U.S. · Tax forms
Form 8889 line 15, qualified medical expenses.
Which HSA withdrawals count, whose expenses qualify, and what line 16 does with it.
Line 15 is the part of your HSA distributions that paid you back for qualified medical expenses not reimbursed by insurance and incurred after the HSA was set up. Line 16, the taxable amount, is line 14c minus line 15, never below zero.
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Result
What counts on line 15 (2025 instructions)
| Line | Meaning | What the IRS says |
|---|---|---|
| Which distributions | Used to pay you for qualified medical expenses | Not reimbursed by insurance or other coverage, and incurred after the HSA was established |
| Whose expenses | You and your spouse | Included |
| Dependents | All your dependents | Included |
| Would-be dependents | A person who would be a dependent except for a joint return, gross income, or being someone else’s dependent | Included |
| Divorced parents | Child of divorced, separated or apart parents for the last 6 months of the year | Treated as the dependent of both parents, whether or not the custodial parent releases the claim |
| Late excess withdrawal | Excess contribution taken out after the return due date | Not included, even if used for qualified medical expenses |
| Schedule A | Itemized medical deduction | You cannot deduct on Schedule A any amount you include on line 15 |
How line 15 changes your tax
Line 16 is line 14c minus line 15, and a result of zero or less is entered as zero. Anything left is taxable and also added to Schedule 1 (Form 1040), Part I, line 8f. That leftover is the amount that may also face the additional 20% tax on line 17b unless an exception applies.
What counts as a qualified medical expense
The instructions say qualified medical expenses for HSA purposes are generally unreimbursed medical expenses that could otherwise be deducted on Schedule A (Form 1040), and point to the Instructions for Schedule A and Publication 502. Nonprescription medicines other than insulin qualify for HSA purposes even though they do not for the itemized deduction, and so do menstrual care products. Expenses incurred before you establish your HSA do not qualify. Insurance premiums generally do not qualify, except long-term care, COBRA continuation coverage, coverage while receiving unemployment compensation, and Medicare and other health coverage if you were 65 or older (not Medigap).
Use all HSAs
The instructions say to include on line 15 distributions from all HSAs in 2025 used for the qualified medical expenses of the people listed above. If you have an HSA at more than one custodian, add the qualifying distributions across all of them.
No double dip
An expense you paid from the HSA tax-free cannot also be deducted as an itemized medical expense on Schedule A. The instructions say so directly for any amount included on line 15.
Worked example
Rita had $6,000 on line 14c. From the HSA she paid herself back for $2,100 of her own unreimbursed dental work, $900 for her spouse and $1,000 for a dependent child, a total of $4,000 on line 15. Line 16 is $6,000 − $4,000 = $2,000. That $2,000 is taxable, and the 20% additional tax on line 17b applies to it unless an exception applies. Names and figures are made up.
More Form 8889 line pages
Other pages in this set: Form 8889 Line 3, Form 8889 Line 6, Form 8889 Line 9, Form 8889 Line 13, Form 8889 Line 14a, Form 8889 Line 17b.
Sources
- Instructions for Form 8889 (2025): the line-by-line instructions on this page. Page last reviewed or updated April 30, 2026. Read November 2, 2026.
- Form 8889 (2025): the printed line wording and arithmetic on the form. Read November 2, 2026.
Tax year 2025 edition. Line numbers and dollar limits are those printed in the 2025 instructions and form and change by year. Names in worked examples are made up.
Frequently asked questions
What goes on Form 8889 line 15?
HSA distributions used to pay you for qualified medical expenses that were not reimbursed by insurance or other coverage and were incurred after the HSA was established.
Whose medical expenses count?
Yours, your spouse’s, all your dependents, and anyone who would be a dependent except for a joint return, gross income, or being someone else’s dependent.
Can I also deduct those expenses on Schedule A?
No. The instructions say you cannot deduct on Schedule A any amount you include on line 15.
Does a late excess withdrawal count?
No. Do not include a distribution of an excess contribution taken after the due date including extensions, even if used for qualified medical expenses.
Do insurance premiums count?
Generally not. The instructions allow only long-term care insurance, COBRA continuation coverage, coverage while receiving unemployment compensation, and Medicare or other health coverage if you were 65 or older (other than Medigap).
Not tax advice
This page summarizes IRS instructions, mostly written for the people who prepare the form, and is not tax, legal or financial advice. A CPA or an enrolled agent can confirm what a line means for your return. Everything runs in your browser; nothing you enter is sent anywhere.