Form 8853
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Form 8853: Archer MSAs and Long-Term Care Insurance Contracts

Individuals who have or are considering contributing to an Archer Medical Savings Account must file Form 8853 by December 31, 2007, to report any contributions, deductions, distributions, or accelerated death benefits.

What is Form 8853?

An Archer Medical Savings Account (MSA) is a tax-advantaged medical savings account available to taxpayers who are covered under a high deductible health plan (HDHP). Form 8853 is used to report Archer MSA contributions or distributions, LTC insurance payments, and accelerated death benefits from life insurance. The form is generally required to be filed if contributions were made to or if distributions were taken from an Archer MSA in the tax year. Additional information can be found in Publication 969.

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IRS Form 8853 – Who Needs to Fill It Out?

Those who need to fill out IRS Form 8853 are those who made contributions to an Archer Medical Savings Account (MSA) for the tax year ending after December 31, 2007, those who acquired an interest in an Archer MSA or a Medicare Advantage MSA due to the death of an account holder, policyholders who received payments under an LTC insurance contract, and those who received Archer MSA or Medicare Advantage MSA distributions in 2022. It must be filled out even if there is no taxable income or other reason for filing Form 1040, 1040-SR, or 1040-NR. Additionally, refer to Pub. 969 for more information on MSAs.

Step-by-Step: Form 8853 Instructions For Filling Out the Document

Form 8853 is an IRS document used to report Archer and Medicare Advantage Medical Savings Account contributions, distributions, long-term care insurance payments, and life insurance policy accelerated death benefits. Anyone who made, received, or was a policyholder of any of the above in 2022 must complete the form. Step-by-step instructions for filling the document out are included in Publication 969, which provides more information on MSAs. Form 8853 should be filled out to report the above and, if applicable, to figure out the Archer MSA deduction for the tax year.

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Below, we present a table that will help you understand how to fill out Form 8853.

Form Name Form 8853
Purpose Report Archer and Medicare Advantage Medical Savings Account contributions, distributions, long-term care insurance payments, and life insurance policy accelerated death benefits.
Filing Requirements Anyone who made, received, or was a policyholder of any of the above in 2022 must complete the form. Use it to report the listed items and figure out the Archer MSA deduction if applicable.
Additional Information Refer to Publication 969 for step-by-step instructions. File with the appropriate income tax return.
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Do You Need to File Form 8853 Each Year?

Yes, if you are an Archer Medical Savings Account (MSA) participant or received distributions from an MSA, then you must file Form 8853 each year. Other times to file include if an employer or spouse has contributed to your MSA, if you acquired an interest in an MSA due to the death of the account holder, or if you received payments from an LTC insurance contract or accelerated death benefits from a life insurance policy. For more information, consult Pub. 969, Health Savings Accounts and Other Tax-Favored Health Plans.

Download the official IRS Form 8853 PDF

On the official IRS website, you will find a link to download Form 8853. However, to make it easier for you, we are providing the link in our article, which comes directly from the official irs.gov website! Click to download: Form 8853

Sources:

https://www.irs.gov/forms-pubs/about-form-8853

https://www.irs.gov/instructions/i8853

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