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Click ‘Get Form’ to open the 2015 8853 form in the editor.
Begin by entering your name and social security number at the top of the form. If applicable, include your spouse's information if filing jointly.
In Section A, provide details about Archer MSA contributions. Fill out Part I by entering total employer contributions and your personal contributions for the year.
Complete lines regarding distributions received from Archer MSAs, ensuring to note any rollovers or excess contributions as instructed.
Move to Section B for Medicare Advantage MSA distributions. Enter total distributions and any unreimbursed qualified medical expenses.
Finally, complete Section C for Long-Term Care Insurance Contracts, providing necessary details about payments received and costs incurred.

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What is a form 8853?

Use Form 8853 to: Report Archer MSA contributions (including employer contributions), Figure your Archer MSA deduction, Report distributions from Archer MSAs or Medicare Advantage MSAs, Report taxable payments from long-term care (LTC) insurance contracts, or.

What are Archer MSA contributions?

Archer MSAs were created to help self-employed individuals and employees of certain small employers meet the medical care costs of the account holder, the account holders spouse, or the account holders dependent(s).

How do I know if I have an Archer MSA?

Archer MSA eligibility Archer MSAs cover self-employed workers or those who work for a company with an average of 50 or fewer employees over either of the preceding two years. Your health plan must be a high-deductible plan, and you must have no other health coverage, although there are some exceptions to the rule.

What is Archer MSA deduction?

A Medicare Advantage MSA is an Archer MSA designed by Medicare to be used solely to pay the qualified medical expenses of the account holder who is enrolled in Medicare. Contributions can only be made by Medicare. The contributions are not included in your gross income, nor are they deductible.