Valerie Spring is 63 years old. Valerie is single, is not disabled, and has no d

ID: 2719879 • Letter: V

Question

Valerie Spring is 63 years old.

Valerie is single, is not disabled, and has no dependents.

In 2015, she had earnings from her job of $22,300.

Valerie has participated in her employer's self-only HDHP coverage since May 1, 2015 when she started a new job.

Valerie asked the HSA trustee from her previous job to transfer the balance of $2,300 into the HSA at her new job.

In 2015, Valerie contributed $750 to her HSA.

Contact lenses (needed for medical reasons)—$380

Medication for a skin condition (prescription from a doctor)—$215

Dental visit—$500

Health club fees—$400

Valerie is a U.S. citizen, has a valid Social Security number, and is not eligible to be claimed as a dependent.

Interview Notes

Valerie Spring is 63 years old.

Valerie is single, is not disabled, and has no dependents.

In 2015, she had earnings from her job of $22,300.

Valerie has participated in her employer's self-only HDHP coverage since May 1, 2015 when she started a new job.

Valerie asked the HSA trustee from her previous job to transfer the balance of $2,300 into the HSA at her new job.

In 2015, Valerie contributed $750 to her HSA.

In 2015, Valerie took funds from her HSA to pay the following expenses:

Contact lenses (needed for medical reasons)—$380

Medication for a skin condition (prescription from a doctor)—$215

Dental visit—$500

Health club fees—$400

Valerie is a U.S. citizen, has a valid Social Security number, and is not eligible to be claimed as a dependent.

8. What is the amount reported on Form 8889, line 15? A. $615 B. $900 C. $1,095 D. $1,495

Contact lenses (needed for medical reasons)—$380

Medication for a skin condition (prescription from a doctor)—$215

Dental visit—$500
line 15 distributions from all HSAs in 2015 that were used for the qualified medical expenses ($380 + $215+$500) = $1095

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