Form 8889 is the IRS form for health savings accounts (HSAs). You use it to report contributions, work out your HSA deduction and report any withdrawals. As of October 2026, you must file it with your return if anyone paid into your HSA or if it paid anything out, even when you've got no other reason to file.
HSAs are one of the few accounts that can be tax-free going in, growing and coming out, but only if Form 8889 says so. If you're self-employed and pay into your own HSA, this is also the form that turns those payments into a deduction. The IRS's 2025 instructions, used for returns filed in 2026, set the rules below.
Who must file Form 8889
- You, your employer or anyone else contributed to your HSA.
- Your HSA made a distribution.
- You stopped being an eligible individual during a testing period and have to add income.
- You inherited an interest in an HSA when the account holder died.
If you or your spouse took any HSA distribution in 2025, you must file Form 8889 with Form 1040, 1040-SR or 1040-NR even if you've no taxable income.
The 2025 numbers
| Item | Self-only coverage | Family coverage |
|---|---|---|
| Maximum HSA contribution | $4,300 | $8,550 |
| Minimum annual deductible for an HDHP | $1,650 | $3,300 |
| Maximum annual out-of-pocket for an HDHP | $8,300 | $16,600 |
| Extra catch-up if 55 or older at year end | $1,000 | $1,000, with special rules for couples |
These are the 2025 figures in the instructions as of October 2026. The out-of-pocket limit doesn't apply to out-of-network services.
Who counts as an eligible individual
You need to be covered by a high deductible health plan (HDHP) and have no other health cover apart from certain disregarded coverage. You also can't be enrolled in Medicare or be someone else's dependent. If you're eligible, anyone can pay into your HSA.
Disregarded cover includes accidents, disability, dental, vision, long-term care and, after the July 2025 law (P.L. 119-21), telehealth and other remote care for plan years beginning after 2024. A plan also won't stop being an HDHP just because it has no deductible for telehealth.
The last-month rule and its trap
If you're eligible on December 1 (the first day of the last month for most people), you can treat yourself as eligible for the whole year and contribute the full annual amount. That's the last-month rule.
The catch is the testing period. It starts with that last month and runs until the last day of the 12th month after it. Drop out of eligibility during that time for any reason other than death or disability, and the extra you contributed thanks to the rule is added to your income for that year, plus a 10% additional tax. Only use the rule if you're confident you'll keep HDHP cover for the next 12 months.
Distributions and the 20% tax
Withdrawals for qualified medical expenses are tax-free. Anything else is added to your income and hit with an additional 20% tax, unless the payout happens after the account holder dies, becomes disabled or turns 65.
Two details matter. Expenses from before you opened the HSA aren't qualified medical expenses. And if you used the last-month rule, only expenses after you set the account up count.
Put in too much? Take it out before your deadline
Your excess is what was contributed (line 2) minus what you can deduct (line 13). You can withdraw some or all of a 2025 excess and have it treated as never contributed, as long as you:
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- take it out by the due date of your 2025 return, including extensions
- don't claim a deduction for the amount you withdraw
- also withdraw the income it earned and report those earnings as other income for the year you take them out
Miss that and the excess stays in the account, where the 6% excess contribution tax on Form 5329 applies. Employer overpayments have their own rule: if an excess wasn't included in income on your W-2, you report it as other income.
Rollovers and inherited HSAs
A rollover from one HSA or Archer MSA into another HSA of yours is tax-free if you complete it within 60 days, and an HSA can receive only one rollover contribution in a 1-year period. If an account holder dies and their spouse is the designated beneficiary, the HSA simply becomes the spouse's. Anyone else inherits an account that stops being an HSA on the date of death: they write 'Death of HSA account beneficiary' across the top of Form 8889 and report the account's fair market value on that date on line 14a.
Filling it in, step by step
- Part I: list your contributions and your employer's (employer amounts should be on box 12, code W of your Form W-2), then work out your limit and deduction.
- Line 3: enter $4,300 or $8,550 if you were eligible all year with one type of cover, or use the limitation worksheet if not.
- Part II: report distributions and how much went on qualified medical expenses.
- Part III: add income and the 10% tax if you failed the testing period.
Keep your HSA provider's year-end statements with your other account forms so the contribution figures match.
My take
Form 8889 is short, but it decides whether your HSA keeps its tax breaks. Check that your contributions don't pass the limit, keep receipts for every medical expense you reimburse, and think twice before using the last-month rule if a job change is coming.
Frequently asked questions
Do I need Form 8889 if only my employer paid into my HSA?
Yes. You must file it if you, your employer or anyone else contributed to your HSA.
What were the 2025 HSA contribution limits?
As of October 2026 the instructions give $4,300 for self-only cover and $8,550 for family cover, plus $1,000 if you were 55 or older at year end.
What happens if I use HSA funds for something that isn't medical?
The amount is added to your income and an additional 20% tax applies, unless the payout is after death, disability or turning 65.
What is the HSA testing period?
It runs from the last month of the tax year to the end of the 12th month after it. Lose eligibility then and the extra contribution becomes income plus a 10% tax.
