Box 1: Gross Distribution
Report this in the HSA section.
- Federal Section
- Health Savings Account
- Scroll down to Distributions
Total distributions received during 2021 from all HSAs. - Pulls to line 14a, Form 8889
- Total distributions include:
- amounts paid with a debit card that restricts payments to health care and
- amounts withdrawn by other individuals that you have designated
Distributions used for qualified medical expenses - Pulls to line 15, Form 8889
- Include distributions from your HSA that were used to pay for qualified medical expenses not reimbursed by insurance or other coverage and that you incurred after the HSA was established.
- Do not include the distribution of an excess contribution taken out after the due date, including
extensions, of your return even if used for qualified medical expenses.
- In general, include distributions from all HSAs in 2021 that were used for the qualified medical expenses of:
- You and your spouse.
- All your dependents.
- Any person who would be a dependent except that:
- The person filed a joint return.
- The person had gross income.
- You, or your spouse if filing jointly, are dependents of someone else.
NOTE: If you do not enter an amount here your entire distribution will be considered taxable
Box 2: Earnings on Excess Contributions
The total earnings distributed with any excess HSA or Archer MSA contributions returned by the due date of the account holder's tax return.
- Included in Box 1 amount
- If the amount in box 2 includes earnings on excess contributions, You will have distribution code 2 in box 3.
- Report this as Other Income on the tax return
- Complete form 5329 to report the excess contributions.
Box 3: Distribution Code: Not Supported in program
|1—Normal distributions||Use this code for normal distributions to the account holder and any direct payments to a medical service provider. Use this code if no other code applies.|
|2—Excess contributions||Use this code for distributions of excess HSA or Archer MSA contributions to the account holder|
|3—Disability||Use this code if you made distributions after the account holder was disabled|
|4—Death distribution other than code 6||Use this code for payments to a decedent's estate in the year of death. Also use this code for payments to an estate after the year of death.|
|5—Prohibited transaction||See sections 220(e)(2) and 223(e)(2).|
|6—Death distribution after year of death to a non-spouse beneficiary||Use this code for payments to a decedent's non-spouse beneficiary, other than an estate, after the year of death.|
Box 4: FMV on date of death-Not supported in program
Box 5: Checkbox- Not supported in program
Check the box to indicate if this distribution was from an HSA, Archer MSA, or MA MSA.