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IRS.gov Website
Publication 17
taxmap/pub17/p17-108.htm#en_us_publink100033898

What Medical Expenses Are Includible?(p146)

rule
Use Table 21-1, later, as a guide to determine which medical and dental expenses you can include on Schedule A (Form 1040).
This table does not include all possible medical expenses. To determine if an expense not listed can be included in figuring your medical expense deduction, see What Are Medical Expenses, earlier.
taxmap/pub17/p17-108.htm#en_us_publink100033899

Insurance Premiums(p146)

rule
You can include in medical expenses insurance premiums you pay for policies that cover medical care. Medical care policies can provide payment for treatment that includes:
If you have a policy that provides payments for other than medical care, you can include the premiums for the medical care part of the policy if the charge for the medical part is reasonable. The cost of the medical part must be separately stated in the insurance contract or given to you in a separate statement.
Note.When figuring the amount of insurance premiums you can include in medical expenses on Schedule A, do not include any health coverage tax credit advance payments shown in box 1 of Form 1099-H, Health Coverage Tax Credit (HCTC) Advance Payments. Also, do not include insurance premiums attributable to a nondependent child under age 27 if your premiums increased as a result of adding this child to your policy.
taxmap/pub17/p17-108.htm#en_us_publink100033901

Employer-sponsored health insurance plan.(p146)

rule
Do not include in your medical and dental expenses any insurance premiums paid by an employer-sponsored health insurance plan unless the premiums are included in box 1 of your Form W-2. Also, do not include any other medical and dental expenses paid by the plan unless the amount paid is included in box 1 of your Form W-2.
taxmap/pub17/p17-108.htm#en_us_publink100033902

Example.(p146)

You are a federal employee participating in the premium conversion plan of the Federal Employee Health Benefits (FEHB) program. Your share of the FEHB premium is paid by making a pre-tax reduction in your salary. Because you are an employee whose insurance premiums are paid with money that is never included in your gross income, you cannot deduct the premiums paid with that money.
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Long-term care services.(p146)

rule
Contributions made by your employer to provide coverage for qualified long-term care services under a flexible spending or similar arrangement must be included in your income. This amount will be reported as wages in box 1 of your Form W-2.
taxmap/pub17/p17-108.htm#en_us_publink100033904

Health reimbursement arrangement (HRA).(p146)

rule
If you have medical expenses that are reimbursed by a health reimbursement arrangement, you cannot include those expenses in your medical expenses. This is because an HRA is funded solely by the employer.
taxmap/pub17/p17-108.htm#en_us_publink100033905

Retired public safety officers.(p146)

rule
If you are a retired public safety officer, do not include as medical expenses any health or long-term care premiums that you elected to have paid with tax-free distributions from your retirement plan. This applies only to distributions that would otherwise be included in income.
taxmap/pub17/p17-108.htm#en_us_publink100033906

Medicare A.(p146)

rule
If you are covered under social security (or if you are a government employee who paid Medicare tax), you are enrolled in Medicare A. The payroll tax paid for Medicare A is not a medical expense.
If you are not covered under social security (or were not a government employee who paid Medicare tax), you can voluntarily enroll in Medicare A. In this situation you can include the premiums you paid for Medicare A as a medical expense.
taxmap/pub17/p17-108.htm#en_us_publink100033907

Medicare B.(p146)

rule
Medicare B is supplemental medical insurance. Premiums you pay for Medicare B are a medical expense. Check the information you received from the Social Security Administration to find out your premium.
taxmap/pub17/p17-108.htm#en_us_publink100033908

Medicare D.(p146)

rule
Medicare D is a voluntary prescription drug insurance program for persons with Medicare A or B. You can include as a medical expense premiums you pay for Medicare D.
taxmap/pub17/p17-108.htm#en_us_publink100033909

Prepaid insurance premiums.(p146)

rule
Premiums you pay before you are age 65 for insurance for medical care for yourself, your spouse, or your dependents after you reach age 65 are medical care expenses in the year paid if they are:
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Unused sick leave used to pay premiums.(p146)

rule
You must include in gross income cash payments you receive at the time of retirement for unused sick leave. You also must include in gross income the value of unused sick leave that, at your option, your employer applies to the cost of your continuing participation in your employer's health plan after you retire. You can include this cost of continuing participation in the health plan as a medical expense.
If you participate in a health plan where your employer automatically applies the value of unused sick leave to the cost of your continuing participation in the health plan (and you do not have the option to receive cash), do not include the value of the unused sick leave in gross income. You cannot include this cost of continuing participation in that health plan as a medical expense.
taxmap/pub17/p17-108.htm#en_us_publink1000253357

Table 21-1. Medical and Dental Expenses Checklist. See Publication 502 for more information about these and other expenses.

You can include:You cannot include:
  • Bandages
  • Birth control pills prescribed by your doctor
  • Body scan
  • Braille books
  • Breast pump and supplies
  • Capital expenses for equipment or improvements to your home needed for medical care (see the worksheet in Publication 502)
  • Diagnostic devices
  • Expenses of an organ donor
  • Eye surgery—to promote the correct function of the eye
  • Fertility enhancement, certain procedures
  • Guide dogs or other animals aiding the blind, deaf, and disabled
  • Hospital services fees (lab work, therapy, nursing services, surgery, etc.)
  • Lead-based paint removal
  • Legal abortion
  • Legal operation to prevent having children such as a vasectomy or tubal ligation
  • Long-term care contracts, qualified
  • Meals and lodging provided by a hospital during medical treatment
  • Medical services fees (from doctors, dentists, surgeons, specialists, and other medical practitioners)
  • Medicare Part D premiums
  • Medical and hospital insurance premiums
  • Nursing services
  • Oxygen equipment and oxygen
  • Part of life-care fee paid to retirement home designated for medical care
  • Physical examination
  • Pregnancy test kit
  • Prescription medicines (prescribed by a doctor) and insulin
  • Psychiatric and psychological treatment
  • Social security tax, Medicare tax, FUTA, and state employment tax for worker providing medical care (see Wages for nursing services, below)
  • Special items (artificial limbs, false teeth, eye-glasses, contact lenses, hearing aids, crutches, wheelchair, etc.)
  • Special education for mentally or physically disabled persons
  • Stop-smoking programs
  • Transportation for needed medical care
  • Treatment at a drug or alcohol center (includes meals and lodging provided by the center)
  • Wages for nursing services
  • Weight-loss, certain expenses for obesity
  • Baby sitting and childcare
  • Bottled water
  • Contributions to Archer MSAs (see Publication 969)
  • Diaper service
  • Expenses for your general health (even if following your doctor's advice) such as—
    —Health club dues
    —Household help (even if recommended by a doctor)
    —Social activities, such as dancing or swimming lessons
    —Trip for general health improvement
  • Flexible spending account reimbursements for medical expenses (if contributions were on a pre-tax basis)
  • Funeral, burial, or cremation expenses
  • Health savings account payments for medical expenses
  • Illegal operation, treatment, or medicine
  • Life insurance or income protection policies, or policies providing payment for loss of life, limb, sight, etc.
  • Maternity clothes
  • Medical insurance included in a car insurance policy covering all persons injured in or by your car
  • Medicine you buy without a prescription
  • Nursing care for a healthy baby
  • Prescription drugs you brought in (or ordered shipped) from another country, in most cases
  • Nutritional supplements, vitamins, herbal supplements, "natural medicines," etc., unless recommended by a medical practitioner as a treatment for a specific medical condition diagnosed by a physician
  • Surgery for purely cosmetic reasons
  • Toothpaste, toiletries, cosmetics, etc.
  • Teeth whitening
  • Weight-loss expenses not for the treatment of obesity or other disease
taxmap/pub17/p17-108.htm#en_us_publink100033911

Meals and Lodging(p146)

rule
You can include in medical expenses the cost of meals and lodging at a hospital or similar institution if a principal reason for being there is to get medical care. See Nursing home, later.
You may be able to include in medical expenses the cost of lodging not provided in a hospital or similar institution. You can include the cost of such lodging while away from home if all of the following requirements are met. The amount you include in medical expenses for lodging cannot be more than $50 for each night for each person. You can include lodging for a person traveling with the person receiving the medical care. For example, if a parent is traveling with a sick child, up to $100 per night can be included as a medical expense for lodging. Meals are not included.
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Nursing home.(p146)

rule
You can include in medical expenses the cost of medical care in a nursing home, home for the aged, or similar institution, for yourself, your spouse, or your dependents. This includes the cost of meals and lodging in the home if a principal reason for being there is to get medical care.
Do not include the cost of meals and lodging if the reason for being in the home is personal. You can, however, include in medical expenses the part of the cost that is for medical or nursing care.
taxmap/pub17/p17-108.htm#en_us_publink100033913

Transportation(p146)

rule
Include in medical expenses amounts paid for transportation primarily for, and essential to, medical care. You can include:
taxmap/pub17/p17-108.htm#en_us_publink100033915

Car expenses.(p146)

rule
You can include out-of-pocket expenses, such as the cost of gas and oil, when you use your car for medical reasons. You cannot include depreciation, insurance, general repair, or maintenance expenses.
If you do not want to use your actual expenses for 2013, you can use the standard medical mileage rate of 24 cents per mile.
You can also include parking fees and tolls. You can add these fees and tolls to your medical expenses whether you use actual expenses or use the standard mileage rate.
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Example.(p147)

In 2013, Bill Jones drove 2,800 miles for medical reasons. He spent $500 for gas, $30 for oil, and $100 for tolls and parking. He wants to figure the amount he can include in medical expenses both ways to see which gives him the greater deduction.
He figures the actual expenses first. He adds the $500 for gas, the $30 for oil, and the $100 for tolls and parking for a total of $630.
He then figures the standard mileage amount. He multiplies 2,800 miles by 24 cents a mile for a total of $672. He then adds the $100 tolls and parking for a total of $772.
Bill includes the $772 of car expenses with his other medical expenses for the year because the $772 is more than the $630 he figured using actual expenses.
taxmap/pub17/p17-108.htm#en_us_publink100033917

Transportation expenses you cannot include.(p147)

rule
You cannot include in medical expenses the cost of transportation in the following situations.
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Disabled Dependent
Care Expenses(p147)

rule
Some disabled dependent care expenses may qualify as either: You can choose to apply them either way as long as you do not use the same expenses to claim both a credit and a medical expense deduction.