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This form is used for reporting Archer Medical Savings Accounts (MSAs) and distributions from long-term care insurance contracts to the Internal Revenue Service (IRS). It includes sections for contributions,
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How to fill out form 8853

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How to fill out Form 8853

01
Download Form 8853 from the IRS website or obtain it from a tax professional.
02
Fill out your personal information at the top of the form, including your name, address, and Social Security number.
03
Complete Part I of the form, which pertains to Archer MSAs, if applicable.
04
Provide the necessary details about your Archer MSA contributions and distributions in Part I.
05
If you have a health savings account (HSA), complete Part II of the form with the relevant information.
06
Detail your HSA contributions and distributions in Part II as required.
07
Ensure that you have the correct totals before you transfer any information to your tax return.
08
Review your completed Form 8853 for accuracy, then sign and date it.
09
Submit Form 8853 with your annual income tax return.

Who needs Form 8853?

01
Individuals who have an Archer Medical Savings Account (MSA) need Form 8853.
02
Taxpayers who have a Health Savings Account (HSA) must also file Form 8853.
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People Also Ask about

A tax-qualified long term care insurance contract qualifies for favorable federal income tax treatment. If the policy only pays benefits that reimburse you for qualified long-term care expenses you will not owe federal income tax on these benefits.
You need to file Form 8853 if you contribute to an Archer MSA, receive distributions, inherit an MSA, or receive taxable payments from long-term care insurance or accelerated death benefits.
The Form 1099-LTC report reflects payments made directly to you as well as those payments made to third parties on your behalf. People are often surprised to receive this report.
Form 1099-C. Lenders or creditors are required to issue Form 1099-C, Cancellation of Debt, if they cancel a debt owed to them of $600 or more. Generally, an individual taxpayer must include all canceled amounts (even if less than $600) on the "Other Income" line of Form 1040.
You need to file Form 8853 if you contribute to an Archer MSA, receive distributions, inherit an MSA, or receive taxable payments from long-term care insurance or accelerated death benefits.
To be eligible for an Archer MSA, you (or your spouse) must be an employee of a small employer or be self-employed. You (or your spouse) must be covered under an HDHP and have no other health coverage except permitted coverage. You must not be enrolled in Medicare and can't be another person's dependent.
Form 8233. The Form 8233 (pdf) should be used by nonresident alien students, teachers, and researchers to claim exemption from withholding on compensation for services that is exempt from taxation under a U.S. tax treaty. View IRS instructions for completing the form (pdf).
Use Form 8853 to: Report Archer MSA contributions (including employer contributions), Figure your Archer MSA deduction, Report distributions from Archer MSAs or Medicare Advantage MSAs, Report taxable payments from long-term care (LTC) insurance contracts, or.

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Form 8853 is a tax form used by individuals to report certain tax benefits related to health savings accounts (HSAs) and Archer medical savings accounts (MSAs).
Taxpayers who have contributed to or received distributions from an HSA or Archer MSA are required to file Form 8853.
To fill out Form 8853, gather necessary information about your HSA or Archer MSA, including contributions, distributions, and any applicable deductions. Follow the provided instructions on the form to report this information accurately.
The purpose of Form 8853 is to report contributions to and distributions from HSAs and Archer MSAs to ensure compliance with tax regulations and to determine eligibility for related tax benefits.
Form 8853 requires reporting information such as the amounts contributed to and distributed from HSAs or Archer MSAs, and any other relevant details regarding those accounts.
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