2019 Medical Deductions - Sched A Itemized Deductions

Schedule A Medical Deductions Checklist

Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatements affecting any part or function of the body.  They include the costs of equipment, supplies, and diagnostic devices needed for these purposes.  They must be primarily to alleviate or prevent a physical or mental defect or illness.

The following items are deductible medical expenses unless stated otherwise:

  • Abortion, medical expenses for a legal abortion
  • Acupuncture
  • Air conditioning device installed (but moveable) in room for relief from allergies or other respiratory ailments (Rev Rul 55-261)
  • Alcoholism.  Treatment costs at a therapeutic center for alcohol addiction, including meals and lodging at the center during treatment.   Also includes transportation to and from AA meetings, if attending meetings on medical advice (Rev Rul 73-325)
  • Ambulance service
  • Artificial limbs and artificial teeth
  • Attendant for blind or deaf student
  • Bandages.  The cost of medical supplies such as bandages, even without a prescription
  • Birth control pills and other contraceptives prescribed by a doctor (Rev Rul 73-200)
  • Body scan.  Electronic body scan (Rev Rul 2007-72)
  • Braces
  • Braille books/magazines for use by a visually impaired person.   Deduct the cost that is more than the regular printed editions.
  • Breast pumps.   Breast pump purchase or rental and related supplies that assist lactation (Announcement 2011-14)
  • Breast reconstruction after a mastectomy to treat cancer (Rev Rul 2003-57)
  • Camp.   Tuition for YMCA day camp program designed for children with disabilities (Emanual, TC Summary Opinion 2002-127)
  • Capital Expenses.   Special equipment installed in the home, or improvements that provide a medical benefit
  • Cars.   Cost of hand controls or the extra cost of a car or van specially designed to hold a wheelchair
  • Childbirth preparation classes
  • Chiropractor
  • Contact lenses, including equipment and materials for using contacts, such as saline solution and enzyme cleaner
  • Cosmetic surgery if necessary to improve a deformity related to a congenital abnormality, accident or disease, including obesity (Letter Rel 200344010).  Nondeductible:  Face lifts, hair transplants, hair removal, liposuction and other unnecessary cosmetic surgery.
  • Crutches
  • Dancing lessons.  Nondeductible, even if recommended by a doctor
  • Dental treatment, including cost of braces, dentures, etc (but not teeth whitening)
  • Detachable home installations such as air conditioners, heaters, humidifiers and air cleaners used for the benefit of a sick person
  • Diagnostic devices.  Cost of devices used in diagnosing and treating illness and disease, such as a blood sugar test kit for a diabetic, even without a prescription
  • Diaper service.  Nondeductible, unless needed to relieve the effects of a particular disease
  • Diet, special.  Tax Court has allowed the extra cost of special food over the cost of a normal diet when prescribed by a doctor to alleviate a specific medical condition.  Nondeductible:  Special food that merely replaces food normally consumed (Massa, 85 AFTR 2d 2000-1072 10th Cir 2000)
  • Doctor of physician.  Legal medical services provided by medical doctors, surgeons, osteopathic doctors, dentists, eye doctors, chiropractors, podiatrists, psychiatrists, psychologists, physical therapists, acupuncturists, psychoanalysts (medical care only) and authorized Christian Science practitioners
  • Drug addiction.  Inpatient treatment, meals and lodging at therapeutic center for drug addiction.
  • Dyslexia language training
  • Exercise program if doctor recommended as treatment for a specific condition.  Nondeductible:  Program to improve general health, even if doctor recommended
  • Eyeglasses.  If needed for medical reasons.  Also includes eye exam fees
  • Eye surgery for nearsightedness (LASIK and radial keratotomy) Rev Rul 2003-57
  • Fertility enhancement.  In vitro fertilization or surgery, including surgery that reverses prior surgery.  Expenses to obtain an egg donor including agency fees, donor fees, the donor's medical and psychological testing fees, insurance paid for post-procedure donor assistance and the legal fees for preparation of the contract with the donor (Ltr Rul 200318017)  Nondeductible:   Taxpayer had no medical condition or defect, such as infertility, that required such treatment (Magdalin TC Memo 2008-293)
  • Flexible spending account.  Do not include in medical expenses, amounts for which the taxpayer is reimbursed by a flexible spending account if the contribution is on a pre-tax basis.
  • Funeral expenses.   Nondeductible -- Deductible on decedent's Federal Estate Tax Return (Form 706)
  • Guide dog or other animal to be used by visually impaired, hearing-impaired or other physically disabled persons
  • Health club dues.  Nondeductible, unless related to a specific medical condition
  • Health Institute.  Fees paid 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.
  • Health Maintenance Organization (HMO).  These amounts are treated the same as medical insurance premiums
  • Hearing aids including repairs and batteries
  • Hospital care.  Inpatient care, including meals and lodging, if the main reason for being there is to receive medical care
  • Household help for nursing care of qualified long-term care services only.   Nondeductible:  Personal and household services
  • Insurance premiums for medical and dental care coverage, and replacement of lost of damaged contact lenses.  Don't claim on Schedule A any amount reported as a self-employed health insurance deduction on line 29 or Form 1040, or any premiums paid to an employer-sponsored health plan with pre-tax dollars.  Also see Medical premiums and Qualified long-term care insurance premiums     Nondeductible:  Medical portion of auto insurance, insurance premiums for life insurance, loss of earnings, loss of life, limb or sight or guaranteed payments for days in the hospital
  • Laboratory fees
  • Laetrile anti-cancer treatment (legal)
  • Laser eye surgery
  • Lead paint removal if done for a child who has, or has had, lead poisoning from eating the paint (Rev Rul 79-66)
  • Legal fees paid to authorize treatment for mental illness.  Nondeductible:  Legal fees for guardianship estate management
  • Liftime care advance payments.  If part of the advance fee is allocated to medical care, the percentage must be specified by the retirement home in the agreement
  • Lodging expenses not provided in a hospital or similar institution while away from home to receive medical care in a hospital or medical facility related to a hospital, not to exceed $50 per night for each person.  If a person is unable to travel alone, lodging of a person to accompany the ill person is also deductible.  Nondeductible:  Meals
  • Long-term care insurance/expenses.  Subject to limitations (ask me)
  • Marijuana.   Nondeductible, even if legal under state law when prescribed by a physician in the state where the taxpayer lives.   Possession of marijuana is a violation of the Federal Controlled Substances Act and is not consider legally procured under Regulation Section 1.213-1(e)(2) -- Rev Rul 97-9
  • Maternity clothes.  Nondeductible
  • Mattresses and boards bought specifically to alleviate an arthritic condition (Rev Rul 55-261)
  • Meals.   Meals that are not part of inpatient care are nondeductible
  • Medical aids.  Wheelchairs, hearing aids and batteries, eye-glasses, contact lenses, crutches, braces, diagnostic devices and guide dogs (including costs paid for their care)
  • Medical conferences. Admission and transportation to a medical conference if the conference concerns the chronic illness of the taxpayer, spouse, or dependent.  The costs of the medical conference must be primarily for, and necessary to the medical care.  The majority of the time spent at the conference must be spent attending sessions on medical information.  Meals and lodging while attending the conference are not deductible
  • Medical Information Plan.  Amounts paid to a plan that keeps medical information in a computer data bank and retrieves and furnishes the information to a physician upon request.
  • Medicare premiums.  Medicare Parts B (supplemental insurance) and D (Prescription drug) are deductible; Part A only if not covered under Social Security, so voluntarily enrolled
  • Medicine and drugs, including insulin, when prescribed by a doctor.   Nondeductible:  Over-the-counter medicine (other than insulin) and prescribed drugs brought in (or ordered and shipped) from another country, including Canada (since the Food and Drug Administation has announced it is illegal for individuals to import drugs from another country) (INFO 2005-0011)
  • Medical equipment and supplies sold 'over-the-counter' (without a prescription).  This includes needles, crutches, bandages or diagnostic devices such as blood sugar kits.  (INFO 2005-0008; Rev Rul 2003-58)
  • Nursing care.  Wages, employment taxes and other amounts (such as attendants' meals) paid for nursing services connected with caring for a patient's condition including extra rent or utilities for a larger apartment required to provide space for nurse/attendant.  Nondeductible:  Personal and household services provided by attendant, or nursing services for a normal, healthy baby.  
  • Nursing home.  Entire costs for medical care, including meals and lodging, if the main reason for being in the home is to obtain medical care.  If not entering the home primarily to obtain medical care, only the portion of the fee actually spent on medical treatment is deductible.  If the care is qualified long-term care, see Long-Term Care Insurance and Expenses.
  • Nutritional supplements and vitamins.  Deductible only if they are recommended by a medical practitioner as treatment for a specific medical condition diagnosed by a physician.  Items taken to maintain ordinary good health are not deductible.
  • Orthopedic shoes (excess cost)
  • Optometrist
  • Osteopath
  • Oxygen/oxygen equipment to relieve medical breathing problems
  • Physical examination, even if not ill at the time of the exam 
  • Prepaid insurance paid before age 65 for coverage after reaching age 65 if (1) paid in equal yearly installments, or more often, and (2) payable for at least 10 years, or until taxpayer reaches age 65 (but not less than five years [IRC 213(d)(7)]
  • Pregnancy test kit 
  • Prosthetic limbs
  • Psychiatric care.  Includes the cost of supporting a mentally ill dependent at a specially equipped medical center where the dependent receives medical care
  • Psychoanalysis.  Payments for psychoanalysis is deductible, however, payments for psychoanalysis that is part of required training to be a psychoanalyst cannot be included.  Expenses for marriage counseling is not deductible (Rev Rul 75-319)
  • Reclining chair bought on a doctor's advice by a person with a cardiac condition, and not generally used as furniture (Rev Rul 58-155)
  • Self-initiated medical diagnostic tests.  Amount paid by individuals for self-initiated diagnostic tests and similar procedures are deductible as medical expenses, even if no symptoms of illness exist and no physician's recommendation is obtained (Rev Rul 2007-72)
  • Sex reassignment surgery and related hormone therapy.   Treatment of gender identity disorder disease.  This is a reversal of the previous IRS position
  • Sex Therapy at a hospital upon doctor's advice (Rev Rul 75-187)
  • Smoking cessation programs and prescribed drugs to alleviate nicotine withdrawal are deductible.  Program does not need to be recommended by a physician or for a specific condition (Rev Rul 99-28)  Nondeductible:  Nonprescription nicotine patches and gum
  • Special education.  Tuition for sending a mentally impaired or physically disabled person to a special school that has resources to relieve the disability
  • Meals, lodging and transportation to and from the school are also deductible.  A school need not be a 'special school' for tuition to be deductible, instead, tuition is a deductible medical expense if the principal reason for the child attending the school is to receive medical care in the form of special eduction for a diagnosed medical condition that handicaps the child's ability to learn (Ltr Rul 200521003).  Also tuition to a special school or tutoring fees by a specially trained teacher for a child with severe learning disabilities.   Nondeductible:   Cost of sending a problem child to a special school if medical care is not the principal reason for sending
  • Sterilization, legal
  • Swimming.  Prescribed therapeutic swimming costs including cost of maintaining a swimming pool at taxpayer's residence (Emanual, TC Summary Opinion 2002-127)   Nondeductible:   Swimming lessons, even if recommended by a doctor
  • Teeth whitening.   Nondeductible, even when performed by a dentist (Rev Rul 2003-57)
  • Telephone.  Cost/repair of special telephone equipment for hearing-impaired person
  • Television.   Cost of equipment to display the audio part of a television program for hearing-impaired persons, or cost of specially equipped television that exceeds the cost of the same model regular television.
  • Therapy, received as medical treatment
  • Transplants.  Surgical, hospital, laboratory and transportation expenses for a transplant donor or possible donor (even if found to be unacceptable)
  • Transportation costs to obtain medical care such as ambulance service, bus, taxi, train, plane fares, parking fees, tolls and use of personal vehicle at 18 cents per mile for 2018 OR actual cost of gas and oil.   Nondeductible:  Extra commuting expenses to take a  disabled person to work who cannot drive himself.  The transportation was not for the treatment of a medical condition (Alderman, TC Summary Opinion 2004-74)
  • Travel by parents to visit their child in a special school for children with drug problems.  Parents required to participate in family therapy sessions (Urbauer, TC Memo 1992-170).   Also see Lodging expenses.   Nondeductible:  Meals
  • Vasectomy (legal) and reversal
  • Veterinary fees.   Only if incurred to maintain the health of a guide dog or other service animal so that it may perform its duties assisting a person with physical disabilities
  • Visual alert system for hearing impaired
  • Vitamins and other nutritional supplements.  Nondeductible, unless recommended by a medical practitioner as treatment for a specific physician-diagnosed medical condition
  • Weight loss program (but generally not food) as treatment for a specific disease, including health club costs if necessary to fulfill the individual's exercise needs (INFO 2002-0077).  Obesity is a disease as long as a physician has made a diagnosis of obesity (Rev Rul 2002-19)
  • Wheelchairs and motorized scooters for permanent or temporary disability
  • Wig for the mental health of a patient with hair loss caused by disease
  • X-ray services