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Irs Publication 600 - Introductory Material Table of Contents Introduction Introduction The Tax Relief and Health Care Act of 2006 extended the election to deduct state and local general sales taxes for 2006. Irs The act was enacted after Schedule A (Form 1040), Itemized Deductions, and its instructions were printed. Irs Because we were not able to include the instructions for figuring the deduction in the Schedule A instructions, we are providing this publication to help you figure this deduction. Irs You can elect to deduct state and local general sales taxes instead of state and local income taxes as a deduction on Schedule A. Irs You cannot deduct both. Irs To figure your deduction, you can use either: Your actual expenses, or The optional sales tax tables plus the general sales taxes paid on certain specified items. Irs Prev  Up  Next   Home   More Online Publications
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Irs Publication 502 - Main Content Table of Contents What Are Medical Expenses? What Expenses Can You Include This Year?Community property states. Irs How Much of the Expenses Can You Deduct? Whose Medical Expenses Can You Include?Spouse Dependent Decedent What Medical Expenses Are Includible?Abortion Acupuncture Alcoholism Ambulance Annual Physical Examination Artificial Limb Artificial Teeth Bandages Birth Control Pills Body Scan Braille Books and Magazines Breast Pumps and Supplies Breast Reconstruction Surgery Capital Expenses Car Chiropractor Christian Science Practitioner Contact Lenses Crutches Dental Treatment Diagnostic Devices Disabled Dependent Care Expenses Drug Addiction Drugs Eye Exam Eyeglasses Eye Surgery Fertility Enhancement Founder's Fee Guide Dog or Other Service Animal Health Institute Health Maintenance Organization (HMO) Hearing Aids Home Care Home Improvements Hospital Services Insurance Premiums Intellectually and Developmentally Disabled, Special Home for Laboratory Fees Lactation Expenses Lead-Based Paint Removal Learning Disability Legal Fees Lifetime Care—Advance Payments Lodging Long-Term Care Meals Medical Conferences Medical Information Plan Medicines Nursing Home Nursing Services Operations Optometrist Organ Donors Osteopath Oxygen Physical Examination Pregnancy Test Kit Prosthesis Psychiatric Care Psychoanalysis Psychologist Special Education Sterilization Stop-Smoking Programs Surgery Telephone Television Therapy Transplants Transportation Trips Tuition Vasectomy Vision Correction Surgery Weight-Loss Program Wheelchair Wig X-ray What Expenses Are Not Includible?Baby Sitting, Childcare, and Nursing Services for a Normal, Healthy Baby Controlled Substances Cosmetic Surgery Dancing Lessons Diaper Service Electrolysis or Hair Removal Flexible Spending Account Funeral Expenses Future Medical Care Hair Transplant Health Club Dues Health Coverage Tax Credit Health Savings Accounts Household Help Illegal Operations and Treatments Insurance Premiums Maternity Clothes Medical Savings Account (MSA) Medicines and Drugs From Other Countries Nonprescription Drugs and Medicines Nutritional Supplements Personal Use Items Swimming Lessons Teeth Whitening Veterinary Fees Weight-Loss Program How Do You Treat Reimbursements?Insurance Reimbursement How Do You Figure and Report the Deduction on Your Tax Return?What Tax Form Do You Use? Sale of Medical Equipment or Property Damages for Personal Injuries Impairment-Related Work Expenses Health Insurance Costs for Self-Employed Persons COBRA Premium Assistance Health Coverage Tax CreditWho Can Take This Credit? Qualifying Family Member Qualified Health Insurance Nonqualified Health Insurance Eligible Coverage Month How To Take the Credit How To Get Tax HelpLow Income Taxpayer Clinics What Are Medical Expenses? 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. Irs These expenses include payments for legal medical services rendered by physicians, surgeons, dentists, and other medical practitioners. Irs They include the costs of equipment, supplies, and diagnostic devices needed for these purposes. Irs Medical care expenses must be primarily to alleviate or prevent a physical or mental defect or illness. Irs They do not include expenses that are merely beneficial to general health, such as vitamins or a vacation. Irs Medical expenses include the premiums you pay for insurance that covers the expenses of medical care, and the amounts you pay for transportation to get medical care. Irs Medical expenses also include amounts paid for qualified long-term care services and limited amounts paid for any qualified long-term care insurance contract. Irs What Expenses Can You Include This Year? You can include only the medical and dental expenses you paid this year, regardless of when the services were provided. Irs (But see Decedent under Whose Medical Expenses Can You Include, for an exception. Irs ) If you pay medical expenses by check, the day you mail or deliver the check generally is the date of payment. Irs If you use a “pay-by-phone” or “online” account to pay your medical expenses, the date reported on the statement of the financial institution showing when payment was made is the date of payment. Irs If you use a credit card, include medical expenses you charge to your credit card in the year the charge is made, not when you actually pay the amount charged. Irs If you did not claim a medical or dental expense that would have been deductible in an earlier year, you can file Form 1040X, Amended U. Irs S. Irs Individual Income Tax Return, for the year in which you overlooked the expense. Irs Do not claim the expense on this year's return. Irs Generally, an amended return must be filed within 3 years from the date the original return was filed or within 2 years from the time the tax was paid, whichever is later. Irs You cannot include medical expenses that were paid by insurance companies or other sources. Irs This is true whether the payments were made directly to you, to the patient, or to the provider of the medical services. Irs Separate returns. Irs   If you and your spouse live in a noncommunity property state and file separate returns, each of you can include only the medical expenses each actually paid. Irs Any medical expenses paid out of a joint checking account in which you and your spouse have the same interest are considered to have been paid equally by each of you, unless you can show otherwise. Irs Community property states. Irs   If you and your spouse live in a community property state and file separate returns or are registered domestic partners in Nevada, Washington, or California, any medical expenses paid out of community funds are divided equally. Irs Generally, each of you should include half the expenses. Irs If medical expenses are paid out of the separate funds of one individual, only the individual who paid the medical expenses can include them. Irs If you live in a community property state and are not filing a joint return, see Publication 555, Community Property. Irs How Much of the Expenses Can You Deduct? Generally, you can deduct on Schedule A (Form 1040) only the amount of your medical and dental expenses that is more than 10% of your AGI. Irs But if either you or your spouse was born before January 2, 1949, you can deduct the amount of your medical and dental expenses that is more than 7. Irs 5% of your AGI. Irs Example. Irs You are unmarried and were born after January 2, 1949, and your AGI is $40,000, 10% of which is $4,000. Irs You paid medical expenses of $2,500. Irs You cannot deduct any of your medical expenses because they are not more than 10% of your AGI. Irs Whose Medical Expenses Can You Include? You can generally include medical expenses you pay for yourself, as well as those you pay for someone who was your spouse or your dependent either when the services were provided or when you paid for them. Irs There are different rules for decedents and for individuals who are the subject of multiple support agreements. Irs See Support claimed under a multiple support agreement , later under Qualifying Relative. Irs Spouse You can include medical expenses you paid for your spouse. Irs To include these expenses, you must have been married either at the time your spouse received the medical services or at the time you paid the medical expenses. Irs Example 1. Irs Mary received medical treatment before she married Bill. Irs Bill paid for the treatment after they married. Irs Bill can include these expenses in figuring his medical expense deduction even if Bill and Mary file separate returns. Irs If Mary had paid the expenses, Bill could not include Mary's expenses in his separate return. Irs Mary would include the amounts she paid during the year in her separate return. Irs If they filed a joint return, the medical expenses both paid during the year would be used to figure their medical expense deduction. Irs Example 2. Irs This year, John paid medical expenses for his wife Louise, who died last year. Irs John married Belle this year and they file a joint return. Irs Because John was married to Louise when she received the medical services, he can include those expenses in figuring his medical expense deduction for this year. Irs Dependent You can include medical expenses you paid for your dependent. Irs For you to include these expenses, the person must have been your dependent either at the time the medical services were provided or at the time you paid the expenses. Irs A person generally qualifies as your dependent for purposes of the medical expense deduction if both of the following requirements are met. Irs The person was a qualifying child (defined later) or a qualifying relative (defined later), and The person was a U. Irs S. Irs citizen or national or a resident of the United States, Canada, or Mexico. Irs If your qualifying child was adopted, see Exception for adopted child , later. Irs You can include medical expenses you paid for an individual that would have been your dependent except that: He or she received gross income of $3,900 or more in 2013, He or she filed a joint return for 2013, or You, or your spouse if filing jointly, could be claimed as a dependent on someone else's 2013 return. Irs Exception for adopted child. Irs   If you are a U. Irs S. Irs citizen or national and your adopted child lived with you as a member of your household for 2013, that child does not have to be a U. Irs S. Irs citizen or national, or a resident of the United States, Canada, or Mexico. Irs Qualifying Child A qualifying child is a child who: Is your son, daughter, stepchild, foster child, brother, sister, stepbrother, stepsister, half brother, half sister, or a descendant of any of them (for example, your grandchild, niece, or nephew), Was: Under age 19 at the end of 2013 and younger than you (or your spouse, if filing jointly), Under age 24 at the end of 2013, a full-time student, and younger than you (or your spouse, if filing jointly), or Any age and permanently and totally disabled, Lived with you for more than half of 2013, Did not provide over half of his or her own support for 2013, and Did not file a joint return, other than to claim a refund. Irs Adopted child. Irs   A legally adopted child is treated as your own child. Irs This child includes a child lawfully placed with you for legal adoption. Irs   You can include medical expenses that you paid for a child before adoption if the child qualified as your dependent when the medical services were provided or when the expenses were paid. Irs   If you pay back an adoption agency or other persons for medical expenses they paid under an agreement with you, you are treated as having paid those expenses provided you clearly substantiate that the payment is directly attributable to the medical care of the child. Irs   But if you pay the agency or other person for medical care that was provided and paid for before adoption negotiations began, you cannot include them as medical expenses. Irs    You may be able to take a credit for other expenses related to an adoption. Irs See the Instructions for Form 8839, Qualified Adoption Expenses, for more information. Irs Child of divorced or separated parents. Irs   For purposes of the medical and dental expenses deduction, a child of divorced or separated parents can be treated as a dependent of both parents. Irs Each parent can include the medical expenses he or she pays for the child, even if the other parent claims the child's dependency exemption, if: The child is in the custody of one or both parents for more than half the year, The child receives over half of his or her support during the year from his or her parents, and The child's parents: Are divorced or legally separated under a decree of divorce or separate maintenance, Are separated under a written separation agreement, or Live apart at all times during the last 6 months of the year. Irs This does not apply if the child's exemption is being claimed under a multiple support agreement (discussed later). Irs Qualifying Relative A qualifying relative is a person: Who is your: Son, daughter, stepchild, or foster child, or a descendant of any of them (for example, your grandchild), Brother, sister, half brother, half sister, or a son or daughter of any of them, Father, mother, or an ancestor or sibling of either of them (for example, your grandmother, grandfather, aunt, or uncle), Stepbrother, stepsister, stepfather, stepmother, son-in-law, daughter-in-law, father-in-law, mother-in-law, brother-in-law, or sister-in-law, or Any other person (other than your spouse) who lived with you all year as a member of your household if your relationship did not violate local law, Who was not a qualifying child (see Qualifying Child, earlier) of any taxpayer for 2013, and For whom you provided over half of the support in 2013. Irs But see Child of divorced or separated parents , earlier, Support claimed under a multiple support agreement, next, and Kidnapped child under Qualifying Relative in Publication 501. Irs Support claimed under a multiple support agreement. Irs   If you are considered to have provided more than half of a qualifying relative's support under a multiple support agreement, you can include medical expenses you pay for that person. Irs A multiple support agreement is used when two or more people provide more than half of a person's support, but no one alone provides more than half. Irs   Any medical expenses paid by others who joined you in the agreement cannot be included as medical expenses by anyone. Irs However, you can include the entire unreimbursed amount you paid for medical expenses. Irs Example. Irs You and your three brothers each provide one-fourth of your mother's total support. Irs Under a multiple support agreement, you treat your mother as your dependent. Irs You paid all of her medical expenses. Irs Your brothers repaid you for three-fourths of these expenses. Irs In figuring your medical expense deduction, you can include only one-fourth of your mother's medical expenses. Irs Your brothers cannot include any part of the expenses. Irs However, if you and your brothers share the nonmedical support items and you separately pay all of your mother's medical expenses, you can include the unreimbursed amount you paid for her medical expenses in your medical expenses. Irs Decedent Medical expenses paid before death by the decedent are included in figuring any deduction for medical and dental expenses on the decedent's final income tax return. Irs This includes expenses for the decedent's spouse and dependents as well as for the decedent. Irs The survivor or personal representative of a decedent can choose to treat certain expenses paid by the decedent's estate for the decedent's medical care as paid by the decedent at the time the medical services were provided. Irs The expenses must be paid within the 1-year period beginning with the day after the date of death. Irs If you are the survivor or personal representative making this choice, you must attach a statement to the decedent's Form 1040 (or the decedent's amended return, Form 1040X) saying that the expenses have not been and will not be claimed on the estate tax return. Irs Qualified medical expenses paid before death by the decedent are not deductible if paid with a tax-free distribution from any Archer MSA, Medicare Advantage MSA, or health savings account. Irs What if the decedent's return had been filed and the medical expenses were not included?   Form 1040X can be filed for the year or years the expenses are treated as paid, unless the period for filing an amended return for that year has passed. Irs Generally, an amended return must be filed within 3 years of the date the original return was filed, or within 2 years from the time the tax was paid, whichever date is later. Irs Example. Irs John properly filed his 2012 income tax return. Irs He died in 2013 with unpaid medical expenses of $1,500 from 2012 and $1,800 in 2013. Irs If the expenses are paid within the 1-year period, his survivor or personal representative can file an amended return for 2012 claiming a deduction based on the $1,500 medical expenses. Irs The $1,800 of medical expenses from 2013 can be included on the decedent's final return for 2013. Irs What if you pay medical expenses of a deceased spouse or dependent?   If you paid medical expenses for your deceased spouse or dependent, include them as medical expenses on your Form 1040 in the year paid, whether they are paid before or after the decedent's death. Irs The expenses can be included if the person was your spouse or dependent either at the time the medical services were provided or at the time you paid the expenses. Irs What Medical Expenses Are Includible? Following is a list of items that you can include in figuring your medical expense deduction. Irs The items are listed in alphabetical order. Irs This list does not include all possible medical expenses. Irs To determine if an expense not listed can be included in figuring your medical expense deduction, see What Are Medical Expenses , earlier. Irs Abortion You can include in medical expenses the amount you pay for a legal abortion. Irs Acupuncture You can include in medical expenses the amount you pay for acupuncture. Irs Alcoholism You can include in medical expenses amounts you pay for an inpatient's treatment at a therapeutic center for alcohol addiction. Irs This includes meals and lodging provided by the center during treatment. Irs You can also include in medical expenses amounts you pay for transportation to and from Alcoholics Anonymous meetings in your community if the attendance is pursuant to medical advice that membership in Alcoholics Anonymous is necessary for the treatment of a disease involving the excessive use of alcoholic liquors. Irs Ambulance You can include in medical expenses amounts you pay for ambulance service. Irs Annual Physical Examination See Physical Examination , later. Irs Artificial Limb You can include in medical expenses the amount you pay for an artificial limb. Irs Artificial Teeth You can include in medical expenses the amount you pay for artificial teeth. Irs Bandages You can include in medical expenses the cost of medical supplies such as bandages. Irs Birth Control Pills You can include in medical expenses the amount you pay for birth control pills prescribed by a doctor. Irs Body Scan You can include in medical expenses the cost of an electronic body scan. Irs Braille Books and Magazines You can include in medical expenses the part of the cost of Braille books and magazines for use by a visually impaired person that is more than the cost of regular printed editions. Irs Breast Pumps and Supplies You can include in medical expenses the cost of breast pumps and supplies that assist lactation. Irs Breast Reconstruction Surgery You can include in medical expenses the amounts you pay for breast reconstruction surgery, as well as breast prosthesis, following a mastectomy for cancer. Irs See Cosmetic Surgery , later. Irs Capital Expenses You can include in medical expenses amounts you pay for special equipment installed in a home, or for improvements, if their main purpose is medical care for you, your spouse, or your dependent. Irs The cost of permanent improvements that increase the value of your property may be partly included as a medical expense. Irs The cost of the improvement is reduced by the increase in the value of your property. Irs The difference is a medical expense. Irs If the value of your property is not increased by the improvement, the entire cost is included as a medical expense. Irs Certain improvements made to accommodate a home to your disabled condition, or that of your spouse or your dependents who live with you, do not usually increase the value of the home and the cost can be included in full as medical expenses. Irs These improvements include, but are not limited to, the following items. Irs Constructing entrance or exit ramps for your home. Irs Widening doorways at entrances or exits to your home. Irs Widening or otherwise modifying hallways and interior doorways. Irs Installing railings, support bars, or other modifications to bathrooms. Irs Lowering or modifying kitchen cabinets and equipment. Irs Moving or modifying electrical outlets and fixtures. Irs Installing porch lifts and other forms of lifts (but elevators generally add value to the house). Irs Modifying fire alarms, smoke detectors, and other warning systems. Irs Modifying stairways. Irs Adding handrails or grab bars anywhere (whether or not in bathrooms). Irs Modifying hardware on doors. Irs Modifying areas in front of entrance and exit doorways. Irs Grading the ground to provide access to the residence. Irs Only reasonable costs to accommodate a home to a disabled condition are considered medical care. Irs Additional costs for personal motives, such as for architectural or aesthetic reasons, are not medical expenses. Irs Capital expense worksheet. Irs   Use Worksheet A to figure the amount of your capital expense to include in your medical expenses. Irs Worksheet A. Irs Capital Expense Worksheet Instructions: Use this worksheet to figure the amount, if any, of your medical expenses due to a home improvement. Irs 1. Irs Enter the amount you paid for the home improvement 1. Irs   2. Irs Enter the value of your home immediately after the improvement 2. Irs       3. Irs Enter the value of your home immediately before the improvement 3. Irs       4. Irs Subtract line 3 from line 2. Irs This is the increase in the value of your home due to the improvement 4. Irs     • If line 4 is more than or equal to line 1, you have no medical expenses due to the home improvement; stop here. Irs       • If line 4 is less than line 1, go to line 5. Irs     5. Irs Subtract line 4 from line 1. Irs These are your medical expenses due to the home improvement 5. Irs   Operation and upkeep. Irs   Amounts you pay for operation and upkeep of a capital asset qualify as medical expenses, as long as the main reason for them is medical care. Irs This rule applies even if none or only part of the original cost of the capital asset qualified as a medical care expense. Irs Improvements to property rented by a person with a disability. Irs   Amounts paid to buy and install special plumbing fixtures for a person with a disability, mainly for medical reasons, in a rented house are medical expenses. Irs Example. Irs John has arthritis and a heart condition. Irs He cannot climb stairs or get into a bathtub. Irs On his doctor's advice, he installs a bathroom with a shower stall on the first floor of his two-story rented house. Irs The landlord did not pay any of the cost of buying and installing the special plumbing and did not lower the rent. Irs John can include in medical expenses the entire amount he paid. Irs Car You can include in medical expenses the cost of special hand controls and other special equipment installed in a car for the use of a person with a disability. Irs Special design. Irs   You can include in medical expenses the difference between the cost of a regular car and a car specially designed to hold a wheelchair. Irs Cost of operation. Irs   The includible costs of using a car for medical reasons are explained under Transportation , later. Irs Chiropractor You can include in medical expenses fees you pay to a chiropractor for medical care. Irs Christian Science Practitioner You can include in medical expenses fees you pay to Christian Science practitioners for medical care. Irs Contact Lenses You can include in medical expenses amounts you pay for contact lenses needed for medical reasons. Irs You can also include the cost of equipment and materials required for using contact lenses, such as saline solution and enzyme cleaner. Irs See Eyeglasses and Eye Surgery , later. Irs Crutches You can include in medical expenses the amount you pay to buy or rent crutches. Irs Dental Treatment You can include in medical expenses the amounts you pay for the prevention and alleviation of dental disease. Irs Preventive treatment includes the services of a dental hygienist or dentist for such procedures as teeth cleaning, the application of sealants, and fluoride treatments to prevent tooth decay. Irs Treatment to alleviate dental disease include services of a dentist for procedures such as X-rays, fillings, braces, extractions, dentures, and other dental ailments. Irs But see Teeth Whitening under What Expenses Are Not Includible, later. Irs Diagnostic Devices You can include in medical expenses the cost of devices used in diagnosing and treating illness and disease. Irs Example. Irs You have diabetes and use a blood sugar test kit to monitor your blood sugar level. Irs You can include the cost of the blood sugar test kit in your medical expenses. Irs 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 dependent care. Irs (See Publication 503, Child and Dependent Care Expenses. Irs ) 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. Irs Drug Addiction You can include in medical expenses amounts you pay for an inpatient's treatment at a therapeutic center for drug addiction. Irs This includes meals and lodging at the center during treatment. Irs Drugs See Medicines , later. Irs Eye Exam You can include in medical expenses the amount you pay for eye examinations. Irs Eyeglasses You can include in medical expenses amounts you pay for eyeglasses and contact lenses needed for medical reasons. Irs See Contact Lenses , earlier, for more information. Irs Eye Surgery You can include in medical expenses the amount you pay for eye surgery to treat defective vision, such as laser eye surgery or radial keratotomy. Irs Fertility Enhancement You can include in medical expenses the cost of the following procedures to overcome an inability to have children. Irs Procedures such as in vitro fertilization (including temporary storage of eggs or sperm). Irs Surgery, including an operation to reverse prior surgery that prevented the person operated on from having children. Irs Founder's Fee See Lifetime Care—Advance Payments , later. Irs Guide Dog or Other Service Animal You can include in medical expenses the costs of buying, training, and maintaining a guide dog or other service animal to assist a visually impaired or hearing disabled person, or a person with other physical disabilities. Irs In general, this includes any costs, such as food, grooming, and veterinary care, incurred in maintaining the health and vitality of the service animal so that it may perform its duties. Irs Health Institute You can include in medical expenses fees you pay for treatment at a health institute only if the treatment is prescribed by a physician and the physician issues a statement that the treatment is necessary to alleviate a physical or mental defect or illness of the individual receiving the treatment. Irs Health Maintenance Organization (HMO) You can include in medical expenses amounts you pay to entitle you, your spouse, or a dependent to receive medical care from an HMO. Irs These amounts are treated as medical insurance premiums. Irs See Insurance Premiums , later. Irs Hearing Aids You can include in medical expenses the cost of a hearing aid and batteries, repairs, and maintenance needed to operate it. Irs Home Care See Nursing Services , later. Irs Home Improvements See Capital Expenses , earlier. Irs Hospital Services You can include in medical expenses amounts you pay for the cost of inpatient care at a hospital or similar institution if a principal reason for being there is to receive medical care. Irs This includes amounts paid for meals and lodging. Irs Also see Lodging , later. Irs Insurance Premiums You can include in medical expenses insurance premiums you pay for policies that cover medical care. Irs Medical care policies can provide payment for treatment that includes: Hospitalization, surgical services, X-rays, Prescription drugs and insulin, Dental care, Replacement of lost or damaged contact lenses, and Long-term care (subject to additional limitations). Irs See Qualified Long-Term Care Insurance Contracts under Long-Term Care, later. Irs 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. Irs The cost of the medical part must be separately stated in the insurance contract or given to you in a separate statement. Irs Health coverage tax credit. Irs   If, during 2013, you were an eligible trade adjustment assistance (TAA) recipient, alternative TAA (ATAA) recipient, reemployment TAA (RTAA) recipient, or Pension Benefit Guaranty Corporation (PBGC) pension recipient, you must complete Form 8885 before completing Schedule A. Irs When figuring the amount of insurance premiums you can deduct on Schedule A, do not include: Any amounts you included on Form 8885, Any qualified health insurance premiums you paid to “U. Irs S. Irs Treasury–HCTC,” or Any health coverage tax credit advance payments shown on Form 1099-H, Health Coverage Tax Credit (HCTC) Advance Payments. Irs 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 on your Form W-2, Wage and Tax Statement. Irs Also, do not include any other medical and dental expenses paid by the plan unless the amount paid is included on your Form W-2. Irs Example. Irs You are a federal employee participating in the premium conversion plan of the Federal Employee Health Benefits (FEHB) program. Irs Your share of the FEHB premium is paid by making a pre-tax reduction in your salary. Irs 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. Irs Long-term care services. Irs   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. Irs This amount will be reported as wages on your Form W-2. Irs Retired public safety officers. Irs   If you are a retired public safety officer, do not include as medical expenses any health or long-term care insurance premiums that you elected to have paid with tax-free distributions from a retirement plan. Irs This applies only to distributions that would otherwise be included in income. Irs Health reimbursement arrangement (HRA). Irs   If you have medical expenses that are reimbursed by a health reimbursement arrangement, you cannot include those expenses in your medical expenses. Irs This is because an HRA is funded solely by the employer. Irs 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. Irs The payroll tax paid for Medicare A is not a medical expense. Irs 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. Irs In this situation you can include the premiums you paid for Medicare A as a medical expense. Irs Medicare B Medicare B is a supplemental medical insurance. Irs Premiums you pay for Medicare B are a medical expense. Irs Check the information you received from the Social Security Administration to find out your premium. Irs Medicare D Medicare D is a voluntary prescription drug insurance program for persons with Medicare A or B. Irs You can include as a medical expense premiums you pay for Medicare D. Irs 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: Payable in equal yearly installments or more often, and Payable for at least 10 years, or until you reach age 65 (but not for less than 5 years). Irs 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. Irs 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. Irs You can include this cost of continuing participation in the health plan as a medical expense. Irs 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. Irs You cannot include this cost of continuing participation in that health plan as a medical expense. Irs 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. Irs , 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 that provides medical insurance coverage for all persons injured in or by your car because the part of the premium providing insurance for you, your spouse, and your dependents is not stated separately from the part of the premium providing insurance 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. Irs Taxes imposed by any governmental unit, such as Medicare taxes, are not insurance premiums. Irs Coverage for nondependents. Irs   Generally, you cannot deduct any additional premium you pay as the result of including on your policy someone who is not your spouse or dependent, even if that person is your child under age 27. Irs However, you can deduct the additional premium if that person is: Your child whom you do not claim as a dependent because of the rules for children of divorced or separated parents, Any person you could have claimed as a dependent on your return except that person received $3,900 or more of gross income or filed a joint return, or Any person you could have claimed as a dependent except that you, or your spouse if filing jointly, can be claimed as a dependent on someone else's 2013 return. Irs  Also, if you had family coverage when you added this individual to your policy and your premiums did not increase, you can enter on Schedule A (Form 1040) the full amount of your medical and dental insurance premiums. Irs Intellectually and Developmentally Disabled, Special Home for You can include in medical expenses the cost of keeping a person who is intellectually and developmentally disabled 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. Irs Laboratory Fees You can include in medical expenses the amounts you pay for laboratory fees that are part of medical care. Irs Lactation Expenses See Breast Pumps and Supplies , earlier. Irs 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 had lead poisoning from eating the paint. Irs These surfaces must be in poor repair (peeling or cracking) or within the child's reach. Irs The cost of repainting the scraped area is not a medical expense. Irs If, instead of removing the paint, you cover the area with wallboard or paneling, treat these items as capital expenses. Irs See Capital Expenses , earlier. Irs Do not include the cost of painting the wallboard as a medical expense. Irs Learning Disability See Special Education , later. Irs Legal Fees You can include in medical expenses legal fees you paid that are necessary to authorize treatment for mental illness. Irs 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. Irs 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. Irs The part of the payment you include is the amount properly allocable to medical care. Irs 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. Irs You can use a statement from the retirement home to prove the amount properly allocable to medical care. Irs The statement must be based either on the home's prior experience or on information from a comparable home. Irs Dependents with disabilities. Irs   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. Irs The payments must be a condition for the institution's future acceptance of your child and must not be refundable. Irs Payments for future medical care. Irs   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. Irs This rule does not apply in situations where the future care is purchased in connection with obtaining lifetime care of the type described earlier. Irs 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. Irs See Nursing Home , later. Irs You may be able to include in medical expenses the cost of lodging not provided in a hospital or similar institution. Irs You can include the cost of such lodging while away from home if all of the following requirements are met. Irs The lodging is primarily for and essential to medical care. Irs 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. Irs The lodging is not lavish or extravagant under the circumstances. Irs There is no significant element of personal pleasure, recreation, or vacation in the travel away from home. Irs The amount you include in medical expenses for lodging cannot be more than $50 for each night for each person. Irs You can include lodging for a person traveling with the person receiving the medical care. Irs 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. Irs Meals are not included. Irs 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. Irs 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. Irs Qualified Long-Term Care Services 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: Required by a chronically ill individual, and Provided pursuant to a plan of care prescribed by a licensed health care practitioner. Irs Chronically ill individual. Irs   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. Irs 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. Irs Activities of daily living are eating, toileting, transferring, bathing, dressing, and continence. Irs He or she requires substantial supervision to be protected from threats to health and safety due to severe cognitive impairment. Irs Maintenance and personal care services. Irs    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). Irs Qualified Long-Term Care Insurance Contracts A qualified long-term care insurance contract is an insurance contract that provides only coverage of qualified long-term care services. Irs The contract must: Be guaranteed renewable, Not provide for a cash surrender value or other money that can be paid, assigned, pledged, or borrowed, 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 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. Irs The amount of qualified long-term care premiums you can include is limited. Irs You can include the following as medical expenses on Schedule A (Form 1040). Irs Qualified long-term care premiums up to the following amounts. Irs Age 40 or under – $360. Irs Age 41 to 50 – $680. Irs Age 51 to 60 – $1,360. Irs Age 61 to 70 – $3,640. Irs Age 71 or over – $4,550. Irs Unreimbursed expenses for qualified long-term care services. Irs Note. Irs The limit on premiums is for each person. Irs Also, if you are an eligible retired public safety officer, 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 your income. Irs Meals 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. Irs You cannot include in medical expenses the cost of meals that are not part of inpatient care. Irs Also see Weight-Loss Program and Nutritional Supplements , later. Irs 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. Irs The costs of the medical conference must be primarily for and necessary to the medical care of you, your spouse, or your dependent. Irs The majority of the time spent at the conference must be spent attending sessions on medical information. Irs The cost of meals and lodging while attending the conference is not deductible as a medical expense. Irs 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. Irs Medicines You can include in medical expenses amounts you pay for prescribed medicines and drugs. Irs A prescribed drug is one that requires a prescription by a doctor for its use by an individual. Irs You can also include amounts you pay for insulin. Irs Except for insulin, you cannot include in medical expenses amounts you pay for a drug that is not prescribed. Irs Imported medicines and drugs. Irs   If you imported medicines or drugs from other countries, see Medicines and Drugs From Other Countries , under What Expenses Are Not Includible, later. Irs Nursing Home 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. Irs This includes the cost of meals and lodging in the home if a principal reason for being there is to get medical care. Irs Do not include the cost of meals and lodging if the reason for being in the home is personal. Irs You can, however, include in medical expenses the part of the cost that is for medical or nursing care. Irs Nursing Services You can include in medical expenses wages and other amounts you pay for nursing services. Irs The services need not be performed by a nurse as long as the services are of a kind generally performed by a nurse. Irs 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. Irs These services can be provided in your home or another care facility. Irs Generally, only the amount spent for nursing services is a medical expense. Irs 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. Irs For example, because of your medical condition you pay a visiting nurse $300 per week for medical and household services. Irs She spends 10% of her time doing household services such as washing dishes and laundry. Irs You can include only $270 per week as medical expenses. Irs The $30 (10% × $300) allocated to household services cannot be included. Irs However, certain maintenance or personal care services provided for qualified long-term care can be included in medical expenses. Irs See Maintenance and personal care services under Long-Term Care, earlier. Irs 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. Irs See Publication 503. Irs You can also include in medical expenses part of the amount you pay for that attendant's meals. Irs Divide the food expense among the household members to find the cost of the attendant's food. Irs Then divide that cost in the same manner as in the preceding paragraph. Irs If you had to pay additional amounts for household upkeep because of the attendant, you can include the extra amounts with your medical expenses. Irs This includes extra rent or utilities you pay because you moved to a larger apartment to provide space for the attendant. Irs Employment taxes. Irs   You can include as a medical expense social security tax, FUTA, Medicare tax, and state employment taxes you pay for an attendant who provides medical care. Irs 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. Irs For information on employment tax responsibilities of household employers, see Publication 926, Household Employer's Tax Guide. Irs Operations You can include in medical expenses amounts you pay for legal operations that are not for unnecessary cosmetic surgery. Irs See Cosmetic Surgery under What Expenses Are Not Includible, later. Irs Optometrist See Eyeglasses , earlier. Irs Organ Donors See Transplants , later. Irs Osteopath You can include in medical expenses amounts you pay to an osteopath for medical care. Irs Oxygen You can include in medical expenses amounts you pay for oxygen and oxygen equipment to relieve breathing problems caused by a medical condition. Irs Physical Examination You can include in medical expenses the amount you pay for an annual physical examination and diagnostic tests by a physician. Irs You do not have to be ill at the time of the examination. Irs Pregnancy Test Kit You can include in medical expenses the amount you pay to purchase a pregnancy test kit to determine if you are pregnant. Irs Prosthesis See Artificial Limb and Breast Reconstruction Surgery , earlier. Irs Psychiatric Care You can include in medical expenses amounts you pay for psychiatric care. Irs This includes the cost of supporting a mentally ill dependent at a specially equipped medical center where the dependent receives medical care. Irs See Psychoanalysis, next, and Transportation , later. Irs Psychoanalysis You can include in medical expenses payments for psychoanalysis. Irs However, you cannot include payments for psychoanalysis that is part of required training to be a psychoanalyst. Irs Psychologist You can include in medical expenses amounts you pay to a psychologist for medical care. Irs 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. Irs 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. Irs A doctor must recommend that the child attend the school. Irs 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. Irs Special education includes: Teaching Braille to a visually impaired person, Teaching lip reading to a hearing disabled person, or Giving remedial language training to correct a condition caused by a birth defect. Irs 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). Irs Also see Vasectomy , later. Irs Stop-Smoking Programs You can include in medical expenses amounts you pay for a program to stop smoking. Irs 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. Irs Surgery See Operations , earlier. Irs Telephone You can include in medical expenses 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. Irs This includes teletypewriter (TTY) and telecommunications device for the deaf (TDD) equipment. Irs You can also include the cost of repairing the equipment. Irs Television You can include in medical expenses the cost of equipment that displays the audio part of television programs as subtitles for persons with a hearing disability. Irs This may be the cost of an adapter that attaches to a regular set. Irs 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. Irs Therapy You can include in medical expenses amounts you pay for therapy received as medical treatment. Irs Transplants You can include in medical expenses amounts paid for medical care you receive because you are a donor or a possible donor of a kidney or other organ. Irs This includes transportation. Irs You can include any expenses you pay for the medical care of a donor in connection with the donating of an organ. Irs This includes transportation. Irs Transportation You can include in medical expenses amounts paid for transportation primarily for, and essential to, medical care. Irs You can include:    Bus, taxi, train, or plane fares or ambulance service, Transportation expenses of a parent who must go with a child who needs medical care, Transportation expenses of a nurse or other person who can give injections, medications, or other treatment required by a patient who is traveling to get medical care and is unable to travel alone, and Transportation expenses for regular visits to see a mentally ill dependent, if these visits are recommended as a part of treatment. Irs Car expenses. Irs   You can include out-of-pocket expenses, such as the cost of gas and oil, when you use a car for medical reasons. Irs You cannot include depreciation, insurance, general repair, or maintenance expenses. Irs   If you do not want to use your actual expenses for 2013, you can use the standard medical mileage rate of 24 cents a mile. Irs    You can also include parking fees and tolls. Irs You can add these fees and tolls to your medical expenses whether you use actual expenses or the standard mileage rate. Irs Example. Irs In 2013, Bill Jones drove 2,800 miles for medical reasons. Irs He spent $500 for gas, $30 for oil, and $100 for tolls and parking. Irs He wants to figure the amount he can include in medical expenses both ways to see which gives him the greater deduction. Irs He figures the actual expenses first. Irs He adds the $500 for gas, the $30 for oil, and the $100 for tolls and parking for a total of $630. Irs He then figures the standard mileage amount. Irs He multiplies 2,800 miles by 24 cents a mile for a total of $672. Irs He then adds the $100 tolls and parking for a total of $772. Irs 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. Irs Transportation expenses you cannot include. Irs    You cannot include in medical expenses the cost of transportation in the following situations. Irs Going to and from work, even if your condition requires an unusual means of transportation. Irs Travel for purely personal reasons to another city for an operation or other medical care. Irs Travel that is merely for the general improvement of one's health. Irs The costs of operating a specially equipped car for other than medical reasons. Irs Trips You can include in medical expenses amounts you pay for transportation to another city if the trip is primarily for, and essential to, receiving medical services. Irs You may be able to include up to $50 for each night for each person. Irs You can include lodging for a person traveling with the person receiving the medical care. Irs 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. Irs Meals are not included. Irs See Lodging , earlier. Irs You cannot include in medical expenses a trip or vacation taken merely for a change in environment, improvement of morale, or general improvement of health, even if the trip is made on the advice of a doctor. Irs However, see Medical Conferences , earlier. Irs Tuition Under special circumstances, you can include charges for tuition in medical expenses. Irs See Special Education , earlier. Irs You can include charges for a health plan included in a lump-sum tuition fee if the charges are separately stated or can easily be obtained from the school. Irs Vasectomy You can include in medical expenses the amount you pay for a vasectomy. Irs Vision Correction Surgery See Eye Surgery , earlier. Irs Weight-Loss Program You can include in medical expenses amounts you pay to lose weight if it is a treatment for a specific disease diagnosed by a physician (such as obesity, hypertension, or heart disease). Irs This includes fees you pay for membership in a weight reduction group as well as fees for attendance at periodic meetings. Irs You cannot include membership dues in a gym, health club, or spa as medical expenses, but you can include separate fees charged there for weight loss activities. Irs You cannot include the cost of diet food or beverages in medical expenses because the diet food and beverages substitute for what is normally consumed to satisfy nutritional needs. Irs You can include the cost of special food in medical expenses only if: The food does not satisfy normal nutritional needs, The food alleviates or treats an illness, and The need for the food is substantiated by a physician. Irs The amount you can include in medical expenses is limited to the amount by which the cost of the special food exceeds the cost of a normal diet. Irs See also Weight-Loss Program under What Expenses Are Not Includible, later. Irs Wheelchair You can include in medical expenses amounts you pay for a wheelchair used mainly for the relief of sickness or disability, and not just to provide transportation to and from work. Irs The cost of operating and maintaining the wheelchair is also a medical expense. Irs Wig You 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 of his or her hair from disease. Irs X-ray You can include in medical expenses amounts you pay for X-rays for medical reasons. Irs What Expenses Are Not Includible? Following is a list of some items that you cannot include in figuring your medical expense deduction. Irs The items are listed in alphabetical order. Irs Baby Sitting, Childcare, and Nursing Services for a Normal, Healthy Baby You cannot include in medical expenses amounts you pay for the care of children, even if the expenses enable you, your spouse, or your dependent to get medical or dental treatment. Irs Also, any expense allowed as a childcare credit cannot be treated as an expense paid for medical care. Irs Controlled Substances You cannot include in medical expenses amounts you pay for controlled substances (such as marijuana, laetrile, etc. Irs ), even if such substances are legalized by state law. Irs Such substances are not legal under federal law and cannot be included in medical expenses. Irs Cosmetic Surgery Generally, you cannot include in medical expenses the amount you pay for unnecessary cosmetic surgery. Irs This includes any procedure that 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. Irs You generally cannot include in medical expenses the amount you pay for procedures such as face lifts, hair transplants, hair removal (electrolysis), and liposuction. Irs You can include in medical expenses the amount you pay for cosmetic surgery if it is necessary to improve a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease. Irs Example. Irs An individual undergoes surgery that removes a breast as part of treatment for cancer. Irs She pays a surgeon to reconstruct the breast. Irs The surgery to reconstruct the breast corrects a deformity directly related to the disease. Irs The cost of the surgery is includible in her medical expenses. Irs Dancing Lessons You cannot include in medical expenses the cost of dancing lessons, swimming lessons, etc. Irs , even if they are recommended by a doctor, if they are only for the improvement of general health. Irs Diaper Service You cannot include in medical expenses the amount you pay for diapers or diaper services, unless they are needed to relieve the effects of a particular disease. Irs Electrolysis or Hair Removal See Cosmetic Surgery , earlier. Irs Flexible Spending Account You cannot include in medical expenses amounts for which you are fully reimbursed by your flexible spending account if you contribute a part of your income on a pre-tax basis to pay for the qualified benefit. Irs Funeral Expenses You cannot include in medical expenses amounts you pay for funerals. Irs Future Medical Care 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. Irs This rule does not apply in situations where the future care is purchased in connection with obtaining lifetime care or long-term care of the type described at Lifetime Care—Advance Payments or Long-Term Care, earlier under What Medical Expenses Are Includible. Irs Hair Transplant See Cosmetic Surgery , earlier. Irs Health Club Dues You cannot include in medical expenses health club dues or amounts paid to improve one's general health or to relieve physical or mental discomfort not related to a particular medical condition. Irs You cannot include in medical expenses the cost of membership in any club organized for business, pleasure, recreation, or other social purpose. Irs Health Coverage Tax Credit You cannot include in medical expenses amounts you pay for health insurance that you use in figuring your health coverage tax credit. Irs For more information, see Health Coverage Tax Credit , later. Irs Health Savings Accounts You cannot include in medical expenses any payment or distribution for medical expenses out of a health savings account. Irs Contributions to health savings accounts are deducted separately. Irs See Publication 969. Irs Household Help You cannot include in medical expenses the cost of household help, even if such help is recommended by a doctor. Irs This is a personal expense that is not deductible. Irs However, you may be able to include certain expenses paid to a person providing nursing-type services. Irs For more information, see Nursing Services , earlier under What Medical Expenses Are Includible. Irs Also, certain maintenance or personal care services provided for qualified long-term care can be included in medical expenses. Irs For more information, see Long-Term Care , earlier under What Medical Expenses Are Includible. Irs Illegal Operations and Treatments You cannot include in medical expenses amounts you pay for illegal operations, treatments, or controlled substances whether rendered or prescribed by licensed or unlicensed practitioners. Irs Insurance Premiums See Insurance Premiums under What Medical Expenses Are Includible, earlier. Irs Maternity Clothes You cannot include in medical expenses amounts you pay for maternity clothes. Irs Medical Savings Account (MSA) You cannot include in medical expenses amounts you contribute to an Archer MSA. Irs You cannot include expenses you pay for with a tax-free distribution from your Archer MSA. Irs You also cannot use other funds equal to the amount of the distribution and include the expenses. Irs For more information on Archer MSAs, see Publication 969. Irs Medicines and Drugs From Other Countries In general, you cannot include in your medical expenses the cost of a prescribed drug brought in (or ordered shipped) from another country. Irs You can only include the cost of a drug that was imported legally. Irs For example, you can include the cost of a prescribed drug the Food and Drug Administration announces can be legally imported by individuals. Irs You can include the cost of a prescribed drug you purchase and consume in another country if the drug is legal in both the other country and the United States. Irs Nonprescription Drugs and Medicines Except for insulin, you cannot include in medical expenses amounts you pay for a drug that is not prescribed. Irs Example. Irs Your doctor recommends that you take aspirin. Irs Because aspirin is a drug that does not require a physician's prescription, you cannot include its cost in your medical expenses. Irs Nutritional Supplements You cannot include in medical expenses the cost of nutritional supplements, vitamins, herbal supplements, “natural medicines,” etc. Irs unless they are recommended by a medical practitioner as treatment for a specific medical condition diagnosed by a physician. Irs Otherwise, these items are taken to maintain your ordinary good health, and are not for medical care. Irs Personal Use Items You cannot include in medical expenses the cost of an item ordinarily used for personal, living, or family purposes unless it is used primarily to prevent or alleviate a physical or mental defect or illness. Irs For example, the cost of a toothbrush and toothpaste is a nondeductible personal expense. Irs In order to accommodate an individual with a physical defect, you may have to purchase an item ordinarily used as a personal, living, or family item in a special form. Irs You can include the excess of the cost of the item in a special form over the cost of the item in normal form as a medical expense. Irs (See Braille Books and Magazines under What Medical Expenses Are Includible, earlier. Irs ) Swimming Lessons See Dancing Lessons , earlier. Irs Teeth Whitening You cannot include in medical expenses amounts paid to whiten teeth. Irs See Cosmetic Surgery , earlier. Irs Veterinary Fees You generally cannot include veterinary fees in your medical expenses, but see Guide Dog or Other Service Animal under What Medical Expenses Are Includible, earlier. Irs Weight-Loss Program You cannot include in medical expenses the cost of a weight-loss program if the purpose of the weight loss is the improvement of appearance, general health, or sense of well-being. Irs You cannot include amounts you pay to lose weight unless the weight loss is a treatment for a specific disease diagnosed by a physician (such as obesity, hypertension, or heart disease). Irs If the weight-loss treatment is not for a specific disease diagnosed by a physician, you cannot include either the fees you pay for membership in a weight reduction group or fees for attendance at periodic meetings. Irs Also, you cannot include membership dues in a gym, health club, or spa. Irs You cannot include the cost of diet food or beverages in medical expenses because the diet food and beverages substitute for what is normally consumed to satisfy nutritional needs. Irs See Weight-Loss Program under What Medical Expenses Are Includible, earlier. Irs How Do You Treat Reimbursements? You can include in medical expenses only those amounts paid during the tax year for which you received no insurance or other reimbursement. Irs Insurance Reimbursement You must reduce your total medical expenses for the year by all reimbursements for medical expenses that you receive from insurance or other sources during the year. Irs This includes payments from Medicare. Irs Even if a policy provides reimbursement only for certain specific medical expenses, you must use amounts you receive from that policy to reduce your total medical expenses, including those it does not reimburse. Irs Example. Irs You have insurance policies that cover your hospital and doctors' bills but not your nursing bills. Irs The insurance you receive for the hospital and doctors' bills is more than their charges. Irs In figuring your medical deduction, you must reduce the total amount you spent for medical care by the total amount of insurance you received, even if the policies do not cover some of your medical expenses. Irs Health reimbursement arrange