HSA Contribution & Reimbursement Log

An HSA has two jobs most people only use one of. It pays this year’s medical bills, and it quietly stores a claim on tax-free money for decades — but only if you keep the receipts. This log does both.

What This Workbook Does

• The top block checks contributions against the annual limit, with employer money in its own column because it counts against the same limit.
• REMAINING ROOM tells you what you may still put in before the filing deadline.
• The Reimbursements tab logs every qualified expense, and totals the ones you paid out of pocket and have not yet reimbursed — the amount you could withdraw tax-free at any point in the future.

How to Use It

1. Enter this year’s IRS contribution limit for your coverage tier. The workbook does not hard-code it, because it changes every year.
2. Add the catch-up amount only if you are 55 or older. Each spouse aged 55 or over needs a separate HSA to use their own catch-up.
3. Log every transaction as it happens. Enter withdrawals as negative numbers.
4. Watch REMAINING ROOM. An over-contribution can be corrected without penalty if you catch it before the tax filing deadline.
5. Log qualified expenses on the Reimbursements tab whether you paid with the HSA card or out of pocket.
6. Anything marked out of pocket and not yet reimbursed adds to the banked total. Keep the receipt — the receipt is what makes the future withdrawal tax-free.

What It Will Not Do

The limit check counts only what you have logged. If a payroll contribution has not been entered, the remaining-room figure will be too high. Enter contributions as they happen, not once a year.