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Can You Cash Out an HSA?

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After saving diligently, using either individual or employer contributions, you may want to take your money out of your Health Savings Account and use it for something different. Before you go to the ATM or HSA website and withdraw all of your HSA funds, take heed: there may be tax consequences to improperly withdrawing money. Let’s discuss the implications and options.

Part of the advantage of an HSA is that the money is triple tax advantaged – you are able to save significantly on taxes by contributing to the HSA. The catch is, this money is required to be used for qualified medical expenses. As such, the government does not look fondly at taking a tax advantage and then not playing by the rules.

Nevertheless, let’s discuss 4 options for removing money from an HSA account:

1) Non Qualified Withdrawal (Penalty Tax)

This is the hard way, just rip the money out and pay the price. From the IRS HSA page:

You can receive tax-free distributions from your HSA to pay or be reimbursed for qualified medical expenses you incur after you establish the HSA. If you receive distributions for other reasons, the amount you withdraw will be subject to income tax and may be subject to an additional 20% tax.

Yes, that 20% tax sure bites, as it was your money to begin with but it is stuck in a “special” government account. That said, this is always an option. When you file your IRS Form 8899, you will have to call out this amount on Line 16 as a taxable distribution. This amount will be added as income on Form 1040 (i.e. you will then pay tax on it), plus Line 17b will assess a 20% penalty that flows over to Form 1040. An expensive option, but at least you can get the funds out of the HSA.

2) Use for Qualified Medical Expenses

This is the right way to remove funds from an HSA account, paying for (or reimbursing) qualified medical expenses. Assume you have a doctor appointment that you pay for out of pocket using a credit card, debit card, or cash. Since this is a qualified medical expense, you are immediately entitled to reimburse yourself for that expense out of your HSA. This is simply a transfer from HSA to other account for the amount of the expense, justified by the receipt. Little by little, you can gradually drain your HSA as you use it to pay for qualified medical expenses. Or, you may want to pull an expense (say, surgery or dental expense) forward so at least you can use those HSA funds. Remember, you can spend HSA funds on other people than just yourself.

Alternatively, you can preempt this situation by building up a nice stack of pending reimbursements. This would involved paying for medical expenses out of pocket and delaying your reimbursement from the HSA. You are then entitled to that reimbursement at any time. Eventually, these reimbursements can add up and you can withdraw a large sum from your HSA. My service TrackHSA.com is a great way to keep a record of these un-reimbursed transactions.

3) Invest your HSA, offset by separate account withdrawal

We know that you can invest your HSA account in stocks, bonds, ETF’s, etc. to let it grow over time. If you need cash, consider other sources first. Instead of raiding your HSA, consider withdrawing funds from a different investment account with no / less penalty. Then, you can invest your HSA to “replace” your prior withdrawal.

For example, assume that I need $2k for some reason. Instead of withdrawing from my HSA and facing a penalty, I could withdraw this from a more liquid account, such as an investment account. I could then offset this by investing my HSA in the same instruments that I just sold, so my investment position is maintained. This could also work if the other account (such as a 401(k)) has a withdrawal penalty but it is smaller (say, 10%) than that of the HSA (20%).

4) Use the funds for anything once you turn 65

Once you turn 65 years of age, your Health Savings Account is liberated substantially. You are free to spend your HSA funds on whatever you want, not just qualified medical expenses. Note that any distribution for non qualified medical expenses will be taxed (just like ordinary income), but at least you are getting the funds out of your HSA. This is fair as well because you never paid tax on the HSA contribution – since you didn’t use it for medical expenses, they make you pay it now. However, you may have gotten the benefit of tax free investment earnings on that money for many years. Either way, this is superior to option 1 above as you do not owe the 20% penalty, just the tax. And that 20% can be a huge number

Note: if you have an HSA, you need to file IRS tax Form 8889 each year you make contributions or withdrawals. Please consider using my automated service EasyForm8889.com to quickly and easily generate your HSA Form 8889. In 10 minutes, it asks you simple questions that correctly populates Form 8889 no matter your situation and delivers you the completed PDF.

EasyForm8889.com - complete HSA Form 8889 in 10 minutes!

How to File HSA Tax Form 8889

Update: There has been a lot of questions about Form 8889 and this is one of the most popular pages on the site. Knowing Form 8889 is a beast, I created EasyForm8889.com to fill it out for you. Just answer simple questions and in less than 10 minutes, you download a completed Form 8889 PDF. Hope you like it – thanks!


If you have an HSA account and have activity in it during the year, you are required to file IRS Form 8889, which is a tax form used to report HSA contributions, distributions and tax deductions. While this may sound like a pain, don’t worry, it isn’t too bad. Moreover, doing so insures that your contributions are tax exempt, a key part of the HSA’s triple tax advantage. It also prevents you from paying excessive penalties or taxes.

Here is a copy of IRS tax Form 8889 for 2015 so you can see what it looks like.

I have created the following video to walk you through Form 8889. In it, I provide explanations and examples for each section and line, so that you can file your Form 8889 with confidence. The transcription of the information is below.

Watch on Youtube: How to File HSA Tax Form 8889

Who is required to file Form 8889 for their Health Savings Account?

  • You (or someone on your behalf, i.e. an employer) made contributions to your HSA during the year
  • You received HSA distributions (cash transferred out) during the year
  • You over contributed to your HSA, likely by using the Last Month Rule last year but violating the Testing Period.
  • You acquired an HSA due to the death of the account beneficiary

What tax forms you will need

  • IRS Form 5498-SA (contribution activity, provided by HSA custodian)
  • W-2 Form (if your employer made HSA contributions)
  • IRS Form 1099-SA (distribution activity, provided by HSA custodian)
  • IRS Form 8889 and the Form 8889 Instructions (check that your tax software prompts you for HSA information)

EasyForm8889.com - complete HSA Form 8889 in 10 minutes!

How to fill out Tax Form 8889

Definitely view the Instructions for Form 8889 if you need help or have a complicated case. With those by your side, just go through each line one at a time and consider what it is asking. Populate that data before moving onto the next one. If you get stuck, check the Instructions or the above video for my advice.

If you are filing your taxes electronically, be sure to look out for any questions relating to HSA’s on the standard forms. Checking them correctly will trigger the software to include tax form 8889 automatically into your tax preparation so that you don’t miss it. If in doubt, search or call the company you are using.

In sum, the form is trying to establish 3 things:

  • Amount of HSA Contribution
  • Amount of HSA Distribution
  • Total Income or Additional Tax Due

Let’s take a look now at each section and each line of Form 8889

Part I – Contributions and Deduction

This part of the form asks you to verify that you were covered under a high deductible health plan during the year in question, how much you and then your employer contributed, and calculates your contribution amount was for the year. This contribution amount is the actual amount you can deduct from your taxable income, so it is very important. This calculation occurs on Line 3 of Form 8889 and can be tricky, so pay attention there.

  1. Line 1 – Select a plan to indicate your coverage (Single or Family) for the year. If your plan changed during the year, choose the plan that was in effect the longest. You will square this up on Line 3, Contribution Limit.
  2. Line 2 – Your HSA contributions – see Form 5498-SA from your HSA custodian. Do not include employer contributions, those go in Line 9.
  3. Line 3 – Your contribution limit for the year – very important. If you had the same HSA eligible insurance for the full year, simply enter that contribution limit here (2015: single=$3,350, family=$6,650). If your insurance changed, you will use a pro rata methodology. See the instructions (and the Youtube video has a good example of this) but going by month, sum the yearly contribution limits for the year, then divide by 12. That is your contribution limit. If you joined an HSA this year, you can contribute the full amount under the Last Month Rule. However, you will have to maintain coverage into next year per the Testing Period or face a penalty.
  4. Line 4 – Archer MSA activity. For most people, this is $0. If you have an Archer MSA (an antiquated precursor to the HSA), see the instructions to populate this amount.
  5. Line 5 – Subtraction.
  6. Line 6 – If you and your spouse both have an HSA and are covered under a family plan, you can decide how to allocate the income tax deduction from your HSA. This may be beneficial for tax purposes in certain situation. If this applies to you, see the Instructions to calculate this amount.
  7. Line 7 – If you are 55 or older and have family coverage, you are eligible for additional contribution to your HSA above the limit. See instructions to determine this.
  8. Line 8 – Addition
  9. Line 9 – Your employer contribution to your HSA. If this is not on the form 5498-SA you received from your HSA provider, you can find it on box 12 of your W-2 marked with code “W”.
  10. Line 10 – This is rare, and a described line. For line 10, Qualified HSA funding distributions refers to distributions from IRA / Roth IRA accounts to your HSA. This does not mean distributions our of your HSA, say for qualified medical expenses. That will occur in Part II, line 14a.
  11. Line 11 – Addition
  12. Line 12 – Subtraction. This makes sense – notice how it is reducing your contribution limit by any amount that your employer contributed. This prevents you from having both a large personal and employer contribution, and enjoying all of that tax reduction / money from both.
  13. Line 13 – Important – this is the actual amount you can deduct from your income per HSA tax law. This will make its way onto Form 1040, line 25, and is an important mechanism for how the HSA tax deduction works. By reducing your taxable income, the HSA allows you to pay less in taxes.
  14. Part II – Distributions

    This part of the form looks at money you removed from the HSA and verified it was spent properly. If not, it assesses a penalty.

  15. Line 14 – Distributions from HSA
    • a) These are funds you took out of your HSA during the year. This can occur in many forms – bank transfer to reimburse yourself, cash withdrawal from HSA, HSA debit card purchase, or check written against your HSA. All of these amounts need to be added up and included here. You can reference form 1099-SA for distribution activity.
    • b) HSA rollovers – only if you physically received a check to deposit into another HSA account. Or if you over contributed for the year and then withdrew that money to true up. They will remove these amounts from line 14a since it does not truly count as a spent distribution.
    • c) Subtraction
  16. Line 15 – Very important. Now that we know how much you removed from your HSA in 14c, the government wants to know how much of that was spent on qualified medical expenses. They do not ask for proof at the time you file taxes, but they will certainly audit this value if you are so lucky. Any amount greater than box 14c will be penalized.

    This is why TrackHSA is so valuable – you can view your account and verify all activity that came from your HSA was legit. You can even upload receipts to back it up. So if Uncle Sam comes knocking for an audit, you can easily compile all information to defend yourself.

  17. Line 16 – This subtraction determines if you spent any HSA proceeds on non qualified medical expenses. If you get a positive number here, you are going to owe tax and penalty (20%, 17b) on it, so you should go back and reconsider what you are doing. This amount makes its way onto Form 1040 as “Other Income”, which will be taxed.

    Another plug for TrackHSA. Say you spent more on qualified medical insurance than you distributed from your HSA. This is actually a smart move because you are allowing that money to stay in your HSA, invest and grow, instead of spending it. I call this amount “unreimbursed qualified medical expenses” and it puts you ahead of the game. Moreover, you can later distribute that money from your HSA should you need it. I call this “using your HSA as an ATM“. TrackHSA will maintain this purchase amount for your as “unreimbursed amount”, so that in the future you can reimburse yourself for it and populate it that year’s HSA tax form. TrackHSA let’s you substantiate it later on, proving it was legit.

  18. Line 17 – Penalty on excess distributions. If you have a positive # in Line 16 it means you mispent your HSA fund on non qualified medical expenses and the penalty occurs here.
    • a) If you had a positive number in Line 16, you have one last change to avoid penalty if 1) you turned 65 2) became disabled or 3) the account holder died. See instructions for specifics.
    • b) Penalty time. If nothing in 17a pertained to you, you have to pay a 20% penalty on your excess distributions from line 16. Not fun. This makes its way back to Form 1040 on line 62 as Other Taxes (read: penalty) from “HSA”.
  19. Part III – Taxes and Penalties from Last Month Rule

    In this section, the form assesses additional taxes and penalties for 1) previously violating the Last Month Rule and 2) HSA funding Distribution from IRA/Roth IRA. These amounts will make their way to Form 1040 and be taxed (line 20) and penalized (line 21), so best to avoid this if possible.

  20. Line 18 – Uncommon – for most people this is $0. The naming here is very vague, but if you look at the instructions, this only applies if:
    1. In a previous tax year, you utilized the Last Month Rule AND
    2. Later ended your HSA insurance early, violating the Testing Period.

    If this is the case, you in fact over contributed and will need to enter the excess amount you contributed from the Last Month Rule compared to if you hadn’t used it. In other words, by how much did you over contribute? For example, if you began insurance on July 1st and take advantage of the Last Month Rule for the year, you would benefit from an increased contribution limit of 6 months (Jan – Jun). In that case you would enter enter a number which equals 6/12 * Contribution Limit. See Form 8889 Instructions and the Line 3 worksheet to calculate if needed.

  21. Line 19 – Uncommon – for most people this is $0. This goes back to Line 10 where you enter the amount of any funding distribution from a IRA/Roth IRA going into your HSA. Whatever this is the government doesn’t like it, and is going to tax and penalize you on it..
  22. Line 20 – Here, you add up lines 18 + 19 and add this back as Other Income on Line 21 of Form 1040. This is not good because this amount is going to be taxed.
  23. Line 21 – To add insult to injury, not only does the government tax you on the amount of line 20, it penalized it by 10%. This amount makes its way to Form 1040 on Line 62 as “Other Taxes” (read: penalty) and you will have to pay this amount to the government.


So that is a lot of detail and a lot of information, but hopefully it makes filing Form 8889 much easier for you. In the end, just verify where amounts are flowing to Form 1040 and make sure where you want them to be (reducing Taxable Income) and not as as penalties (adding to Taxable Income or as Other Taxes).


Note: if you have an HSA, please consider using my service TrackHSA.com to manage your Health Savings Account. You can store purchases, receipts, and reimbursements securely online. Start for free today.

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How to Use Your HSA While Unemployed

If you are reading this, there is a chance that you are unemployed and looking for work. Sorry to hear that, I have been there and it sucks. Keep your head up, make good financial choices and find the next (better) thing.

Health Insurance is confusing enough, but being unemployed adds a layer of complexity to it. Moreover, there are some complications and rules for using your Health Savings Account while unemployed. The following is a guideline for HSA holders if they ever find themselves unemployed and needing to lower their costs and make smart financial decisions:

Stay Insured

Losing a job definitely means a loss of cash flow and it is wise to seriously curb your spending during this period. That said, health insurance is not something you should cut from your budget. It is never worth opening yourself up to the risk of huge medical bills of a hospital visit just because you lost your job. I often state it as such:

A job loss is a temporary setback, but being injured while uninsured can create a long term crisis.

You should, however, consider cutting back on the type of insurance you have. At this point, you just need barebones, good, solid coverage, not a “cadillac” plan that includes low deductibles, low copays, vision, massage and back rubs, etc. You should be looking at the following and finding one that is affordable:

  • Short Term Insurance
    Short term health insurance is temporary insurance designed to fill gaps in coverage. Typically, this insurance lasts for 6 months but may last up to a year. Premiums are much less expensive than comparable plans and are a great option while you look for a job. You can find your term plans at eHealthInsurance.
  • High Deductible / Catastrophic Health Plan
    If you can’t find a short term insurance plan, search for plans that are longer in duration. What you are looking for is low premiums / high deductible – typical of a HDHP. Your goal is to use this insurance as little as possible (using it can be expensive) and to have it in case something catastrophic happens. You can also get quotes for this at eHealthInsurance.
  • Continue your current health plan using COBRA
    Your previous employer might be required to offer you your current health insurance after you leave as a result of the COBRA health care law. Depending on your plan, you might find COBRA very expensive as you are paying the entire premium now. However, definitely compare it against your other options.

Use HSA funds to pay for health insurance premiums while unemployed

If you had the foresight to contribute to your health savings account prior to losing your job, you will be glad you did. One of the HSA’s best benefits is that it allows you to use your HSA to pay for health insurance premiums while you are unemployed. To qualify, you must be receiving federal/state unemployment insurance or paying for COBRA or other continuation coverage. If so, your health insurance premiums while unemployed are qualified medical expenses.

In essence, you could contribute to you HSA for six months, lose your job, and use those contributions to pay for your health insurance for the next six months, all tax free. It is great piece of mind to know that, should you lose your job, your health insurance is financially covered. It is a part of using an HSA as an unemployment safety net.

Cash out any unreimbursed QME you are due

If you have been an astute HSA holder, you have been protecting your HSA and paying for as many medical expenses out of pocket as you can. Doing so allows two things to happen:

  1. You don’t deplete your HSA, so it continues to grow, tax free
  2. You are allowed to reimburse yourself for those expenses at any time in the future from your HSA

This is all part of the using your HSA as an ATM strategy. Now that you are unemployed, it may be time to cash those expenses in and generate some cash flow. While it isn’t ideal to tap your HSA, sometimes the situation calls for it and this is a great source of cash should you need it.

Negotiate any Health Insurance Expenses

While you are unemployed, cash is definitely king and you want to save as much as you can. You have been smart and gotten a high deductible health plan for the short term, but sometimes things happen and you need medical care. If your unexpected expense is below your deductible, you will likely be paying this out of pocket (or HSA) which can sting (these plans only kick in once you hit that deductible).

Don’t be afraid to negotiate your health care costs should they arise. Be straight up with your hospital billing agent and tell them you have a high deductible health plan that this entire expense will be paid out of pocket. Given that they only receive a fraction of what they bill insurance companies, that is amount you are shooting for.

Here is a great link on how to negotiate lower health care prices while you are unemployed. I have personally negotiated and lowered physician/emergency room medical expenses as well as with insurance companies while I was unemployed. Don’t be afraid, you can do it.