HSA Calculator: Form 8889 Line by Line

Enter the numbers from your Form W-2 (box 12, code W), Form 1099-SA and your medical receipts. The calculator figures your HSA contribution limit, your HSA deduction, any taxable distributions, the 20% additional tax and excess contributions, and shows every line of Form 8889 and where it goes on your return.

Tax Years 2025–2026

Your HSA Information

Coverage and eligibility (Form 8889, Part I)

Family = the plan covers you and at least one other person. If your coverage changed during the year, choose the type you had longer; if you use the last-month rule, choose the type you had on December 1.
Count a month only if, on the 1st day of that month, you had HDHP coverage, no other disqualifying health coverage, were not enrolled in Medicare (Part A counts), and could not be claimed as someone else's dependent.
You must then stay eligible through December 31 of the next year (the testing period), or part of the contribution becomes taxable with a 10% additional tax.

Contributions

Money you (or a relative) deposited directly into the HSA for this year, including deposits made by April 15 of next year that were designated for this year. Do not include anything shown in W-2 box 12, code W — payroll (cafeteria plan) contributions count as employer contributions.
Includes both your employer's money and your own pre-tax payroll deductions. If you have more than one W-2 with code W, add them.

Distributions (Form 8889, Part II)

If you have several 1099-SA forms for this person, add their box 1 amounts. In tax software, enter each 1099-SA only once. Leave blank if you did not take money out.
Unreimbursed medical, dental, vision and pharmacy costs for you, your spouse and dependents, incurred after the HSA was opened. Keep the receipts — you don't send them to the IRS.
Less common situations (rollovers, excess, IRA transfer, testing period)
Only amounts that are part of the 1099-SA total above. Direct trustee-to-trustee transfers are not reported on Form 1099-SA at all.
A once-in-a-lifetime direct transfer from your IRA to your HSA. It counts against the year's limit.
Only if you used the last-month rule for the prior year and lost HSA eligibility during this year (other than by death or disability).
Tax effect of your HSA
$0

Where the Numbers Go on Your Return

Contribution Limit

Form 8889 — Approximate Preview

An approximate picture of the Form 8889 entries for comparison with your return. It is not the official form; use the IRS form for the tax year. Schedule 1 and Schedule 2 line numbers are from the 2025 forms.

Entering It in Tax Software

    How This Calculator Works

    1. The contribution limit (lines 3–13)

    The annual limit is $4,300 self-only / $8,550 family for 2025 and $4,400 / $8,750 for 2026, plus $1,000 if you are 55 or older at the end of the year. If you were not eligible all year, the limit is figured month by month: the yearly amount × months eligible ÷ 12 (the Line 3 Limitation Chart). If you were eligible on December 1, the last-month rule lets you use the full-year limit, provided you stay eligible through December 31 of the following year. Married people with family coverage share one family limit (line 6); a spouse's $1,000 catch-up is figured on line 7 and must go into that spouse's own HSA. Everything your employer put in — including your own pre-tax payroll deductions, shown in W-2 box 12, code W — reduces the room left for deductible contributions (lines 9–12). Your HSA deduction (line 13) is the smaller of what you contributed yourself (line 2) and that remaining room.

    2. Distributions (lines 14–17)

    Line 14a is the total of box 1 of all your Forms 1099-SA. Money spent on qualified medical expenses (line 15) is tax-free. Anything else is taxable income (line 16, to Schedule 1, line 8f) and, unless you were 65 or older, disabled, or the distribution was made after death, also carries a 20% additional tax (line 17b, to Schedule 2, line 17c).

    3. Excess contributions

    Contributions above your limit are not deductible. If you leave them in the account, a 6% excise tax applies every year they stay there (Form 5329, Part VII; the tax is limited to 6% of the account value at year end). You avoid it by withdrawing the excess and its earnings by the due date of your return, including extensions; the earnings are taxable as other income.

    4. What's new

    5. Not covered

    Coverage that switched between self-only and family during the year, figuring the line 18 amount for a failed testing period, Archer MSAs and Medicare Advantage MSAs, inherited HSAs, deemed distributions (prohibited transactions, using the HSA as loan security), and employer contributions that belong to a different year (Employer Contribution Worksheet). State taxes are not included; Florida has no income tax, but a few states (for example, California and New Jersey) tax HSAs.

    Sources

    New to HSAs? Read our short guide: HSA Basics: Limits, Deadlines and Form 8889.

    Estimate only — not tax advice

    This calculator gives an estimate for planning and checking purposes only, not a final calculation. It follows the Form 8889 instructions described above and does not cover every situation (mixed coverage during the year, testing-period recapture, inherited accounts, state taxes). Your tax software or the official IRS form governs. Consult a tax professional before filing. Calculator created October 11, 2026 — figures reflect IRS guidance current as of that date.

    Contacts

    Mail: West Palm Beach, Florida

    Phone: +1 (616) ···-····

    Email: [email protected]

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