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Here's an example given in the Instructions for Form 8889:

 

Example. In 2023, you are an eligible individual and have family HDHP coverage. In March, you divorce and change your coverage as of April 1 to self-only. Neither you nor your ex-spouse qualify for the additional contribution amount. Your ex-spouse continued to have family HDHP coverage and was an eligible individual for the entire year. The contribution limit for the 3 months you both were considered to have family coverage is $1,937.50 ($7,750 × 3 ÷ 12). You and your ex-spouse decide to divide the family coverage contribution in the following manner: 75% to your ex-spouse and 25% to you. Your contribution limit for 9 months of self-only coverage is $2,887.50 ($3,850 × 9 ÷ 12). This amount is not divided between you and your spouse.

Because you are covered under a self-only policy on December 1, you will show $3,850 on line 6 (the greater of either (a) $3,371.87 ($1,937.50 family coverage + $2,887.50 self-only coverage – $1,453.13 spousal allocation) or (b) the maximum amount that can be contributed ($3,850 for self-only coverage)). Your ex-spouse would show $7,750 on line 6 (the greater of either (a) $7,265.62 ($1,937.50 family coverage for the 3 months prior to the divorce + $5,812.50 family coverage maintained after the divorce – $484.38 spousal allocation) or (b) the maximum amount that can be contributed ($7,750 for family coverage)).

 

Isn't this similar to our situation with the exception that:

  • We are still married
  • We qualify for the additional contribution of $1000