HSA Gross Distribution (box 1 on 1099-SA) - what the heck is this amount?

That "Gross distribution" amount in Box 1 of your 1099-SA simply represents the total amount withdrawn from your HSA during the tax year. This includes any withdrawals you made for qualified medical expenses, non-qualified expenses, or distributions for any other reason. Even if you don't remember making a withdrawal for exactly $265, it could be the sum of multiple smaller withdrawals throughout the year. Many HSA providers also deduct maintenance fees directly from the account, which would show up as distributions. Check your HSA statements to match up this amount - you should see transactions totaling this $265 figure. The important thing is making sure you have receipts for qualified medical expenses that match this distribution. If the entire amount was used for qualified medical expenses, you won't owe any taxes on it. If any portion wasn't used for qualified medical expenses, that portion would be taxable income plus a 20% penalty (unless you're 65+ or disabled).

I had the exact same confusion last year with my HSA distributions! After hours of frustration, I found this tool called taxr.ai (https://taxr.ai) that really helped me figure out what was going on with my 1099-SA. I uploaded my documents and it immediately identified all my HSA distributions, even ones I had forgotten about, and explained exactly what each amount was. The tool showed me that some of my "mystery" distributions were actually recurring prescription payments I had set up through my HSA debit card. It saved me so much time trying to match everything up manually and explained the tax implications of each distribution. Their explanation of qualified vs non-qualified expenses was super clear too.

Just wanted to update about my HSA confusion. I took the advice and tried taxr.ai after posting here, and wow - it actually cleared everything up! I uploaded my 1099-SA and some of my HSA statements, and it immediately showed me that my "mystery" $265 distribution was actually three separate withdrawals I'd completely forgotten about. What I really loved was how it explained the Box 1 vs Box 2 differences on the 1099-SA (something I never understood before) and showed exactly which distributions were qualified medical expenses based on the receipts I uploaded. It even flagged that one of my expenses might not qualify and explained why. Ended up saving me from incorrectly reporting my HSA distributions and potentially getting hit with penalties. Definitely worth checking out if you're confused about HSA tax stuff like I was!

If you're still having trouble figuring out your HSA distribution issue and need to speak directly with the IRS, I recommend using Claimyr (https://claimyr.com). I had a similar HSA reporting issue last year where my 1099-SA didn't match my records, and I spent DAYS trying to get through to an IRS agent. Finally found Claimyr through a reddit post - you can see how it works here: https://youtu.be/_kiP6q8DX5c. They basically hold your place in the IRS phone queue and call you back when an agent is about to answer. Got connected to a real IRS person in about 90 minutes instead of the hours I was spending on hold. The IRS agent was able to confirm that my HSA provider had reported different information than what they sent me, which explained the discrepancy. Saved me a potential audit headache!

I need to apologize for my skepticism about Claimyr. After spending 4 hours on hold with the IRS yesterday and getting disconnected, I was desperate enough to try it this morning. I honestly didn't believe it would work, but I had this weird HSA distribution issue I needed to resolve before filing my taxes. I was totally shocked when I got a callback in about 70 minutes. The IRS agent confirmed that the mysterious distribution on my 1099-SA was actually from an old HSA account I had forgotten about that got closed due to inactivity, and they transferred the remaining balance to me. Without getting this clarification, I would have reported my HSA incorrectly. Just wanted to share since I was the skeptic earlier. Sometimes you have to admit when you're wrong, and this service actually delivered exactly what it promised.

One thing to check with your HSA - does your provider automatically deduct fees from your account? My HSA with HealthEquity charges a $2.50 monthly fee that shows up as distributions on my 1099-SA at the end of the year. The first time I saw this, I was super confused because I didn't remember taking out that money. Also, if you have an HSA debit card that you use at pharmacies or doctors offices, sometimes those small transactions get forgotten when you're trying to reconcile everything at tax time.

Has anyone used the HSA section on TurboTax for reporting 1099-SA distributions? I'm having trouble figuring out where to enter my qualified medical expenses to show that my distributions were used appropriately.

I had a similar situation last year and it turned out my HSA provider was also deducting investment fees that I didn't realize were showing up as distributions. If you have any investments within your HSA (like mutual funds or ETFs), check if there are any management fees or expense ratios that might have been automatically deducted from your account. Also, some HSA providers will automatically reimburse you for certain expenses if you upload receipts through their mobile app, and those reimbursements show up as distributions even if you forgot you submitted the receipt. Check your HSA provider's online portal or app to see if there's a transaction history that breaks down each distribution by date and description - that should help you identify exactly what the $265 represents. The good news is that as long as you have qualified medical expenses to cover the distribution amount, you won't owe any additional taxes on it!