Enter $1,000 (the amount used for qualified medical expenses).
Enter the IRS contribution limit for family coverage for the applicable tax year. Form 8889 Examples Filled Out - Syair SDY
$1,500 (Reported on Form W-2, Box 12, Code W) Distributions Taken: $1,000 (Reported on Form 1099-SA) Qualified Medical Expenses: $1,000 ✍️ How to Fill Out the Form Part I: Contributions and Deductions Line 1: Check the Family box. Line 2: Enter $3,000 (your out-of-pocket contributions). Enter $1,000 (the amount used for qualified medical
Enter $0 (subtract line 15 from 14a. Because all funds were used on qualified expenses, no tax is owed). IRS Form 8889 walkthrough (Health Savings Accounts) Line 2: Enter $3,000 (your out-of-pocket contributions)
Enter $1,500 (the amount contributed by your employer).
IRS Form 8889 is used to report Health Savings Account (HSA) contributions, calculate your deduction, and report any distributions.
Enter $1,000 (the total distribution received from the HSA).