Idaho State Tax Commission

Idaho Medical Savings Account

An Idaho Medical Savings Account (MSA) allows you to save for medical expenses and long-term care costs while reducing the amount of Idaho individual income tax that you owe.

Contributions to a federal MSA or health savings account (HSA) don't qualify for this Idaho deduction. The following information refers only to the Idaho MSA; tax consequences of federal MSAs and HSAs differ from the Idaho MSA.

Qualifying accounts and expenses

For your account to qualify as an MSA, the financial institution must include the words "Medical Savings Account" or the letters "MSA" on your statement as well as in the name, title, description, or designation of the account.

This account is used only to pay eligible medical, vision, and dental expenses (as defined by the Internal Revenue Code), along with health insurance and supplemental Medicare premiums and long-term care expenses.

In addition, transportation to and from a medical appointment is an eligible expense. The amount can be based either on your actual cost (e.g. gas, oil, parking) or on the optional standard medical mileage rate set by the Internal Revenue Service.

Withdrawals for ineligible expenses

You must pay tax on any funds you withdraw from the MSA to pay for something other than an eligible medical expense.

Also, if you're less than 59 1/2 years old, funds withdrawn to pay for something other than eligible medical expenses are subject to a 10% penalty.

Financial benefits

Contributions to an Idaho MSA can be deducted from your adjusted gross income when you file an Idaho income tax return. A single person can contribute up to $10,000 each calendar year and a married couple filing jointly can contribute up to $20,000.

Interest earned on this account is also deductible.

These deductions are only entered on your Idaho individual income tax return, not your federal (IRS) tax return.

Using your MSA

Your funds must be in the MSA before you pay the expense.

Example: On May 1 you visit the doctor and on May 3 you open an MSA with a $200 initial deposit. You receive your doctor's bill for $500 on May 20 and pay that bill (from a different account) on May 25. On June 10 you deposit $400 into your MSA. However, you may only reimburse yourself $200 from the MSA because that was the amount that was in the account at the time you paid the bill.

If you mistakenly deposit money to your MSA, you can withdraw it within 30 days with no tax consequences.

If you mistakenly withdraw money from your MSA, you can redeposit the money within 30 days with no tax consequences, and since it's a reimbursement, it's not included in your contribution dollar limit.

Insurance reimbursement

If you take money from your MSA to pay a medical bill but are then reimbursed by your insurance company for that expense, you must deposit the reimbursement into your MSA within 60 days of the date you received the reimbursement.

If you don't redeposit this amount, it must be included in taxable income and you may be subject to a penalty. If you redeposit the funds into the MSA, since it's a reimbursement, it's not included in your contribution dollar limit.

Working with your financial institution

Your financial institution is only required to send a statement showing the amount of interest the account earned, as it does for any other account. The account holder is responsible for keeping accurate records of contributions, distributions, and rollovers.

If you choose, you can move your MSA from one financial institution to another as long as you reinvest the money from the old MSA in a new MSA for the benefit of the same account holder within 60 days of the withdrawal.

Death of the account holder

If the beneficiary is a surviving spouse, the account will continue to qualify as an MSA and can be used by the spouse. If the beneficiary isn't a surviving spouse, the account no longer qualifies as an MSA.

The beneficiary (including an estate) must include in income the amount in the MSA — less any of the decedent's medical expenses paid by the beneficiary within one year of the death.

Tax deduction information

If you pay health insurance premiums from your MSA, you can't also claim the Idaho deduction for health insurance premiums for those contributions.

If your health insurance premiums are deducted from your wages on a pre-tax basis, you can't withdraw those premiums from your MSA to reimburse yourself. Review your W-2 form information or check with your payroll office if you're unsure if your insurance premium deductions are pre-tax.

You can claim on your Schedule A the qualifying expenses you've paid from your MSA, both for your federal and Idaho tax return filings.

Laws and rules

Last updated January 20, 2021

This information is for general guidance only. Tax laws are complex and change regularly. We can't cover every circumstance in our guides. This guidance may not apply to your situation. Please contact us with any questions. We work to provide current and accurate information. But some information could have technical inaccuracies or typographical errors. If there's a conflict between current tax law and this information, current tax law will govern.