[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-303322-105":53,"doc-detail-303322-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","form-1099-sa-distributions-from-an-hsa-2025","Form 1099-SA Distributions from an HSA - 2025","","2025 Form 1099-SA explains HSA distribution reporting for participants. It outlines how lines on the form are used to report gross distributions, earnings on excess contributions, distribution codes, fair market value on date of death, and account type. The document provides recordkeeping expectations, defines qualified medical expenses and related exceptions, and describes how to report qualified versus nonqualified distributions for tax purposes on IRS forms 8889 and 1040, including potential tax and penalty implications.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/form-1099-sa-distributions-from-an-hsa-2025/303322/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/form-1099-sa-distributions-from-an-hsa-2025/303322.png","ImageObject",442,249,{"name":88,"@type":89},"Mabel","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-05","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":47},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"Why am I receiving a Form 1099-SA?","Question",{"text":108,"@type":109},"The IRS requires Fidelity to issue a Form 1099-SA if you took a distribution from your Fidelity HSA.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"How should distributions for nonqualified medical expenses be reported?",{"text":113,"@type":109},"Distributions for nonqualified medical expenses should be reported on IRS Form 1040 (line 21) and Form 8889. They are generally taxable and may be subject to an additional 20% penalty tax.",{"name":115,"@type":106,"acceptedAnswer":116},"If I transferred my HSA to Fidelity during 2025, who will send me my tax forms?",{"text":117,"@type":109},"Your enclosed Form 1099-SA includes distribution activity from the time you began conducting business with Fidelity. Your former HSA custodian should provide a Form 1099-SA for any distribution activity that occurred before the transfer.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},303322,1790416773,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":47,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":9},7971474920318,"https://ap-avatar.wpscdn.com/avatar/74000ee537e6b0ca360?x-image-process=image/resize,m_fixed,w_180,h_180&k=1788430171632181674","FIDELITY INVESTMENTS  \n\n| Your Form 1099-SA for Your Health Savings Account (HSA)\u003Cbr>You may receive more than one Form 1099-SA, because distribution information on each form is limited to one account and one distribution code. |  |\n| --- | --- |\n| National Financial Services LLC\u003Cbr>Agent for Fidelity Personal Trust Company\u003Cbr>P. O. Box 28019\u003Cbr>Albuquerque, NM 87125-8019\u003Cbr>Envelope 0000000000\u003Cbr>CUSTOMER NAME\u003Cbr>ADDRESS\u003Cbr>CITY STATE ZIP\u003Cbr>2025 Form 1099-SA Distributions from an HSA\u003Cbr>123-456789 *** - ** -0000 1 of 2\u003Cbr>Federal ID Number: 00-0000000\u003Cbr>Customer Service:800-544-3716\u003Cbr>Visit Us [Online:Fidelity.com](Online:Fidelity.com)\u003Cbr>Form 1099-SA\u003Cbr>2025 Distributions from an HSA\u003Cbr>This information is being furnished to the Internal Revenue Service.\u003Cbr>0MB No.1545-1517 Copy B for Participant\u003Cbr>1 Gross Distribution ............................................................... ..... 601.70\u003Cbr>2 Earnings on Excess Contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00\u003Cbr>3 Distribution Code ............................................................... ........... 1\u003Cbr>4 Fair Market Value on Date of Death   0.00\u003Cbr>5 Account Type ............................................................... .............. HSA\u003Cbr>This form is for illustrative purposes only.\u003Cbr>LINE 1: Reports the total amount of the distribution(s) . LINE 2: Reports the earnings on any excess contributions you withdrew from an HSA; this amount is also included on Line 1. LINE 3: Shows the distribution code. Please see thereverse side of your Form 1099-SA for official Internal Revenue Service (IRS) distribution code definitions.\u003Cbr>LINE 4: Shows the fair market value (FMV) on date of death for deceased participants.\u003Cbr>LINE 5: Shows the type of account that is reported on this Form 1099-SA.\u003Cbr>Recordkeeping for Your HSA\u003Cbr>• You must keep all receipts and records of medical expenses paid with your Fidelity HSA funds to document that distributions have been made exclusively for qualified medical expenses. You should keep these items for your own records; do not submit them to Fidelity. | • Distributions from your Fidelity HSA will be reported by Fidelity to you and the IRS each tax year on IRS Form 1099-SA.\u003Cbr>• If your tax return is audited by the IRS, you might be asked to provide receipts for qualified medical expenses paid using distributions from your Fidelity HSA.\u003Cbr>Qualified Medical Expenses\u003Cbr>Qualified medical expenses, as defined by the Internal Revenue Code, generally include:\u003Cbr>• Most medical care and services\u003Cbr>• Dental and vision care\u003Cbr>• Prescription drugs and some over-the-counter drugs that are not covered by insurance or otherwise\u003Cbr>Medical insurance premiums are generally not considered qualified medical expenses; however, premiums paid for COBRA continuation coverage, qualified long-term care insurance (subject to certain limitations), and Medicare premiums are considered qualified medical expenses.\u003Cbr>For more details about qualified medical expenses, please refer to IRS Publications 969 and 502, or consulta tax professional. |\n\nFrequently Asked Questions  \n\n| Why am I receiving a Form 1099-SA? | The IRS requires Fidelity to issue a Form 1099-SA if you took a distribution from your Fidelity HSA. |\n| --- | --- |\n| Am I required to report information contained on | Yes. Distributions from HSAs are generally reportable on IRS Form 1040 and Form 8889. |\n| Form 1099-SA on my federal income tax return? | Please refer to the official IRS instructions for Form 1040 and Form 8889, or consult your tax advisor for more information. |\n| How should distributions for qualified medical expenses be reported? | Distributions for qualified medical expenses should be reported on IRS Form 8889. |\n| How should distributions for nonqualified medical expenses be reported? | Distributions for nonqualified medical expenses should be reported on IRS Form 1040 (line 21) and Fo","cbCais2G6A58q2u9","https://ap.wps.com/l/cbCais2G6A58q2u9","pdf",645391,"English","# Frequently Asked Questions\n## Why am I receiving a Form 1099-SA?\n## Am I required to report information contained on Form 1099-SA on my federal income tax return?\n## How should distributions for qualified medical expenses be reported?\n## How should distributions for nonqualified medical expenses be reported?","[{\"question\":\"Why am I receiving a Form 1099-SA?\",\"answer\":\"The IRS requires Fidelity to issue a Form 1099-SA if you took a distribution from your Fidelity HSA.\"},{\"question\":\"How should distributions for nonqualified medical expenses be reported?\",\"answer\":\"Distributions for nonqualified medical expenses should be reported on IRS Form 1040 (line 21) and Form 8889. They are generally taxable and may be subject to an additional 20% penalty tax.\"},{\"question\":\"If I transferred my HSA to Fidelity during 2025, who will send me my tax forms?\",\"answer\":\"Your enclosed Form 1099-SA includes distribution activity from the time you began conducting business with Fidelity. Your former HSA custodian should provide a Form 1099-SA for any distribution activity that occurred before the transfer.\"}]","Form 1099-SA Distributions from an HSA - 2025 | PDF",1789801997]