Deductibility of Medical Expenses

Expenses incurred for medical care are deductible to extent they exceed 7.5% of the taxpayer’s adjusted gross income, as provided by Code Sec. 213.  Accordingly, a taxpayer with $75,000 of adjusted gross income would be allowed no deduction for medical expenses until those expenses exceeded $5,625.  Only unreimbursed amounts actually paid for medical care constitute deductible medical expenses.

Medical care relates to (1) the diagnosis, treatment or prevention of disease, (2) a capital expenditure whose primary purpose is medical care, (3) transportation expenses “primarily for and essential to the rendition of medical care,” or (4) in-patient hospital care.

For purposes of Code Sec. 213, cosmetic surgery is not “medical care,” and amounts spent therefor will not qualify for a deduction, unless that surgical procedure also “meaningfully promote[s] the proper function of the body or prevent[s] or treat[s] illness or disease.”  Deductibility of medicine is also circumscribed: To constitute a deductible medical expense, medicine must “require” a prescription.

Consider the following example:  In January, the taxpayer, in back pain, purchases aspirin and buys a heating pad.  Still in discomfort, the taxpayer consults an orthopedist, who advises the taxpayer to continue taking aspirin; he also prescribes other medicine and suggests that the taxpayer acquire a whirlpool in his home to treat his condition.  In February, the taxpayer vacations in the Caribbean.  All of the measures help, and by June the taxpayer feels much better.  None of the expenses is reimbursed by the taxpayer’s insurance.  (Note that even if otherwise deductible, no deduction will be allowed for any reimbursed medical expense.)

Since the physician’s fee and the cost of prescribed medicine constitute “medical care” and are not reimbursed to the taxpayer, they may be deducted by the taxpayer, subject to the 7.5% floor.  Since the aspirin, though prescribed by the physician does not “require” a prescription, it would appear by negative implication not to constitute a deductible medical expense under Code Sec. 213(d)(3).  However, the heating pad, even though not procured upon the advice of the physician, would nonetheless appear to qualify as a valid medical expense, since the heating pad is for the mitigation of pain, serves no purpose other than a therapeutic one, and neither the Code nor Regulations predicate the deductibility of all medical expenses on a physician’s or other expert’s recommendation.

The whirlpool that the taxpayer was advised to install in his home required an outlay of $2,000, and increased the value of the taxpayer’s home by $1,500.  According to Treasury Reg. 1.213-1, while the whirlpool “would not ordinarily be for the purpose of medical care,” since it is “related directly to medical care” it could qualify as a medical expense to the extent that the expenditure exceeds the increase in the value of the property, or $500.  Finally, although travel to a warmer climate helps the taxpayer’s condition, since it was not prescribed by the physician, and since it promotes only the taxpayer’s “general” health, it cannot constitute a deductible medical expense.

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