Deducting expenses for medical and dental care is easier when you know the rules

If you itemize your deductions for a taxable year on Form 1040, Schedule A Itemized Deductions, you may be able to deduct unreimbursed expenses you paid that year for medical and dental care for yourself, your spouse, and your dependents. You may deduct only the amount of your total medical expenses that exceed 7.5% of your adjusted gross income in 2018 and 10% beginning in 2019.

What qualifies as a medical expense?

Qualifying costs, which include many items other than hospital and doctor bills, often amount to much larger figures than expected. Below are some items you should take into account in determining your medical expenses:

Health insurance premiums

The cost of health insurance is a medical expense. This item, by itself, can total thousands of dollars a year. Even if your employer provides you with health coverage, you can deduct the portion of the premiums that you pay. Long-term care insurance premiums are also included in medical expenses, subject to specific dollar limits based on age. However, pre-tax insurance premiums paid by an individual are not deductible medical expenses.

Transportation

The cost of getting to and from medical treatment is a deductible medical expense. This includes taxi fares, public transportation, or the cost of using your own car. Car costs can be calculated at 20¢ a mile for miles driven in 2019 (18¢ a mile for miles driven in 2018), plus tolls and parking. Alternatively, you can deduct your actual costs, such as for gas and oil (but not your general costs such as insurance, depreciation, or maintenance).

Therapists, nurses, etc.

The services of individuals other than doctors can qualify as long as the services relate to a medical condition and aren’t for general health. For example, costs of physical therapy after knee surgery would qualify, but not costs of a fitness counselor to tone you up. Amounts paid for certain long-term care services required by a chronically ill individual also qualify as deductible medical expenses.

Eyeglasses, hearing aids, dental work, psychotherapy, prescription drugs

Deductible medical expenses include the cost of glasses, hearing aids, dental work, psychiatric counseling, and other ongoing expenses in connection with medical needs. Purely cosmetic expenses (e.g., a “nose job”) don’t qualify. Prescription drugs (including insulin) qualify, but over the counter items such as aspirin and vitamins don’t. Neither do amounts paid for operations or treatments that are illegal under federal law (such as marijuana), even if state or local law permits the procedure or drug.

Smoking-cessation programs

Amounts paid for participation in a smoking-cessation program and for prescribed drugs designed to alleviate nicotine withdrawal are deductible medical expenses. However, non-prescription nicotine gum and certain nicotine patches aren’t deductible.

Weight-loss programs

A weight-loss program is a deductible medical expense if undertaken as treatment for a disease diagnosed by a physician. The disease can be obesity itself or another disease, such as hypertension or heart disease, for which the doctor directs you to lose weight. It’s a good idea to get a written diagnosis before starting the program. Deductible expenses include fees paid to join the program and to attend periodic meetings. However, the cost of low-calorie food that you eat in place of your regular diet isn’t deductible.

Dependents and others

You can deduct the medical costs paid on behalf of dependents, such as your children. Additionally, you may be able to deduct medical costs you pay for an individual, such as an elderly parent or grandparent, who would qualify as your dependent except that he has too much gross income or files jointly. In most cases, the medical costs of a child of divorced parents can be claimed by the parent who pays them, regardless of who gets the dependency exemption.

We’ve got your back

At KRS, our CPAs can help you identify deductible medical expenses to maximize potential tax savings. Give us a call at 201.655.7411 or email me at sfaust@krscpas.com.