This 1099 SA Form 2026 guide explains the IRS Distributions From an HSA, Archer MSA, or Medicare Advantage MSA. Form 1099-SA reports distributions rather than determining whether the money was used for qualified expenses. The account type, distribution code and supporting expense records affect the return treatment. A distribution and a contribution to the account are separate reporting subjects.
Reviewed October 31, 2026. This is an independent guide. The version and availability information below identifies the IRS documents used for this page.
What 1099 SA Form 2026 does and who prepares it
An account custodian reports distributions from the HSA, Archer MSA or Medicare Advantage MSA arrangements covered by the statement.
For the connected reporting route, see Form 8889. Keep the role of that document separate from the task explained on this page.
| Official form | Form 1099-SA |
|---|---|
| IRS title | Distributions From an HSA, Archer MSA, or Medicare Advantage MSA |
| Guide period | 2026 |
| Target version | Apr 2025 |
| Availability | Current IRS catalog PDF |
| Last checked | October 31, 2026 |
Get the 1099 SA Form 2026 PDF and check its status
Use the IRS source to confirm the document before completing a real filing. The download link is a reference to the official file; it is not a statement that every copy inside the PDF may be printed and submitted. Follow any instructions about electronic filing, scannable copies, recipient copies or attachments.
Which version of 1099 SA Form 2026 should you use?
The 2026 in the title identifies the tax year or calendar-year information addressed by this guide. For a 2026 income reporting document, the preparation or filing activity may occur in 2027. Do not change the income year simply because the calendar has changed. The exact filing or furnishing date comes from the instructions for this form and the filer circumstances.
Records to gather for 1099 SA Form 2026
- Distribution statement.
- Account type.
- Qualified medical expense receipts.
- Refund or correction records.
- Contribution history.
Keep a working reconciliation with these records. It should show the source of each reported item, any correction made before filing and the reason a different amount appears on a connected form. This is especially useful when a statement is corrected or a prior-year balance continues into the current calculation.
How to work through 1099 SA Form 2026
- Identify the issuer and recipient. Check which person or entity prepares the information return and which person receives a statement. Use the correct copy and filing route for that role.
- Reconcile the underlying records. Compare the statement with the transaction, payroll, account or payment records. Resolve duplicate reporting and unexplained differences before carrying a total into a return.
- Read boxes and codes separately. Different boxes can describe different tax categories. A gross payment, a taxable amount, a withholding credit and an identifying code should not be combined as if they were one measure.
- Use the correct return treatment. An information return supplies facts. It does not independently establish every deduction, exclusion, credit or final tax result for the recipient.
- Address corrections at the source. Check the issuer correction process for an incorrect statement. If a related tax return has already been filed, review separately whether that return also needs a correction.
Form-specific IRS instructions and reporting details
The following points retain the operative wording of the IRS documents linked above. Read each point with its stated conditions and the applicable form version. References to another form or section describe a connected requirement; they do not mean that every reader must file every referenced document.
(Use with the April 2025 revision of Form 1099-SA and the December 2026 revision of Form 5498-SA.) Distributions From an HSA, Archer MSA, or Medicare Advantage MSA, and HSA, Archer MSA, or Medicare Advantage MSA Information Section references are to the Internal Revenue Code unless otherwise noted.
What’s New Address fields. For the Trustee’s and Participant’s information, we separated the address fields into individual entry boxes on Form 5498-SA. Continuous-use revisions. Use the April 2025 revision of Form 1099-SA, the December 2026 revision of Form 5498-SA, and these instructions to file and furnish 2026 information in early 2027. Continue to use these revisions for subsequent years until we issue a superseding revision. Do not use these revisions for prior years.
File Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA, to report distributions made from a health savings account (HSA), Archer medical savings account (Archer MSA), or Medicare Advantage MSA (MA MSA). The distribution may have been paid directly to a medical service provider or to the account holder. A separate return must be filed for each plan type.
Additional reporting conditions
If amounts were distributed during the year from an HSA because of a mistake of fact due to reasonable cause, the account beneficiary may repay the mistaken distribution no later than the due date of the tax return (not counting extensions) following the first year the account beneficiary knew or should have known the distribution was a mistake. For example, the account beneficiary reasonably, but mistakenly, believed that an expense was a qualified medical expense and was reimbursed for that expense from the HSA. The account beneficiary then repays the mistaken distribution to the HSA.
Under these circumstances, the mistaken distribution is not included in gross income, is not subject to the additional 20% tax, and the repayment is not subject to the excise tax on excess contributions. Do not treat the repayment as a contribution on Form 5498-SA, HSA, Archer MSA, or Medicare Advantage MSA Information. Tip: As the trustee or custodian, you do not have to allow beneficiaries to return a mistaken distribution to the HSA.
However, if you do allow the return of the mistaken distribution, you may rely on the account beneficiary’s statement that the distribution was a mistake. See Notice 2004-50, 2004-33 I.R.B. 196, Q&A 76, available atIRS.gov/irb/2004-33_IRB#NOT-2004-50. Do not report the mistaken distribution on Form 1099-SA. Correct any filed Form 1099-SA with the IRS and the account beneficiary as soon as you become aware of the error. See Corrected Returns on Paper Forms in the current Pub. 1099 for more information.
Calculations and supporting information
If an HSA is closed at any time by the HSA trustee or custodian due to a failure of the participant to satisfy the Customer Identification Program requirements described in section 326 of the USA PATRIOT Act, the distribution from the HSA must be reported. If a regular contribution is made to the HSA that is closed, and a distribution is made to the participant, enter the gross distribution in box 1. If no earnings are distributed, enter zero in box 2. If earnings are distributed, enter the amount of earnings in box 2.
Enter code 2 in box 3. See the instructions for boxes 1 through 3, later. In addition, Form 5498-SA must be filed to report any rollover (qualified HSA funding distributions (trustee-to-trustee transfers from an individual retirement arrangement (IRA) to an HSA under section 408(d)(9))) contributions to the HSA subsequently closed by the trustee or custodian. See the Specific Instructions for Form 5498-SA, later.
Exceptions and related reporting
Distribution after year of death. If you learn of the death of the account holder and make a distribution after the year of death, issue a Form 1099-SA in the year you learned of the death of the account holder. Enter in: • Box 1, the gross distribution; • Box 3, one of the following codes (see Box 3.
Distribution Code, later): 1—If the beneficiary is the spouse, 4—If the beneficiary is the estate, or 6—If the beneficiary is not the spouse or estate; and • Box 4, the FMV of the account on the date of death, reduced by any payments from the HSA made for the decedent’s qualified medical expenses, if paid within 1 year after death.
HSAs. When the account holder dies, the following applies. • If the designated beneficiary is the surviving spouse, the spouse becomes the account holder of the HSA. • If the designated beneficiary is not the surviving spouse, the account ceases to be an HSA on the date of the account holder’s death. The FMV of the account as of the date of death is required to be reported in box 4. Follow the rules and coding above under Distribution in year of death and Distribution after year of death.
If you are required to file Form 1099-SA, you must provide a statement to the recipient. For more information about the requirement to furnish a Form 1099-SA or acceptable substitute statement to recipients, see part M in the current Pub. 1099.
Further form details
The account number is required if you have multiple accounts for a recipient for whom you are filing more than one Form 1099-SA. Additionally, the IRS encourages you to designate an account number for all Forms 1099-SA that you file. See part L in the current Pub. 1099.
Enter the total earnings distributed with any excess HSA or Archer MSA contributions returned by the due date of the account holder’s tax return. Include this amount in box 1. Report earnings on other distributions only in box 1.
Tip: For HSAs and Archer MSAs, if you are reporting earnings on a distribution of excess contributions, use the method under Regulations section 1.408-11 for calculating the net income attributable to IRA contributions that are distributed as a returned contribution. If the amount in box 2 includes earnings on excess contributions, enter distribution code 2 in box 3.
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. Also, see Distribution after year of death, earlier.
A practical example
An HSA holder receives a distribution statement and compares it with medical expense records. The holder identifies any amounts that need a different treatment before completing the HSA form and related return lines.
This example illustrates the order of the review. It does not assume an unverified deduction, exemption, treaty rate or final tax amount. The applicable form instructions and the actual records determine the result.
Common mistakes to avoid with 1099 SA Form 2026
- Do not assume every distribution is tax-free.
- Keep HSA and other account reporting routes distinct.
- Match distributions to supporting expense records without reusing an expense improperly.
Questions about 1099 SA Form 2026
Does receiving or downloading this form mean I must file it?
An account custodian reports distributions from the HSA, Archer MSA or Medicare Advantage MSA arrangements covered by the statement. The form purpose and the applicable filing or furnishing conditions determine the action. Downloading a blank PDF does not itself create a filing obligation or establish eligibility for a tax benefit.
Is the revision date always the same as the tax year?
No. Some forms show a tax year, while continuing-use forms show a revision date and ask separately for the reporting period. Check the actual document and instructions. Do not relabel a payment or transaction solely because it was reported in a later calendar year.
What should I do if the underlying information is wrong?
Do not assume every distribution is tax-free. Keep the original record and the correction trail. The issuer correction process, an amended return and an updated certificate can be different procedures. Choose the process that matches the document and the actual error.
Which records should I keep with the completed form?
Retain the source documents, applicable worksheets, submitted version and filing or furnishing confirmations. For this form, the working file should include distribution statement, account type, qualified medical expense receipts. Keep continuing balances and prior-year support for as long as they remain relevant under the applicable recordkeeping rules.
Related forms and next steps
Use these guides when the connected issue applies to your records. Each page has its own purpose, reporting year and availability status.