Form preview

Get the free Form 8853

Get Form
This document provides detailed instructions for Form 8853, which is used to report Archer Medical Savings Accounts (MSAs) and Long-Term Care Insurance Contracts for the tax year 2004. It includes
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign form 8853

Edit
Edit your form 8853 form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your form 8853 form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing form 8853 online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Here are the steps you need to follow to get started with our professional PDF editor:
1
Register the account. Begin by clicking Start Free Trial and create a profile if you are a new user.
2
Simply add a document. Select Add New from your Dashboard and import a file into the system by uploading it from your device or importing it via the cloud, online, or internal mail. Then click Begin editing.
3
Edit form 8853. Add and replace text, insert new objects, rearrange pages, add watermarks and page numbers, and more. Click Done when you are finished editing and go to the Documents tab to merge, split, lock or unlock the file.
4
Get your file. When you find your file in the docs list, click on its name and choose how you want to save it. To get the PDF, you can save it, send an email with it, or move it to the cloud.
The use of pdfFiller makes dealing with documents straightforward. Try it right now!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out form 8853

Illustration

How to fill out Form 8853

01
Obtain Form 8853 from the IRS website or your tax preparation software.
02
Fill in your personal information at the top of the form, including name and Social Security number.
03
In Part I, report any Health Savings Account (HSA) information if applicable.
04
In Part II, provide details on Archer Medical Savings Accounts (MSAs) if you have any.
05
Complete the necessary calculations and provide information regarding contributions and withdrawals.
06
Double-check your entries for accuracy.
07
Attach Form 8853 to your federal income tax return when filing.

Who needs Form 8853?

01
Anyone who has a Health Savings Account (HSA) or an Archer Medical Savings Account (MSA) and is required to report transactions associated with these accounts needs Form 8853.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.0
Satisfied
52 Votes

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.

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Form 8853 is a tax form used in the United States to report the expenses and contributions to a qualified health savings account (HSA) and to claim certain deductions related to high deductible health plans.
Taxpayers who contribute to a health savings account (HSA) or are enrolled in a high deductible health plan (HDHP) and wish to claim deductions for qualified medical expenses are required to file Form 8853.
To fill out Form 8853, taxpayers need to provide their personal information, report contributions made to their HSA, itemize qualified medical expenses, and calculate any deductions or credits they are eligible for based on their contributions and reported expenses.
The purpose of Form 8853 is to allow taxpayers to report health savings account transactions and to claim any eligible tax deductions for contributions made to HSAs and medical expenses incurred.
Information that must be reported on Form 8853 includes taxpayer identification details, contributions to health savings accounts, qualified medical expenses incurred, and any distributions made from HSAs.
Fill out your form 8853 online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.