Form 5498-SA: The HSA Contribution Statement and What Its Boxes Mean
Published November 7, 2026
Form 5498-SA reports contributions to a health savings account (HSA), an Archer medical savings account (Archer MSA), or a Medicare Advantage MSA (MA MSA). It also reports the account's value at the end of the year. The Instructions for Forms 1099-SA and 5498-SA (2025) explain the boxes. This post is general information, not advice about your own account.
Who files it
The trustee or custodian of the account files Form 5498-SA. The instructions say to file it with the IRS by June 1, 2026, for each person for whom the account was maintained in 2025. Use a separate form for each type of account.
The statement to you
The participant gets a statement, generally Copy B, by June 1, 2026. The trustee may also send a statement of the December 31, 2025, value by February 2, 2026.
If that February statement was sent and no contributions or rollovers were made for 2025, the trustee does not need to send another statement to show zero contributions. The trustee must still file Form 5498-SA with the IRS by June 1, 2026, to report the December 31, 2025, value.
If the account was fully paid out in 2025 and no contributions were made for that year, the trustee generally does not need to file Form 5498-SA.
The boxes
- Box 1, Archer MSA contributions. Regular contributions made in 2025 and through April 15, 2026, for 2025. The instructions say no HSA information goes in box 1.
- Box 2, Total HSA or Archer MSA contributions. Contributions made in 2025, including a 2025 contribution for 2024. It also includes qualified HSA funding distributions, which are trustee-to-trustee transfers from an IRA to an HSA.
- Box 3, Contributions for 2025 made in 2026. Contributions made in 2026 for the 2025 year.
- Box 4, Rollover contributions. Rollovers received in 2025. These amounts are not included in box 2.
- Box 5, Fair market value. The value of the account on December 31, 2025.
- Box 6, Checkbox. The type of account: HSA, Archer MSA, or MA MSA.
Rollovers and transfers
A rollover from one Archer MSA to another Archer MSA, or from an Archer MSA or an HSA to an HSA, is reported in box 4. Trustee-to-trustee transfers from an Archer MSA to another Archer or MA MSA, from an Archer MSA to an HSA, or from one HSA to another HSA are not reported as contributions or rollovers. The transfer from an IRA to an HSA is the exception, and it is reported in box 2.
Account numbers and your taxpayer number
An account number is required if the trustee files more than one Form 5498-SA for the same person. The IRS also encourages a number on every form. On the statement sent to you, the trustee may shorten your taxpayer number. The copy filed with the IRS may not be shortened.
Mistaken distributions
If you repay a mistaken distribution, the instructions say not to treat the repayment as a contribution on Form 5498-SA. Keep the records that show the repayment.
When the account owner dies
In the year the account owner dies, the trustee generally must file Form 5498-SA and give a statement for the decedent. If the designated beneficiary is the surviving spouse, the spouse becomes the account holder of the HSA or Archer MSA.
How this relates to your return
Form 5498-SA is a record of what was put into and held in the account. Your own return may also need Form 8889. Payouts from the account are reported on Form 1099-SA. For the basic rules, read HSA Basics: Eligibility, HDHP Rules, and 2026 Limits.
Checklist
- Find box 2 and compare it with your own contribution records.
- Check box 3 for contributions made in early 2026 for 2025.
- Check box 5 against your account statement at year end.
Sources: Sources: IRS, Instructions for Forms 1099-SA and 5498-SA (2025) (https://www.irs.gov/pub/irs-prior/i1099sa--2025.pdf) This is general information, not advice about your specific return.
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