taxmap/pubs/p502-004.htm#TXMP47054fba
What Medical Expenses Are Includible?(p5)

taxmap/pubs/p502-004.htm#TXMP76b310c3
Note.When figuring the amount of insurance premiums you can deduct 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.

taxmap/pubs/p502-004.htm#TXMP779023bd Employer-Sponsored Health Insurance Plan(p9)

Employer-Sponsored Health Insurance Plan

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, Wage and Tax Statement. 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/pubs/p502-004.htm#TXMP6d1e595b
Example.(p9)

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.

taxmap/pubs/p502-004.htm#TXMP009e97b4 Long-term care services.(p9)

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/pubs/p502-004.htm#TXMP5c7a2039 Health reimbursement arrangement (HRA).(p9)

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/pubs/p502-004.htm#TXMP39338b5c Medicare A(p9)

Medicare A

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/pubs/p502-004.htm#TXMP5fc5251a Medicare B(p9)

Medicare B

Medicare B is a supplemental medical insurance. Premiums you pay for Medicare B are a medical expense. If you applied for it at age 65 or after you became disabled, you can include in medical expenses the monthly premiums you paid. If you were over age 65 or disabled when you first enrolled, check the information you received from the Social Security Administration to find out your premium.

taxmap/pubs/p502-004.htm#TXMP49597fd3 Medicare D(p9)

Medicare D

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/pubs/p502-004.htm#TXMP5369c3f8 Prepaid Insurance Premiums(p9)

Prepaid Insurance Premiums

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:

1. Payable in equal yearly installments or more often, and
2. Payable for at least 10 years, or until you reach age 65 (but not for less than 5 years).

taxmap/pubs/p502-004.htm#TXMP7952b57e Unused Sick Leave Used To Pay Premiums(p9)

Unused Sick Leave Used To Pay Premiums

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/pubs/p502-004.htm#TXMP63f69e9b Insurance Premiums You Cannot Include(p9)

Insurance Premiums You Cannot Include

You cannot include premiums you pay for:

• Life insurance policies,
• Policies providing payment for loss of earnings,
• Policies for loss of life, limb, sight, etc.,
• Policies that pay you a guaranteed amount each week for a stated number of weeks if you are hospitalized for sickness or injury,
• The part of your car insurance premiums that provides medical insurance coverage for all persons injured in or by your car because the part of the premium for you, your spouse, and your dependents is not stated separately from the part of the premium for medical care for others, or
• Health or long-term care insurance if you elected to pay these premiums with tax-free distributions from a retirement plan made directly to the insurance provider and these distributions would otherwise have been included in income.

Taxes imposed by any governmental unit, such as Medicare taxes, are not insurance premiums.

taxmap/pubs/p502-004.htm#TXMP08a57ef3 Laboratory Fees(p10)

Laboratory Fees

You can include in medical expenses the amounts you pay for laboratory fees that are part of medical care.

taxmap/pubs/p502-004.htm#TXMP459e864a Lead-Based Paint Removal(p10)

Lead-Based Paint Removal

You can include in medical expenses the cost of removing lead-based paints from surfaces in your home to prevent a child who has or has had lead poisoning from eating the paint. 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.

If, instead of removing the paint, you cover the area with wallboard or paneling, treat these items as capital expenses. See Capital Expenses, earlier. Do not include the cost of painting the wallboard as a medical expense.

taxmap/pubs/p502-004.htm#TXMP37cbe6ed Learning Disability(p10)

Learning Disability

See Special Education, later.

taxmap/pubs/p502-004.htm#TXMP3a3b1004 Legal Fees(p10)

Legal Expenses

You can include in medical expenses legal fees you paid that are necessary to authorize treatment for mental illness. However, you cannot include in medical expenses fees for the management of a guardianship estate, fees for conducting the affairs of the person being treated, or other fees that are not necessary for medical care.

taxmap/pubs/p502-004.htm#TXMP41363f17 Lifetime Care—Advance Payments(p10)

Lifetime Care—Advance Payments

You can include in medical expenses a part of a life-care fee or "founder's fee" you pay either monthly or as a lump sum under an agreement with a retirement home. The part of the payment you include is the amount properly allocable to medical care. The agreement must require that you pay a specific fee as a condition for the home's promise to provide lifetime care that includes medical care. You can use a statement from the retirement home to prove the amount properly allocable to medical care. The statement must be based either on the home's prior experience or on information from a comparable home.

taxmap/pubs/p502-004.htm#TXMP7bb084b1 Dependents with disabilities.(p10)

You can include in medical expenses advance payments to a private institution for lifetime care, treatment, and training of your physically or mentally impaired child upon your death or when you become unable to provide care. The payments must be a condition for the institution's future acceptance of your child and must not be refundable.

taxmap/pubs/p502-004.htm#TXMP594c5bb4 Payments for future medical care.(p10)

Generally, you cannot include in medical expenses current payments for medical care (including medical insurance) to be provided substantially beyond the end of the year. This rule does not apply in situations where the future care is purchased in connection with obtaining lifetime care of the type described earlier.

taxmap/pubs/p502-004.htm#TXMP3576c117 Lodging(p10)

Lodging

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 receive 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.

1. The lodging is primarily for and essential to medical care.
2. The medical care is provided by a doctor in a licensed hospital or in a medical care facility related to, or the equivalent of, a licensed hospital.
3. The lodging is not lavish or extravagant under the circumstances.
4. There is no significant element of personal pleasure, recreation, or vacation in the travel away from home.

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.

Do not include the cost of lodging while away from home for medical treatment if that treatment is not received from a doctor in a licensed hospital or in a medical care facility related to, or the equivalent of, a licensed hospital or if that lodging is not primarily for or essential to the medical care received.

taxmap/pubs/p502-004.htm#TXMP3ea385bc Long-Term Care(p10)

Long-Term Care

You can include in medical expenses amounts paid for qualified long-term care services and premiums paid for qualified long-term care insurance contracts.

taxmap/pubs/p502-004.htm#TXMP452be70e Qualified Long-Term Care Services(p10)

Qualified long-term care services are necessary diagnostic, preventive, therapeutic, curing, treating, mitigating, rehabilitative services, and maintenance and personal care services (defined later) that are:

1. Required by a chronically ill individual, and
2. Provided pursuant to a plan of care prescribed by a licensed health care practitioner.

taxmap/pubs/p502-004.htm#TXMP03e5fce3 Chronically ill individual.(p10)

An individual is chronically ill if, within the previous 12 months, a licensed health care practitioner has certified that the individual meets either of the following descriptions.

1. He or she is unable to perform at least two activities of daily living without substantial assistance from another individual for at least 90 days, due to a loss of functional capacity. Activities of daily living are eating, toileting, transferring, bathing, dressing, and continence.
2. He or she requires substantial supervision to be protected from threats to health and safety due to severe cognitive impairment.

taxmap/pubs/p502-004.htm#TXMP1105ac3f Maintenance and personal care services.(p11)

Maintenance or personal care services is care which has as its primary purpose the providing of a chronically ill individual with needed assistance with his or her disabilities (including protection from threats to health and safety due to severe cognitive impairment).

taxmap/pubs/p502-004.htm#TXMP23a7d923 Qualified Long-Term Care Insurance Contracts(p11)

Long-Term Care Insurance

A qualified long-term care insurance contract is an insurance contract that provides only coverage of qualified long-term care services. The contract must:

1. Be guaranteed renewable,
2. Not provide for a cash surrender value or other money that can be paid, assigned, pledged, or borrowed,
3. Provide that refunds, other than refunds on the death of the insured or complete surrender or cancellation of the contract, and dividends under the contract must be used only to reduce future premiums or increase future benefits, and
4. Generally not pay or reimburse expenses incurred for services or items that would be reimbursed under Medicare, except where Medicare is a secondary payer, or the contract makes per diem or other periodic payments without regard to expenses.

The amount of qualified long-term care premiums you can include is limited. You can include the following as medical expenses on Schedule A (Form 1040).

1. Qualified long-term care premiums up to the amounts shown below.
   1. Age 40 or under – $290.
   2. Age 41 to 50 – $550.
   3. Age 51 to 60 – $1,110.
   4. Age 61 to 70 – $2,950.
   5. Age 71 or over – $3,680.
2. Unreimbursed expenses for qualified long-term care services.

Note. The limit on premiums is for each person.

Also, you cannot include premiums for long-term care insurance if you elected to pay these premiums with tax-free distributions from a qualified retirement plan made directly to the insurance provider and these distributions would otherwise have been included in income.

taxmap/pubs/p502-004.htm#TXMP4a00a772 Meals(p11)

Meals and Entertainment

You can include in medical expenses the cost of meals at a hospital or similar institution if a principal reason for being there is to get medical care.

You cannot include in medical expenses the cost of meals that are not part of inpatient care.

taxmap/pubs/p502-004.htm#TXMP4bc10e58 Medical Conferences(p11)

Medical Conferences

You can include in medical expenses amounts paid for admission and transportation to a medical conference if the medical conference concerns the chronic illness of yourself, your spouse, or your dependent. The costs of the medical conference must be primarily for and necessary to the medical care of you, your spouse, or your dependent. The majority of the time spent at the conference must be spent attending sessions on medical information.

The cost of meals and lodging while attending the conference is not deductible as a medical expense.

taxmap/pubs/p502-004.htm#TXMP72167139 Medical Information Plan(p11)

Medical Information Plan

You can include in medical expenses amounts paid to a plan that keeps medical information in a computer data bank and retrieves and furnishes the information upon request to an attending physician.

taxmap/pubs/p502-004.htm#TXMP636d29de Medical Services(p11)

Medical Services

You can include in medical expenses amounts you pay for legal medical services provided by:

• Physicians,
• Surgeons,
• Specialists, or
• Other medical practitioners.

taxmap/pubs/p502-004.htm#TXMP1db89c31 Medicines(p11)

Medicines

You can include in medical expenses amounts you pay for prescribed medicines and drugs. A prescribed drug is one that requires a prescription by a doctor for its use by an individual. You can also include amounts you pay for insulin. Except for insulin, you cannot include in medical expenses amounts you pay for a drug that is not prescribed.

taxmap/pubs/p502-004.htm#TXMP0e98bafe Imported medicines and drugs.(p11)

If you imported medicines or drugs from other countries, see Medicines and Drugs From Other Countries, under What Expenses Are Not Includible, later.

taxmap/pubs/p502-004.htm#TXMP049960ff Mentally Retarded,  Special Home for(p12)

Mentally Retarded, Special Home

You can include in medical expenses the cost of keeping a mentally retarded person in a special home, not the home of a relative, on the recommendation of a psychiatrist to help the person adjust from life in a mental hospital to community living.

taxmap/pubs/p502-004.htm#TXMP62c1504c Nursing Home(p12)

Assisted Living

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/pubs/p502-004.htm#TXMP603fade9 Nursing Services(p12)

Nursing Services

You can include in medical expenses wages and other amounts you pay for nursing services. The services need not be performed by a nurse as long as the services are of a kind generally performed by a nurse. This includes services connected with caring for the patient's condition, such as giving medication or changing dressings, as well as bathing and grooming the patient. These services can be provided in your home or another care facility.

Generally, only the amount spent for nursing services is a medical expense. If the attendant also provides personal and household services, amounts paid to the attendant must be divided between the time spent performing household and personal services and the time spent for nursing services. However, certain maintenance or personal care services provided for qualified long-term care can be included in medical expenses. See Maintenance and personal care services under Long-Term Care, earlier. Additionally, certain expenses for household services or for the care of a qualifying individual incurred to allow you to work may qualify for the child and dependent care credit. See Publication 503, Child and Dependent Care Expenses.

You can also include in medical expenses part of the amount you pay for that attendant's meals. Divide the food expense among the household members to find the cost of the attendant's food. Then divide that cost in the same manner as in the preceding paragraph. If you had to pay additional amounts for household upkeep because of the attendant, you can include the extra amounts with your medical expenses. This includes extra rent or utilities you pay because you moved to a larger apartment to provide space for the attendant.

taxmap/pubs/p502-004.htm#TXMP0ca090c7 Employment taxes.(p12)

You can include as a medical expense social security tax, FUTA, Medicare tax, and state employment taxes you pay for a nurse, attendant, or other person who provides medical care. If the attendant also provides personal and household services, you can include as a medical expense only the amount of employment taxes paid for medical services as explained earlier. For information on employment tax responsibilities of household employers, see Publication 926, Household Employer's Tax Guide.

taxmap/pubs/p502-004.htm#TXMP4477b4b1 Operations(p12)

Operations

You can include in medical expenses amounts you pay for legal operations that are not for unnecessary cosmetic surgery. See Cosmetic Surgery under What Expenses Are Not Includible, later.

taxmap/pubs/p502-004.htm#TXMP0fd18d94 Optometrist(p12)

Optometrist

See Eyeglasses, earlier.

taxmap/pubs/p502-004.htm#TXMP6a53ddeb Organ Donors(p12)

Organ Donors

See Transplants, later.

taxmap/pubs/p502-004.htm#TXMP5c787785 Osteopath(p12)

Osteopath

You can include in medical expenses amounts you pay to an osteopath for medical care.

taxmap/pubs/p502-004.htm#TXMP696e9be5 Oxygen(p12)

Oxygen

You can include in medical expenses amounts you pay for oxygen and oxygen equipment to relieve breathing problems caused by a medical condition.

taxmap/pubs/p502-004.htm#TXMP6d33cbf0 Prosthesis(p12)

Prosthesis

See Artificial Limb, earlier.

taxmap/pubs/p502-004.htm#TXMP5f985cd2 Psychiatric Care(p12)

Psychiatric Care

You can include in medical expenses amounts you pay for psychiatric care. This includes the cost of supporting a mentally ill dependent at a specially equipped medical center where the dependent receives medical care. See Psychoanalysis, next, and Transportation, later.

taxmap/pubs/p502-004.htm#TXMP53d44ea5 Psychoanalysis(p12)

Psychoanalysis

You can include in medical expenses payments for psychoanalysis. However, you cannot include payments for psychoanalysis that is part of required training to be a psychoanalyst.

taxmap/pubs/p502-004.htm#TXMP5c160a13 Psychologist(p12)

Psychologist

You can include in medical expenses amounts you pay to a psychologist for medical care.

taxmap/pubs/p502-004.htm#TXMP5e8c7c35 Special Education(p13)

Special Education

You can include in medical expenses fees you pay on a doctor's recommendation for a child's tutoring by a teacher who is specially trained and qualified to work with children who have learning disabilities caused by mental or physical impairments, including nervous system disorders.

You can include in medical expenses the cost (tuition, meals, and lodging) of attending a school that furnishes special education to help a child to overcome learning disabilities. A doctor must recommend that the child attend the school. Overcoming the learning disabilities must be a principal reason for attending the school, and any ordinary education received must be incidental to the special education provided. Special education includes:

• Teaching Braille to a visually impaired person,
• Teaching lip reading to a hearing-impaired person, or
• Giving remedial language training to correct a condition caused by a birth defect.

You cannot include in medical expenses the cost of sending a problem child to a school where the course of study and the disciplinary methods have a beneficial effect on the child's attitude if the availability of medical care in the school is not a principal reason for sending the student there.

taxmap/pubs/p502-004.htm#TXMP0ea1d588 Sterilization(p13)

Sterilization

You can include in medical expenses the cost of a legal sterilization (a legally performed operation to make a person unable to have children).

taxmap/pubs/p502-004.htm#TXMP26d116eb Stop-Smoking Programs(p13)

Stop-Smoking Programs

You can include in medical expenses amounts you pay for a program to stop smoking. However, you cannot include in medical expenses amounts you pay for drugs that do not require a prescription, such as nicotine gum or patches, that are designed to help stop smoking.

taxmap/pubs/p502-004.htm#TXMP0390084b Surgery(p13)

Surgery

See Operations, earlier.

taxmap/pubs/p502-004.htm#TXMP2f179563 Telephone(p13)

Telephone

You can include in medical expenses the cost of special telephone equipment that lets a hearing-impaired person communicate over a regular telephone. This includes teletypewriter (TTY) and telecommunications device for the deaf (TDD) equipment. You can also include the cost of repairing the equipment.

taxmap/pubs/p502-004.htm#TXMP07cf873c Television(p13)

Television

You can include in medical expenses the cost of equipment that displays the audio part of television programs as subtitles for hearing-impaired persons. 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.

taxmap/pubs/p502-004.htm#TXMP06b8fe1f Therapy(p13)

Therapy

You can include in medical expenses amounts you pay for therapy received as medical treatment.

taxmap/pubs/p502-004.htm#TXMP5224e852 "Patterning" exercises.(p13)

You can include in medical expenses amounts you pay to an individual for giving "patterning" exercises to a mentally retarded child. These exercises consist mainly of coordinated physical manipulation of the child's arms and legs to imitate crawling and other normal movements.

taxmap/pubs/p502-004.htm#TXMP0ea25cee Transplants(p13)

Transplants

You can include any expenses you pay for medical care you receive because you are a donor or a possible donor of a kidney or other organ. This includes transportation.

You can include any expenses you pay for the medical care of a donor in connection with the donating of an organ. This inc