Health Savings Accounts (HSAs), Federal Form 8889, 2023

Form 8889 is used to report Health Savings Account (HSA) activities, including contributions, deductions, distributions, and related tax obligations. HSAs are accounts established for qualified medical expenses, providing tax advantages for eligible individuals.

Who Must File Form 8889?

You must file if:

  • Contributions were made to your HSA in 2023.
  • You received HSA distributions in 2023.
  • Certain amounts must be included in income due to eligibility changes.
  • You acquired an HSA interest due to the death of the account beneficiary.

Note: Even with no taxable income, filing Form 8889 is required if you received HSA distributions in 2023.

Who are Eligible Individual?

  • Covered under a high deductible health plan (HDHP) with no other health coverage, except disregarded coverage.
  • Not enrolled in Medicare or a dependent on someone else's tax return.

What is a Last-Month Rule?

  • Eligible on the first day of the last month (December 1 for most) to be considered eligible for the entire year.
  • Testing period extends from the last month of the tax year to the 12th month following (e.g., December 1, 2023 – December 31, 2024).

What are the Qualified Medical Expenses?

  • Include unreimbursed medical expenses deductible on Schedule A (Form 1040).
  • COVID-19-related expenses, such as personal protective equipment and home testing, qualify.
  • Certain nutrition, wellness, and general health expenses may be reimbursed; check IRS.gov for details.

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