Tax Form 8853  
Form 8853 - Archer MSAs and Long-Term Care Insurance Contracts

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Form 8853

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Archer MSAs and Long-Term Care Insurance Contracts. Form 8853

Use Form 8853, Archer MSAs and Long-Term Care Insurance Contracts, to:

  • Report Archer MSA contributions (including employer contributions),
  • Figure your Archer MSA deduction,
  • Report distributions from Archer MSAs or Medicare Advantage MSAs,
  • Report taxable payments from long-term care (LTC) insurance contracts, or
  • Report taxable accelerated death benefits from a life insurance policy.

Additional information. See Pub. 969, Health Savings Accounts and Other Tax-Favored Health Plans, for more details on MSAs.


From Fedforms.Gov:
"Individuals use Form 8853 to report contributions to and figure deductions for Archer MSAs, to report distributions from MSAs, to report payments from long-term care insurance contracts, and to report accelerated death benefits from life insurance policies."


DOWNLOAD Form 8853

This form may be downloaded directly from the IRS website. To open or download, in PDF format, simply click on the link below:

Form 8853

 



 

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