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Getting a healthy deduction from medical costs

What do doctors’ visits, Navajo healing ceremonies and clarinet lessons have in common? All can qualify, under the right circumstances, as tax-deductible medical expenses.
/ Source: The Associated Press

What do doctors’ visits, Navajo healing ceremonies and clarinet lessons have in common? All can qualify, under the right circumstances, as tax-deductible medical expenses.

It’s not that easy to take the deduction — medical expenses must exceed 7.5 percent of adjusted gross income before they can be deducted. On the other hand, taxpayers can cast a wide net to reach that threshold, so it may be easier than you think.

Costs for elastic hosiery, seeing-eye dogs, stop-smoking and weight-loss programs, lead paint removal, special mattresses for relief of arthritis or spine problems, reclining chairs prescribed by a doctor — all have been permitted by either the Internal Revenue Service or the U.S. Tax Court, where tax disputes are heard.

“If it was prescribed for a medical purpose or to alleviate a condition, you have a good chance of getting it through,” said Donna LeValley, a tax attorney and contributing editor of the J.K. Lasser tax publications.

The key is whether the expense involves the diagnosis, cure, treatment or prevention of a disease or health condition for you, a spouse or a dependent.

Don’t stretch it too far. Health clubs, therapeutic dance lessons, marriage counseling, tattooing, sex-change operations and diaper services don’t qualify as medical expenses. Costs of divorce, even if recommended by a psychiatrist, don’t qualify; neither does a hotel room used for sex therapy.

Also not deductible: Funeral and burial expenses, toothpaste, toiletries, cosmetics and most cosmetic surgery, unless necessary to improve a disfigurement from disease, birth or accidental injury.

Still, legitimate expenses do add up. They can include air conditioners for relief of allergies or breathing problems, hearing aids, eyeglasses, contact lenses, Braille books, adapters for closed-caption service for the deaf, orthopedic shoes, crutches, wheelchairs, wigs for those who’ve lost hair through disease, and legal fees for guardianship of a mentally ill spouse.

Deducting clarinet lessons was permitted because a dentist recommended them for treatment of tooth defects, LeValley noted.

“You can see how that might be a little iffy, but it made sense once you see what the dentist was trying to achieve,” she said.

Traditional health expenses — doctors’ visits, laboratory tests and prescription drugs — qualify, but so do alternative procedures like acupuncture, Navajo healing “sings,” electric shock, whirlpool baths, hydrotherapy and heat treatments. (But marijuana isn’t deductible, even when prescribed by a doctor in a state permitting the prescription.)

Childbirth classes for expectant mothers — but not maternity clothes — are deductible, and so are remedial reading expenses for a child suffering from dyslexia and the wages of a blind person’s guide.

Health insurance premiums, including Medicare B supplemental insurance and Part D prescription drug insurance, are deductible. But you can’t deduct insurance premiums paid by an employer-sponsored health insurance plan unless the premiums are included in Box 1 of your Form W-2.

Also, be sure to subtract insurance company reimbursement from the expenses you submit for the medical expenses deduction.

Keep in mind that no medical expenses can be deducted until the 7.5 percent adjusted gross income threshold is reached, and even then only by taxpayers who itemize deductions. (For more information, see the IRS Publication 502, “Medical and Dental Expenses.”)

With those caveats, here’s a list of some deductible medical expenses:

  • Fees paid to doctors, dentists, surgeons, chiropractors, psychiatrists, psychologists and Christian Science practitioners.
  • Hospital services, certain long-term care services, nursing services and laboratory fees.
  • Acupuncture treatments or inpatient treatment at a center for alcohol or drug addiction.
  • Costs of stop-smoking programs and drugs prescribed to alleviate nicotine withdrawal, but not for nicotine gum and nicotine patches, which don’t require a prescription.
  • Costs of participating in a weight-loss program for a specific disease, including obesity, diagnosed by a physician, but not the cost of purchasing diet food items.
  • Transportation expenses such as tolls and parking fees, taxis, and bus, train and airplane fares for trips to doctors’ offices, health care facilities and laboratories. Either auto mileage or actual out-of-pocket costs for gas and oil for such trips also can be deducted.
  • Ambulance fees.
  • Meals and lodging charged by the hospital or similar institution if your main reason for being there is to receive medical care.
  • Insurance premiums for accident and health or qualified long-term care insurance (but not for life insurance, policies providing for loss of wages because of illness or injury, or policies that pay a guaranteed amount each week for a sickness).
  • False teeth, prescription eyeglasses and contact lenses, laser eye surgery, hearing aids, crutches, wheelchairs, and guide dogs for the blind or deaf.
  • Canes, walkers, orthopedic shoes and other equipment for the disabled.
  • Nursing home expenses incurred primarily for medical care.
  • Over-the-counter medical supplies like bandages and aspirin.
  • Costs of home renovation to improve handicapped access.