[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-303856-105":53,"doc-detail-303856-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-8889-health-savings-account-hsas","Form 8889 - Health Savings Account (HSAs)","","Form 8889 (2011) provides the reporting structure for Health Savings Accounts (HSAs), including contributions and deductions, distributions, and any additional tax tied to maintaining HDHP coverage. It directs filers to complete the appropriate parts based on whether filing jointly and whether both spouses have separate HSAs. The form references related IRS forms and includes line items for distribution totals, taxable portions, medical expenses, and income calculation entries.",{"@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-8889-health-savings-account-hsas/303856/",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-8889-health-savings-account-hsas/303856.png","ImageObject",442,249,{"name":88,"@type":89},"Ben ","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-26","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":76},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What must be completed before using Form 8889?","Question",{"text":108,"@type":109},"Complete Form 8853, Archer MSAs and Long-Term Care Insurance Contracts, if required, before completing Form 8889.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"Which part of Form 8889 reports HSA contributions and the HSA deduction?",{"text":113,"@type":109},"Part I reports HSA contributions and the HSA deduction, with separate Part I completion required for each spouse if both have separate HSAs while filing jointly.",{"name":115,"@type":106,"acceptedAnswer":116},"How does Form 8889 treat HSA distributions for tax purposes?",{"text":117,"@type":109},"Part II breaks out total HSA distributions, amounts rolled over or related excess contributions, unreimbursed qualified medical expenses, taxable distributions, and any additional 20% tax when applicable.","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},303856,1790223595,{"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":76,"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},2336478951081,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Form 8889  \nDepartment of the Treasury Internal Revenue Service  \nHealth Savings Account (HSAs)  \n Attach to Form 1040 or Form 1040NR.  See separate instructions.  \n| Name(s) shown on Form 1040 or Form 1040NR\u003Cbr>I .M . /SHEEZA HOPEFULL | Social security number of HSA\u003Cbr>beneficiary. If both spouses have\u003Cbr>HSAs, see instructions  | 321-88-7777 |\n| --- | --- | --- |\n\nBefore you begin: Complete Form 8853, Archer MSAs and Long-Term Care Insurance Contracts, if required.  \nPart I  HSA Contributions and Deduction. See the instructions before completing this part. If you are filing jointly  \nand both you and your spouse each have separate HSAs, complete a separate Part I for each spouse.  \n1 Check the box to indicate your coverage under a high-deductible health plan (HDHP) during  \n2011 (see instructions)    Self-only Family  \n2 HSA contributions you made for 2011 (or those made on your behalf), including those made from January 1, 2012, through April 17, 2012, that were for 2011. Do not include employer  \ncontributions, contributions through a cafeteria plan, or rollovers (see instructions) . . . . . . . . .  \n3 If you were under age 55 at the end of 2011, and on the first day of every month during 2011, you were, or were considered, an eligible individual with the same coverage, enter $3,050 ($6,150 for family coverage) . All others, see the instructions for the amount to enter    \n4 Enter the amount you and your employer contributed to your Archer MSAs for 2011 from Form 8853, lines 1 and 2. If you or your spouse had family coverage under an HDHP at any time  \nduring 2011, also include any amount contributed to your spouse’s Archer MSAs . . . . . . . . . .  \n5 Subtract line 4 from line 3. If zero or less, enter-0-    \n6 Enter the amount from line 5. But if you and your spouse each have separate HSAs and had family coverage under an HDHP at any time during 2011, see the instructions for the amount to enter    \n7 If you were age 55 or older at the end of 2011, married, and you or your spouse had family coverage under an HDHP at any time during 2011, enter your additional contribution amount (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  \n8 Add lines 6 and 7    \n9 Employer contributions made to your HSAs for 2011   9  \n10 Qualified HSA funding distributions . . . . . . . . . . . . . . . . . . .  \n11 Add lines 9 and 10   11  \n12 Subtract line 11 from line 8. If zero or less, enter-0-    \n13 HSA deduction. Enter the smaller of line 2 or line 12 here and on Form 1040, line 25, or Form 1040NR, line 25   Caution: If line 2 is more than line 13, you may have to pay an additional tax (see instructions) .  \nX  \nPart II  HSA Distributions. If you are filing jointly and both you and your spouse each have separate HSAs, complete a separate Part II for each spouse.  \n\n| 14a Total distributions you received in 2011 from all HSAs (see instructions) . . . . . . . . . . . . . . b Distributions included on line 14a that you rolled over to another HSA. Also include any excess contributions (and the earnings on those excess contributions) included on line 14a that were\u003Cbr>withdrawn by the due date of your return (see instructions) . . . . . . . . . . . . . . . . . . . . . c Subtract line 14b from line 14a  \u003Cbr>15 Unreimbursed qualified medical expenses (see instructions) . . . . . . . . . . . . . . . . . . . .\u003Cbr>16 Taxable HSA distributions. Subtract line 15 from line 14c. If zero or less, enter-0- . Also,\u003Cbr>include this amount in the total on Form 1040, line 21, or Form 1040NR, line 21. On the dotted line next to line 21, enter “HSA” and the amount ...........................\u003Cbr>17a If any of the distributions included on line 16 meet any of the Exceptions to the Additional 20% Tax (see instructions), check here ...........................  \u003Cbr>b Additional 20% tax (see instructions) . Enter 20%(.20) of the distributions included on line 16\u003Cbr>that are subject to the additional 20% tax. Als","cbCaitQrb0ejdGKV","https://ap.wps.com/l/cbCaitQrb0ejdGKV","pdf",1443151,"English","# HSA Contributions and Deduction\n## Part I\n# HSA Distributions\n## Part II\n# Income and Additional Tax for Failure To Maintain HDHP Coverage\n## Part III","[{\"question\":\"What must be completed before using Form 8889?\",\"answer\":\"Complete Form 8853, Archer MSAs and Long-Term Care Insurance Contracts, if required, before completing Form 8889.\"},{\"question\":\"Which part of Form 8889 reports HSA contributions and the HSA deduction?\",\"answer\":\"Part I reports HSA contributions and the HSA deduction, with separate Part I completion required for each spouse if both have separate HSAs while filing jointly.\"},{\"question\":\"How does Form 8889 treat HSA distributions for tax purposes?\",\"answer\":\"Part II breaks out total HSA distributions, amounts rolled over or related excess contributions, unreimbursed qualified medical expenses, taxable distributions, and any additional 20% tax when applicable.\"}]","Form 8889 - Health Savings Account (HSAs) | PDF",1789807732]