of the HDHP deductible which are 65% for self-only coverage and 75% for family coverage.
Medicare Advantage MSAs are a type of Medicare Advantage plan that combines a high-deductible Medicare health plan with a tax-free medical savings account for healthcare expenses. It is funded only by Medicare and has no individual contributions.
A trustee or a custodian who maintains HSA, Archer MSA, or MA MSA will be required to file Form 5498-SA. Individuals who made contributions to these accounts will be the recipients.
A separate form is required for each type of plan, whether it is an HSA, Archer MSA, or Medicare Advantage MSA.
Regular contributions to the Archer MSA, including any excess contributions, by an employee or a self-employed person.
Total HSA or Archer MSA contributions made in 2025, including qualified HSA funding distributions.
Total HSA or Archer MSA contributions made in 2026 for 2025.
Rollover contributions to the HSA or Archer MSA received during 2025.
Fair Market Value of the account on December 31, 2025.
Indicate if the account is an HSA, Archer MSA, or MA MSA.