Does IRS check HSA accounts?

Asked by: Ms. Zella Schumm II  |  Last update: November 10, 2025
Score: 4.1/5 (4 votes)

Verification of expenses is not required for HSAs. However, total withdrawals from your HSA are reported to the IRS on Form 1099-SA. You are responsible for reporting qualified and non-qualified withdrawals when completing your taxes.

Does the IRS check your HSA?

Does HSA spending trigger an audit? The IRS doesn't monitor how you spend your HSA funds throughout the year, but that doesn't mean they won't ask for proof that your expenses were eligible. And if your tax return contains unrelated IRS audit red flags, your risk for an HSA audit could increase.

Does HSA report to IRS?

The 1099-SA is used to report any distribution (withdrawal) of funds from your HSA during the prior year. You must report distributions from your HSA on IRS Form 8889. You will receive a separate 1099-SA for each type of distribution made during the tax year.

Does the IRS ask for HSA receipts?

The IRS requires that you keep receipts for all your Health Savings Account (HSA) spending. HSA distributions (money taken from an HSA account) are nontaxable, but only when the money is used to pay for qualified medical expenses.

What if I accidentally used my HSA card for groceries?

If you catch the transaction early enough, you might even be able to contact the retailer and ask them to reverse the charge and fill it on a new card. If you bought something in person, you can also return it to the store and then buy it again with a different card.

The Real TRUTH About An HSA - Health Savings Account Insane Benefits

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Can I get in trouble for using HSA money?

When health savings accounts aren't used for their intended purposes, account holders are often assessed penalties. When an account holder under the age of 65 uses their health savings account's funds for non-medical expenses, they have to pay income tax on the money spent plus a 20-percent penalty.

What are the most common mistakes for HSA?

Common HSA mistakes and how to avoid them
  • Using an HSA when you're not eligible. ...
  • Paying for ineligible expenses. ...
  • Contributing too much to your account. ...
  • Paying someone else's medical bills. ...
  • Using all of your funds. ...
  • Using both an HSA and FSA. ...
  • Stay ahead of mistakes with HSA Store.

How far back can the IRS audit HSA?

Generally, the IRS can include returns filed within the last three years in an audit. If we identify a substantial error, we may add additional years. We usually don't go back more than the last six years. The IRS tries to audit tax returns as soon as possible after they are filed.

What happens if I don't report my HSA on taxes?

Other relevant forms include Form 8889 for HSA reporting on your tax return and IRS Form 5329 for excess contributions. Not reporting contributions or distributions for your HSA can result in penalties and interest, affect taxable income calculations, require amended returns, and increase the risk of an IRS audit.

What is the 12 month rule for HSA?

It means you must remain eligible for the HSA until December 31 of the following year. The only exceptions are death or disability. If you violate the testing period requirement, your ineligible contributions become taxable income.

What is the tax loophole for HSA?

HSA Tax Advantages

All interest earned in your HSA is 100 percent tax-deferred, meaning the funds grow without being subject to taxes unless they are used for non-eligible medical expenses.

What is the downside of an HSA?

Drawbacks of HSAs include tax penalties for nonmedical expenses before age 65, and contributions made to the HSA within six months of applying for Social Security benefits may be subject to penalties. HSAs have fewer limitations and more tax advantages than flexible spending accounts (FSAs).

Can gym membership be paid with HSA?

While some companies and private insurers may offer discounts on gym memberships, you generally can't use your FSA or HSA account to pay for gym or health club memberships. An exception to that rule would be if your doctor deems fitness medically necessary for your recovery or treatment.

Do you report HSA to IRS?

More In Forms and Instructions

File Form 8889 to: Report health savings account (HSA) contributions (including those made on your behalf and employer contributions). Figure your HSA deduction. Report distributions from HSAs.

Does the IRS audit for medical expenses?

Claiming deductions for things like charitable donations or medical expenses to lower your tax bill doesn't in itself make you prime audit material. But claiming substantial deductions in proportion to your income does.

Does using your HSA affect my taxes?

Tax-free withdrawals:

Distributions used to pay for or be reimbursed for qualified medical expenses are tax-free provided they are for expenses you incur after you establish your HSA. HSA funds may be used to pay for qualified medical expenses at any time.

Does IRS check HSA receipts?

However, total withdrawals from your HSA are reported to the IRS on Form 1099-SA. You are responsible for reporting qualified and non-qualified withdrawals when completing your taxes. You are also responsible for saving all receipts as verification of expenses in the case of an IRS audit.

Can I leave my HSA off my taxes?

You can claim a tax deduction for contributions you, or someone other than your employer, make to your HSA even if you don't itemize your deductions on Schedule A (Form 1040). Contributions to your HSA made by your employer (including contributions made through a cafeteria plan) may be excluded from your gross income.

Do I get a 1099 for my HSA?

Form 1099-SA is filed by providers of HSAs or MSAs, including Archer and Medicare MSAs. These forms are sent to individual account holders and the IRS. Like other 1099 forms, the issuing entity should send it to the taxpayer by the end of January each year.

What triggers an HSA audit?

It is important to keep the receipts to prove that the payment was indeed for a qualified medical expense in case of an audit. HSA spending may be subject to IRS audit. Even if HSA funds were used for qualified medical expenses, the IRS may ask for proof that the funds were spent correctly.

What will trigger an IRS audit?

Not reporting all of your income

The IRS will typically receive a copy of all the tax forms that you do, including distributed income. The IRS will match the reported items to a person's return. If they see something missing, they will automatically conduct at least a letter audit.

What triggers an IRS criminal investigation?

Specifically, unreported income, a false statement, the use of an impermissible accounting or banking service, or declaring too many deductions are things that could initiate an audit, which could then rise to the level of an IRS criminal investigation process.

What if I accidentally bought food on my HSA?

Yes, you read that correctly—even if you accidentally paid for a burger with your HSA debit card, you will have to report it on your annual income tax return and pay taxes on it. If you're under 65 and spend the money on unqualified purchases, you must also pay a 20% penalty on top of the income tax.

What are the tax secrets of HSA?

As a quick refresher, HSAs offer three major benefits for federal income taxes: Contributions reduce your taxable income without having to itemize deductions. Growth of the account is tax-deferred. Distributions for qualified medical expenses—for you and your family—are tax-free.

What's one potential downside of an HSA?

HSA Cons. The big drawback of an HSA is that you have to sign up with a high deductible health plan to be eligible for one. It is difficult to forecast medical expenses accurately.