IRS Form 5498-SA

Edit
Fill out
Sign
Export or Print
Download your fillable IRS Form 5498-SA in  PDF
IRS Form 5498-SA

Several IRS forms and documents that taxpayers receive and complete must be attached to their tax return. But some of them are for informational purposes only. This type of paper includes Form 5498-SA.

If you have a Health Savings Account (HSA), Medicare Advantage Medical Savings Account (MA MSA), or Archer Medical Savings Account (MSA), your trustee or account manager will send you this document.

Below we will figure out what kind of paper it is, why and who sends it, how to read the report and how to use it further.

What Is 5498-SA?

This document displays data about the contributions credited to your MSA, MA MSA, or HSA during the tax year.

This document does not need to be attached to your tax return. You need the information reflected in the document to file another form — 8889 (which is filed to the Revenue Service). You can use our form-building software to complete this document.

You should receive the form by the end of January to 31st May. The paper is to be completed by the provider or bank where your account is located.

As most HSA contributions are transferred from your paychecks before federal income taxes are taken out, they are usually already tax-free.

Difference Between 5498-SA and 1099-SA

You can also get a seemingly similar document, Form 1099-SA. Their difference is that:

  • 5498-SA gives information about how much money has been deposited into accounts;
  • 1099-SA presents data on how much money from these accounts was spent to cover unqualified expenses.

Other IRS Forms

The Internal Revenue Service gathers vital information about different types of taxpayers using IRS forms. Familiarize yourself with all the forms that could apply to your case.


How to Read This Form

So, you will receive a completed form, and you do not need to add anything to it. Nevertheless, we will tell you what information is reflected in this paper.

The form consists of three copies, each of which is sent to its addressee:

  • Copy A is provided to the IRS Center
  • Copy B is sent to you
  • Copy C remains with the Trustee for internal reporting
  • Let’s consider Copy B more attentively

Trustee Data

In the upper left corner, you will find information about the Trustee who generated this document:

  • Full name
  • Address
  • Telephone number
  • TIN

step 1 trustee data filling out irs form 5498 sa

Your Data

Next, you will see your data:

  • TIN
  • Name
  • Address
  • Account number

Please check carefully that you have received the correct form, completed in your name. We also draw your attention to the fact that you will receive a separate form for each of your accounts (if you have several ones).

step 2 your data filling out irs form 5498 sa

Boxes 1-3

These sections contain different amounts of contributions, namely:

  1. Archer MSA contributions made for 2021
  2. Total contributions in 2021
  3. Total HSA or Archer MSA contributions made in 2022 for 2021

You need the information in Box 2 and 3 just for review, but you can probably use the data from Box 1 when filling out Forms 1040 or 1040-SR.

step 3 boxes 1 3 filling out irs form 5498 sa

Boxes 4 and 5

In Box 5, you will see the fair market value of your accounts in 2021.

Box 4 will give you information if there were any rollover contributions. It is important to note that these amounts are not included in the first 3 Boxes.

step 4 boxes 4 and 5 filling out irs form 5498 sa

The Type of the Account

Since a separate form must be filled out for each account, in Box 6, there will be a checkmark next to the appropriate type.

step 5 the type of the account filling out irs form 5498 sa

Do not lose your Form. Although you do not need to attach it to the rest of your tax return documents, you should keep the document in a safe place. Some forms require you to indicate the information provided in it.