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HSA distributions are exempt from income taxes if all of the funds are used to pay qualified medical expenses that were incurred after the HSA was established. If any portion of a distribution is not used for qualified medical expenses, that portion is taxable as income and subject to a 20 percent penalty.
If you hold an HSA account (or are the beneficiary of a deceased HSA holder), youre required to attach Form 8889 to your Form 1040 when filing your personal income tax or information return. If you fail to do so, youll be unable to deduct your HSA contributions.
While employer contributions to an HSA may be excluded from the employees income, all employer contributions, including those made by the employee through a cafeteria plan, must be reported in box 12 of the employees W-2.
Employer contributions arent included in income. Distributions from an HSA that are used to pay qualified medical expenses arent taxed.
If, during the tax year, you are the beneficiary of two or more HSAs or you are a beneficiary of an HSA and you have your own HSA, you must complete a separate Form 8889 for each HSA.
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File Form 8889 to: Report health savings account (HSA) contributions (including those made on your behalf and employer contributions).
Disregard any plans with self-only coverage. Complete a separate Form 8889 for each spouse. Combine the amounts on line 13 of both Forms 8889 and enter this amount on Schedule 1 (Form 1040), line 13. Be sure to attach both Forms 8889 to your paper tax return.
Part I HSA Contributions Deductions - This section of Form 8889 is used to report contributions that were made to an HSA by the taxpayer, their employer, or a trustee-to-trustee funding distribution from a traditional or Roth IRA.
You must always file a Form 8889 in any year you or an employer contributes money to your HSA or you make withdrawals from the account. The deduction you calculate on Form 8889 is taken on the first page of your income tax return.
If you have an HSA, you need to include information from two IRS forms Form 1099-SA and Form 8889 on your 1040 tax form. Form 1099-SA reports the total distributions (withdrawals) made from your HSA account during the taxable year. Form 8889 reports all contributions made to your account.

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