A Comprehensive Guide for Itemized Medical Deductions

In today's world, where medical costs are soaring, understanding the intricacies of tax-deductible medical expenses is not just beneficial—it's necessary for effective financial planning. This guide explores the ins and outs of deductible medical expenses, touching on critical aspects like the 7.5% of Adjusted Gross Income (AGI) limitation, and provides a detailed look at the various expenditures that qualify as eligible medical expenses.

The Internal Revenue Code permits taxpayers to deduct certain unreimbursed medical and dental expenses as itemized deductions on Schedule A of Form 1040. To qualify, these expenses must exceed 7.5% of your adjusted gross income (AGI).

The 7.5% of AGI limitation is a threshold below which medical expenses are not deductible. Specifically, only medical expenses exceeding 7.5% of your AGI can be deducted. For example, if your AGI is $50,000, only the amount of your medical expenses over $3,750 ($50,000 x 7.5%) can be deducted. An additional limitation on deducting medical expenses is that you must be itemizing your deductions, which generally only happens when your standard deduction is less than the total of allowed deductions.

Only out-of-pocket medical-related payments are eligible as a medical deduction for tax purposes. For example, if you have a root canal procedure that costs $2,000 and your health insurance covers $1,700 of the cost and you pay $300, just your $300 payment qualifies as a medical deduction. If your policy covered the entire $2,000, your medical tax expense would be $0.

According to the tax law definition, medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body including dental expenses.

Below is a comprehensive list of specific medical expenses that qualify as deductible and some that don’t. Each expense is explained to ensure clarity and support your tax planning: 

1. Abortion: The amount paid for a legal abortion is eligible as a medical expense.
   
   
2. Acupuncture and Chiropractic Care: Fees paid to chiropractors for treatments are deductible. Such care often involves spinal adjustments aimed at improving bodily function.
   
   
3. Adoption Expenses Paid by Adopting Parent: Medical expense payments made by an adopting parent for medical services rendered to a child, even before the child was placed in the parent's home, are deductible if:
   
   · The child is a dependent of the adopting parent when services are rendered or paid; and
   · The expenses are paid by the parent, or agent, for the medical care of the child; and
   · They are not reimbursement for expenses by the adoption agency prior to adoption negotiations; and
   · The expenses are shown to be directly attributable to the medical care of the child.
   
   The adoptive parents cannot deduct the natural mother's childbirth expenses.
   
   
4. Alcoholism and Drug Addiction Treatments: Expenses for treatment in therapeutic centers for alcoholism and drug addiction are deductible. This includes the cost of meals and lodging when these are necessary for the treatment.
   
   
5. Auto Travel: When using a vehicle for medical reasons, deduction is allowed at a specified rate per mile (21 cents for 2025) or for actual cost of gas and oil (not repairs, maintenance, depreciation, lease fees, etc.).
     
6. Birth Control Pills: A taxpayer can include in medical expenses the amount paid for birth control pills provided they were prescribed by a doctor.
   
   
7. Body Scan: The amount paid for a full-body scan was an allowed expense even though the taxpayer who underwent the test was not experiencing symptoms of illness and had not obtained a physician’s recommendation before undergoing the procedure. This procedure was for diagnosis, and since it did not have a non-medical function, the IRS allowed it, despite its high cost or the possible existence of less expensive alternatives.
   
   
8. Christian Science Practitioners: Payments to recognized practitioners for healing sessions qualify, reflecting the IRS's acknowledgment of diverse medical practices.
   
   
9. Condoms, Vasectomy: Expenses for purchasing condoms are recognized as preventive care, thus deductible. The cost of a vasectomy is includible as a medical expense.
   
   
10. Contact Lenses: Costs for contact lenses and maintenance supplies like saline solution are eligible, highlighting the necessity of corrective vision care.
    
    
11. Cosmetic Surgery: This is defined as any procedure which is directed at improving the patient's appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease. Cosmetic surgery or other similar procedures can't be considered as a medical expense deduction, unless the surgery or procedure is necessary to ameliorate a deformity arising from (or directly related to) a (1) congenital abnormality, (2) personal injury resulting from an accident or trauma, or (3) disfiguring disease. The IRS specifically ruled that breast reconstruction surgery paid for by a breast cancer patient who had a mastectomy as part of her cancer treatment was a deductible medical expense.
     
12. Crutches, Canes, Walker: Purchasing or renting walking aids qualify, as they aid in mobility during recovery from injuries.
    
    
13. Decedent’s Medical Expenses: Medical expenses of the decedent paid before death are claimed as an itemized deduction in the usual manner on the decedent’s final individual return. Medical expenses paid after the decedent’s death become the liability of the decedent’s estate, and they are claimed on the estate tax return if one is required to be filed. However, expenses that were paid out of estate funds within one year after the day of death can be treated as if paid by the decedent and claimed on the decedent’s final return instead. Consult with the estate executor.
    
    
14. Direct Primary Care Arrangements: The costs for direct primary care arrangements (sometimes termed a “concierge doctor”) are considered amounts paid for medical care and deductible as medical expenses.
    
    
15. Disabled Dependent Care Expenses: Some disabled dependent care expenses may qualify as either medical expenses, or work-related expenses for purposes of taking a credit for child and dependent care. The expenses can be applied either way if the same expenses are not used to claim both a credit and a medical expense deduction.
    
    
16. Dental Treatment: Deductible expenses include preventive and corrective dental procedures, such as cleanings, fillings, braces, and extractions.
    
    
17. Diagnostic Devices: The cost of devices for diagnosing illnesses, such as blood sugar test kits for diabetics, is eligible for deduction.
    
    
18. Diapers: To claim the costs of adult diapers, a prescription from the doctor may be needed.
    
    
19. Disabled Dependent Care: Expenses for the care of a disabled dependent may qualify, provided they aren't claimed elsewhere as work-related expenses.
    
    
20. Drug Addiction Treatment: Inpatient treatment costs, including meals and lodging at therapeutic centers, are deductible, addressing the comprehensive nature of addiction recovery.
    
    
21. Egg Donor Expenses: The IRS has ruled privately that a woman who can't conceive children using her own eggs may claim a medical expense deduction for the costs of obtaining an egg donor, including associated legal costs.  
    
    
22. Equipment and Supplies: The IRS has ruled that the prohibition against deductibility of nonprescription medicine or drugs does not apply to such items as crutches, bandages, and diagnostic devices (e.g., blood sugar kits used by diabetics). The costs of such equipment and supplies are deductible if they otherwise meet the general requirement of being paid for the diagnosis, cure, mitigation, treatment, or prevention of disease.
    
    
23. Eye Care: Deductible expenses encompass eye exams, eyeglasses, and surgeries like laser interventions that correct vision defects. But the purchase of a magnifying glass at the drug store would not qualify.
    
    
24. Fertility Enhancement: Costs for treatments aimed at overcoming infertility, such as in vitro fertilization, including temporary storage of eggs or sperm, can be deducted.
    
    
25. Gender Identity Treatment: The cost of surgery and treatments for gender identity disorder is considered deductible following a U.S. Tax Court's decision.
    
    
26. Genetic Diagnosis Testing: The term "diagnosis" encompasses the determination that a disease may or may not be present and includes testing of changes to the function of the body that are unrelated to disease. A Revenue Ruling allows amounts paid by individuals for diagnostic and similar procedures performed without a physician's recommendation and on an individual not experiencing symptoms of an illness or disease, and a pregnancy test that tests the healthy functioning of the body, qualify as medical care. However, the IRS has privately indicated the taxpayer must allocate the price paid for a DNA collection kit and health services between the medical and non-medical items and services to determine what is deductible medical care.
    
    
27. Guide Dogs and Service Animals: The costs of purchasing, training, and maintaining a service animal for a person with a disability are deductible. This does not, however, extend to emotional support animals.
    
    
28. Hearing Aids: Costs include the purchase, maintenance, and repair of hearing aids.
    
    
29. Health Club Dues: Not eligible as a medical expense are health club dues or amounts paid to improve your general health or to relieve physical or mental discomfort not related to a particular medical condition.
    
    
30. Health Reimbursement Arrangements (HRA) Payments: Medical expenses paid by an HRA are not deductible since an HRA is a pre-tax plan funded by an employer.
    
    
31. Health Savings Account (HSA) Payments: Contributions to a Health Savings Account can’t be included as a medical expense. Further, medical expenses paid for with tax-free HSA distributions don’t qualify as a medical expense deduction.
    
    
32. Home Modifications for Medical Reasons: Home modifications for disabled individuals, like widening doorways or installing ramps, can be deducted as medical expenses, with the cost decrease factored into property values.
    
    
33. Household Help as a Medical Expense: The cost of household help cannot be included in medical expenses, even if such help is recommended by a doctor. This is a personal expense that is not deductible.
    
    
34. Insurance Premiums: Amounts paid for insurance including medical, hospital, dental, long-term care (limited), lost or damaged contact lenses, prescription drugs and insulin, and Medicare-B and Medicare-D insurance premiums (see Medicare premiums) are allowed. Premiums paid through an employer’s flexible spending arrangement are not deductible because they are paid with pre-tax dollars. The deduction for insurance premiums for coverage acquired through a health exchange (Marketplace) is allowed net of the premium assistance credit.
    
    Note: Instead of deducting insurance as a medical itemized deduction, if you area self-employed individual (or a partner or a more-than-2%-shareholder of an S corporation), you may be able to deduct as an above-the-line expense 100% of the amount paid during the tax year for medical insurance on behalf of yourself, your spouse, dependents, and children under age 27 even if the child is not a dependent. Check with this office for information on additional requirements to claim this deduction.
    
    
35. Lab Fees, X-rays: Medical expenses include the amounts paid for laboratory fees and costs of X-rays that are part of medical care.
    
    
36. Lactation: The IRS says that breast pumps and supplies that assist lactation are medical care.
    
    
37. Lead-Based Paint Removal: The cost of removing lead-based paints from surfaces in a taxpayer’s home to prevent a child who has or has had lead poisoning from eating the paint can be included in medical expenses. These surfaces must be in poor repair (peeling or cracking) or within the child’s reach. The cost of repainting the scraped area is not a medical expense.  
    
    
38. Learning Disabilities Special Education: Tuition fees paid to special schools for children with severe learning disabilities are deductible if a doctor recommends the school. Tutoring fees from qualified teachers are also deductible if aimed at addressing the student's specific learning challenges.
    
    
39. Legal Expenses: Legal expenses may be deductible medical expenses if they bear a direct or proximate relationship to the provision of medical care to a taxpayer.
    
    
40. Lodging: The cost of meals and lodging at a hospital or similar institution may be included if the main reason for being there is to receive medical care. Medical expenses may also include the cost of lodging not provided in a hospital or similar institution. The cost of such lodging while away from home may be included if the lodging is primarily for and essential to medical care provided by a doctor in a licensed hospital or in a medical care facility related to, or the equivalent of, a licensed hospital, the lodging is not lavish or extravagant under the circumstances and there is no significant element of personal pleasure, recreation, or vacation in the travel away from home.
    
    The amount included in medical expenses for lodging cannot be more than $50 for each night for each person. Lodging is included for a person for whom transportation expenses are a medical expense because that person is traveling with the person receiving the medical care. For example, if a parent is traveling with a sick child, up to $100 per night is included as a medical expense for lodging. Meals are not deductible.
    
    
41. Long-Term Care Insurance: Amounts paid for long-term care services and certain premiums paid on long-term care insurance will be includible as medical expenses on Schedule A subject to certain annually inflation adjusted limitations.  
    
    
42. Meals: Medical expenses may include 100% of the cost of meals at a hospital or similar institution if the main purpose for being there is to get medical care. The cost of meals that are not part of inpatient care may not be included.
    
    
43. Medical Alert Devices: Costs for medical alert devices that the elderly or infirm can wear and get medical help should they fall or have another medical emergency may be deductible. These devices must meet the definition of a medical expense. In some cases, to meet the definition of a medical device requires the device to be prescribed by a medical professional.
    
    
44. Medical Conferences: Costs related to attending medical conferences tied to a dependent's medical condition—excluding meals and accommodations—are deductible.
    
    
45. Medical Insurance Premiums: Medical insurance premiums, including Medicare B and D, and other health policies, are deductible. Coverage obtained through a health exchange is deductible, net of any premium assistance credits.
    
    
46. Medication: Only prescription drugs and insulin are allowed.
    
    
47. Mental Health Support: Fees for psychiatrists, psychologists, and other mental health professionals qualify, reflecting a holistic view of health.
    
    
48. Moving: Where a taxpayer is required to permanently relocate for medical reasons, only transportation costs related to the taxpayer are deductible, and the travel costs for the taxpayer’s family are not deductible. Other typical moving expenses such as van and storage are not deductible.
    
    
49. Nursing Services: While services do not have to be performed by licensed nurses, the primary purpose must be medical care to qualify.
    
    
50. Orgon Donor Expenses: Example: Kidney recipient who pays a kidney donor's surgical, hospital, and transportation expenses may deduct these costs as medical expenses.
    
    
51. Physical Exam: The amount a taxpayer pays for an annual physical exam, even though the taxpayer is not experiencing any symptoms of illness, is allowed.
    
    
52. Personal Protective Equipment (PPE): The IRS has said that amounts paid for personal protective equipment, such as masks, hand sanitizer, and sanitizing wipes, for the primary purpose of preventing the spread of the coronavirus, are treated as amounts paid for medical care.
    
    
53. Pregnancy Test: The cost of a self-administered pregnancy test was deductible even though its purpose was to test the healthy functioning of the body rather than to detect disease.
    
    
54. Schools and Education: Special – A taxpayer can include in medical expenses payments to a special school for a mentally impaired or physically disabled person if the main reason for using the school is its resources for relieving the disability. A taxpayer can include, for example, the cost of:
    
    · Teaching Braille to a visually impaired child,
    · Teaching lip reading to a hearing-impaired child, or
    · Giving remedial language training to correct a condition caused by a birth defect.
    
    The cost of meals, lodging, and ordinary education supplied by a special school can be included in medical expenses only if the main reason for the child’s being there is for the resources the school has to relieve the mental or physical disability.
    
    Do not include in medical expenses the cost of sending a problem child to a special school for benefits the child may get from the course of study and the disciplinary methods.
    
    
55. Smoking-Cessation Programs: IRS has ruled that uncompensated amounts paid by taxpayers for participation in smoking-cessation programs and for prescribed drugs designed to alleviate nicotine withdrawal are eligible medical expenses. No deductions are permitted for the costs of nonprescription nicotine gum and certain nicotine patches.
    
    
56. Spouse - Prior or Current: A taxpayer can include medical expenses paid for a prior or current spouse provided the taxpayer was married to the spouse either at:
    
    · The time the spouse received the medical services or
    · At the time the taxpayer paid the medical expenses.
    
    
57. Stem Cell Therapy and Storage: Treatment of an ailment that meets the tax definition noted at the beginning of this article with stem cell therapy would qualify as a medical deduction. Cord blood contains stem cells that doctors may use to treat disease. Thus, expenses for banking cord blood to treat an existing or imminently probable disease may qualify as deductible medical expenses. However, banking cord blood as a precaution to treat a disease that might possibly develop in the future does not satisfy the existing legal standard that at a minimum a disease must be imminently probable.
    
    
58. Sterilization: The cost of a legal sterilization (a legally performed operation to make a person unable to have children) can be included in medical expenses.
    
    
59. Surgery: Expenses for both non-cosmetic and reconstructive surgeries or operations are deductible if they address a medical condition or result from an accident or trauma.
    
    
60. Surrogate Mother: A surrogate mother is, by definition, neither the taxpayer nor the taxpayer’s spouse, and she is typically not a dependent either. An unborn child is also not a dependent. Thus, medical expenses paid to a surrogate mother and her unborn child do not qualify for a medical deduction.
    
    
61. Telephone: Included in medical expenses is the cost of special telephone equipment that lets a person who is deaf, hard of hearing or has a speech disability communicate over a regular telephone. This includes teletypewriter (TTY) and telecommunications device for the deaf (TDD) equipment and the repair of the equipment. Also Specialized phones with big buttons or pictures in place of the numbers, are available without prescription.
    
    
62. Television: Included in medical expenses is the cost of equipment that displays the audio part of television programs as subtitles for persons with a hearing disability. This may be the cost of an adapter that attaches to a regular set. It also may be the part of the cost of a specially equipped television that exceeds the cost of the same model regular television set.
    
    
63. Transportation: Amounts paid for ambulance service are includible as a medical expense, as are bus, taxi, train, or plane fares paid for transportation primarily for, and essential to, medical care.
    
    
64. Tuition Medical: A lump-sum fee which includes education, board, and medical care, but that does not distinguish which part of the fee relates to medical care, is not considered an amount paid for medical care, and therefore not deductible. However, charges for a health plan included in a lump-sum tuition fee qualify if the charges are separately stated or can easily be obtained from the school.  
    
    
65. Vehicles & Vehicle Modification: Medical expenses include the cost of special hand controls and other special equipment installed in a car for the use of a person with a disability. Medical expenses also include the difference between the cost of a regular car and a car specially designed to hold a wheelchair.
    
    
66. Weight-Loss Programs: Expenses for medically prescribed weight-loss interventions aimed at reducing obesity-related health issues are deductible.
    
    
67. Wig: A taxpayer can include in medical expenses the cost of a wig purchased upon the advice of a physician for the mental health of a patient who has lost all his or her hair from disease.

Maximizing your medical deductions requires strategic documentation. Maintain detailed records of all medical-related transactions, including receipts, invoices, insurance payments and reimbursement, and doctor notes recommending treatments. This practice not only supports your tax filings but also provides a clear financial overview of your medical spending.

Navigating the landscape of medical deductions can be complex, yet the financial rewards are substantial. By understanding and strategically planning your medical expenses, you can significantly lower your taxable income, offering relief and improved financial health. Always consult with a tax advisor to ensure you're leveraging all available opportunities and adhering to the latest IRS guidelines.

Please contact this office for questions or assistance.

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