Updated October 19, 2026. Quick answer: Form 8853 is Archer MSAs and Long-Term Care Insurance Contracts. You file it if you or your employer put money in an Archer MSA, received MSA distributions, or received long-term care payments or accelerated death benefits on a per diem or periodic basis. It is attached to the main return, and it has three sections: Archer MSAs, Medicare Advantage MSA distributions and long-term care contracts.
What Form 8853 is for
The instructions list what the form does: “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 longterm care (LTC) insurance contracts, or” “Report taxable accelerated death benefits from a life insurance policy.”
The form header says where it goes: “Attach to Form 1040, 1040-SR, or 1040-NR.” For more detail on MSAs, the instructions point to “See Pub. 969, Health Savings Accounts and Other” Tax-Favored Health Plans.
Who must file
The instructions open with “You must file Form 8853 if any of the following applies.” The triggers include “You (or your employer) made contributions for 2025 to your Archer MSA.” and “received Archer MSA or Medicare Advantage MSA distributions in 2025.” A policyholder who “received payments under an LTC insurance contract” is also covered.
One caution applies even when there is nothing else to report: “you must file Form 8853 with Form 1040, 1040-SR, or 1040-NR even if you have no taxable income or any other reason for filing”.
The form also carries a limit on new Archer contributions. “After December 31, 2007, contributions can’t be made to an Archer Medical Savings Account (MSA) for you, unless:” “You were an active Archer MSA participant for any tax year ending before January 1, 2008, or”
Section A: Archer MSAs, Parts I and II
Section A has two parts. Part I is the contribution and deduction part, and Part II is the distribution part. The printed lines follow, with the later sections added to the same table.
| Line | As printed on the form |
|---|---|
| Line 1 | “Total employer contributions to your Archer MSA(s) for 2025” |
| Line 2 | “Archer MSA contributions you made for 2025, including those made in 2026 by the unextended due” |
| Line 3 | “Limitation from the Line 3 Limitation Chart and Worksheet in the instructions” |
| Line 5 | “Archer MSA deduction. Enter the smallest of line 2, 3, or 4 here.” |
| Line 6a | “Total distributions you and your spouse received in 2025 from all Archer MSAs” |
| Line 7 | “Unreimbursed qualified medical expenses” |
| Line 8 | “Taxable Archer MSA distributions. Subtract line 7 from line 6c.” |
| Line 9b | “Enter 20% (0.20) of the distributions included on line 8 that are” |
| Line 10 | “Total distributions you received in 2025 from all Medicare Advantage MSAs” |
| Line 12 | “Taxable Medicare Advantage MSA distributions. Subtract line 11 from line 10.” |
| Line 13b | “Enter 50% (0.50) of the distributions included on line 12 that are” |
| Line 17 | “Gross LTC payments received on a per diem or other periodic basis.” |
| Line 21 | “Multiply $420 by the number of days in the LTC period” |
| Line 25 | “Per diem limitation. Subtract line 24 from line 23” |
| Line 26 | “Taxable payments. Subtract line 25 from line 20.” |
Employer money changes Part I. The instructions say “If an employer made contributions to your Archer MSA, you aren’t entitled to a deduction.” In that case the steps are to complete lines 1 and 2, skip lines 3 and 4, and enter zero on line 5. A warning is printed under line 5: “Caution: If line 2 is more than line 5, you may have to pay an additional tax.”
Eligibility, deduction limits and distributions
Who qualifies is described under Eligible Individual: “you (or your spouse) must be an employee of a small employer or be” self-employed. “You must not be enrolled in Medicare and can’t be another person’s dependent.”
The deduction is limited by two things. “The amount you can deduct for Archer MSA contributions is limited by:” “The applicable portion of the HDHP’s annual deductible” on line 3, and “Your compensation from the employer maintaining the” HDHP on line 4. The Line 3 Limitation Chart and Worksheet is completed for each month, with a total divided by 12.
On the distribution side, line 7 counts medical spending. “In general, include on line 7 distributions from all Archer MSAs in 2025 that were used for the qualified medical expenses” of the account holder and family. A rollover is treated separately: “A rollover is a taxfree distribution (withdrawal) of assets from one Archer MSA that is reinvested in another Archer MSA or a health savings account”.
The additional taxes and Section B
Section B covers Medicare Advantage MSA distributions. “A Medicare Advantage MSA is an Archer MSA designated as a Medicare Advantage MSA to be used solely to pay the qualified medical expenses of the account holder.” “Contributions to the account can be made only by Medicare.”
Both sections have an extra tax on taxable distributions, with exceptions the form prints. The key items are in the table.
| Item | As printed in the instructions |
|---|---|
| Additional tax, Archer MSA | “Archer MSA distributions included in income (line 8) are subject to an additional 20% tax unless one of the following exceptions applies.” |
| Age exception | “Turns age 65” |
| Additional tax, Medicare Advantage MSA | “Medicare Advantage MSA distributions included in income (line 12) may be subject to an additional 50% tax unless one of the following exceptions applies.” |
| Rollover window | “Generally, you must complete the rollover within 60 days following the distribution.” |
| Chronically ill, duration | “for at least 90 days, due to a loss of functional capacity” |
| Terminally ill, certification | “can reasonably be expected to result in death within 24 months of the date of certification” |
| Small employer | “A small employer is generally an employer who had an average of 50 or fewer employees during either of the last 2 calendar years.” |
For the Archer MSA tax, the exceptions are distributions made after the account holder “The additional 20% tax doesn’t apply to distributions made after the date that the account holder:” dies, “Becomes disabled (see Disabled, earlier), or” turns the printed age. If one applies, the instruction is “check the box on line 9a.”
Section C: long-term care contracts
Section C is for the policyholder. “The policyholder is the person who owns the proceeds of the LTC insurance contract, life insurance contract, or viatical settlement”. The form defines the per diem term: “Per diem payments are payments of a fixed amount made on a periodic basis without regard to actual expenses incurred.”
The general rule is stated plainly. “In general, amounts paid under a qualified LTC insurance contract are excluded from your income.” “However, if you receive Per Diem Payments (defined next), the amount you can exclude is limited.” The limit is worked out on lines 21 to 25 of the form, and line 21 uses the printed daily figure shown in the table above.
The chronically ill and terminally ill definitions are in the table. “A terminally ill individual is any individual who has been certified by a physician”. If the insured was terminally ill and the only payments were accelerated death benefits, the form tells you to skip lines 17 through 25.
The current form, its instructions and the related publication are on the About Form 8853 page and the About Publication 969 page.
Which revision applies
The editions read for this page are Form 8853 (2025), created 3/27/25, and the Instructions for Form 8853 (2025), dated Oct 28, 2025, both served by irs.gov when they were read on 2026-10-19. Check the revision printed on the form you are attaching, because a later revision can change the line layout, the rates and the per diem figure.
Common mistakes
- Skipping the form because nothing is taxable. The instructions say “you must file Form 8853 with Form 1040, 1040-SR, or 1040-NR even if you have no taxable income or any other reason for filing”
- Taking a deduction when an employer contributed. The instructions say “If an employer made contributions to your Archer MSA, you aren’t entitled to a deduction.”
- Counting the same medical bills twice. The instructions say “You can’t take a deduction on Schedule A (Form 1040) or Schedule A (Form 1040-NR) for any amount you include on line 7.”
- Treating a direct trustee transfer as a rollover distribution. The instructions say “There is no limit on the number of these transfers.”
Related: Form 8889, 1035 exchange to a hybrid long-term-care contract, and what long-term care insurance costs.
Sources
- Form 8853 (2025), Archer MSAs and Long-Term Care Insurance Contracts: https://www.irs.gov/pub/irs-pdf/f8853.pdf
- 2025 Instructions for Form 8853: https://www.irs.gov/pub/irs-pdf/i8853.pdf
Read from the agency documents linked above on October 19, 2026. General information, not tax advice. Your own facts decide the outcome, and a preparer, the account provider or the IRS is the right place to confirm anything consequential.