(Including the Health Coverage Tax Credit)

For use in preparing 2017 Returns

Publication 502 – Introductory Material

Future Developments

For the latest information about developments related to Pub. 502, such as legislation enacted after it was published, go to IRS.gov/Pub502.

What’s New

Medical and dental expenses. Beginning January 1, 2017, you can deduct only the part of your medical and dental expenses that exceed 10% of your adjusted gross income (AGI). The 7.5% rate available for certain taxpayers has expired, however, at the time this publication went to print, Congress was considering legislation that would extend the 7.5% rate. To see if this legislation was enacted, go to IRS.gov/Pub502.

Standard mileage rate. The standard mileage rate allowed for operating expenses for a car when you use it for medical reasons is 17 cents a mile. See Transportation under What Medical Expenses Are Includible.

Reminders

Photographs of missing children. The Internal Revenue Service is a proud partner with the National Center for Missing and Exploited Children® (NCMEC). Photographs of missing children selected by the Center may appear in this publication on pages that would otherwise be blank. You can help bring these children home by looking at the photographs and calling 1-800-THE-LOST (1-800-843-5678) if you recognize a child.

Introduction

This publication explains the itemized deduction for medical and dental expenses that you claim on Schedule A (Form 1040). It discusses what expenses, and whose expenses, you can and can’t include in figuring the deduction. It explains how to treat reimbursements and how to figure the deduction. It also tells you how to report the deduction on your tax return and what to do if you sell medical property or receive damages for a personal injury.

Medical expenses include dental expenses, and in this publication the term “medical expenses” is often used to refer to medical and dental expenses.

You can deduct on Schedule A (Form 1040) only the part of your medical and dental expenses that is more than 10% of your adjusted gross income (AGI).

The 7.5% adjusted gross income (AGI) threshold for deducting medical and dental expenses has expired, however, at the time this publication went to print, Congress was considering legislation that would permit certain individuals to deduct medical expenses that exceed 7.5% of their AGI. To see if this legislation was enacted, go to IRS.gov/Pub502.

This publication also explains how to treat impairment-related work expenses, health insurance premiums if you are self-employed, and the health coverage tax credit that is available to certain individuals.

Pub. 502 covers many common medical expenses but not every possible medical expense. If you can’t find the expense you are looking for, refer to the definition of medical expenses under What Are Medical Expenses .

See How To Get Tax Help near the end of this publication for information about getting publications and forms.

Comments and suggestions.

We welcome your comments about this publication and your suggestions for future editions.

You can send us comments from IRS.gov/FormComments. Or you can write to:

Internal Revenue Service
Tax Forms and Publications
1111 Constitution Ave. NW, IR-6526
Washington, DC 20224

Although we cannot respond individually to each comment received, we do appreciate your feedback and will consider your comments as we revise our tax products.

Ordering forms and publications.

Visit IRS.gov/FormsPubs to download forms and publications. Otherwise, you can go to IRS.gov/OrderForms to order current and prior-year forms and instructions. Your order should arrive within 10 business days.

Tax questions.

If you have a tax question not answered by this publication, check IRS.gov and How To Get Tax Help near the end of this publication.

Useful Items – You may want to see:

Publication

969Health Savings Accounts and Other Tax-Favored Health Plans

Forms (and Instructions)

1040S. Individual Income Tax Return
Schedule A (Form 1040)Itemized Deductions
8885Health Coverage Tax Credit
8962Premium Tax Credit (PTC)

Publication 502 – Main Content

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. These expenses include payments for legal medical services rendered by physicians, surgeons, dentists, and other medical practitioners. They include the costs of equipment, supplies, and diagnostic devices needed for these purposes.

Medical care expenses must be primarily to alleviate or prevent a physical or mental disability or illness. They don’t include expenses that are merely beneficial to general health, such as vitamins or a vacation.

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. Medical expenses also include amounts paid for qualified long-term care services and limited amounts paid for any qualified long-term care insurance contract.

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. (But see Decedent under Whose Medical Expenses Can You Include, for an exception.) If you pay medical expenses by check, the day you mail or deliver the check generally is the date of payment. 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. 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.

If you didn’t claim a medical or dental expense that would have been deductible in an earlier year, you can file Form 1040X, Amended U.S. Individual Income Tax Return, for the year in which you overlooked the expense. Don’t claim the expense on this year’s return. 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.

You can’t include medical expenses that were paid by insurance companies or other sources. This is true whether the payments were made directly to you, to the patient, or to the provider of the medical services.

Separate returns.

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. 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.

Community property states.

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. Generally, each of you should include half the expenses. If medical expenses are paid out of the separate funds of one individual, only the individual who paid the medical expenses can include them. If you live in a community property state and aren’t filing a joint return, see Pub. 555.

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.

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. There are different rules for decedents and for individuals who are the subject of multiple support agreements. See Support claimed under a multiple support agreement , later, under Qualifying Relative.

Spouse

You can include medical expenses you paid for your spouse. 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.

Example 1.

Mary received medical treatment before she married Bill. Bill paid for the treatment after they married. Bill can include these expenses in figuring his medical expense deduction even if Bill and Mary file separate returns.

If Mary had paid the expenses, Bill couldn’t include Mary’s expenses in his separate return. Mary would include the amounts she paid during the year in her separate return. If they filed a joint return, the medical expenses both paid during the year would be used to figure their medical expense deduction.

Example 2.

This year, John paid medical expenses for his wife Louise, who died last year. John married Belle this year and they file a joint return. 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.

Dependent

You can include medical expenses you paid for your dependent. 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. A person generally qualifies as your dependent for purposes of the medical expense deduction if both of the following requirements are met.

The person was a qualifying child (defined later) or a qualifying relative (defined later), and
The person was a U.S. citizen or national or a resident of the United States, Canada, or Mexico. If your qualifying child was adopted, see Exception for adopted child , later.

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 $4,050 or more in 2017,
He or she filed a joint return for 2017, or
You, or your spouse if filing jointly, could be claimed as a dependent on someone else’s 2017 return.

Exception for adopted child.

If you are a U.S. citizen or national and your adopted child lived with you as a member of your household for 2017, that child doesn’t have to be a U.S. citizen or national, or a resident of the United States, Canada, or Mexico.

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:
1. Under age 19 at the end of 2017 and younger than you (or your spouse, if filing jointly),
2. Under age 24 at the end of 2017, a full-time student, and younger than you (or your spouse, if filing jointly), or
3. Any age and permanently and totally disabled,
Lived with you for more than half of 2017,
Didn’t provide over half of his or her own support for 2017, and
Didn’t file a joint return, other than to claim a refund.

Adopted child.

A legally adopted child is treated as your own child. This child includes a child lawfully placed with you for legal adoption.

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.

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.

But if you pay the agency or other person for medical care that was provided and paid for before adoption negotiations began, you can’t include them as medical expenses.

You may be able to take a credit for other expenses related to an adoption. See the Instructions for Form 8839, Qualified Adoption Expenses, for more information.

Child of divorced or separated parents.

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. 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:
1. Are divorced or legally separated under a decree of divorce or separate maintenance,
2. Are separated under a written separation agreement, or
3. Live apart at all times during the last 6 months of the year.

This doesn’t apply if the child’s exemption is being claimed under a multiple support agreement (discussed later).

Qualifying Relative

A qualifying relative is a person:

Who is your:
1. Son, daughter, stepchild, or foster child, or a descendant of any of them (for example, your grandchild),
2. Brother, sister, half brother, half sister, or a son or daughter of any of them,
3. Father, mother, or an ancestor or sibling of either of them (for example, your grandmother, grandfather, aunt, or uncle),
4. Stepbrother, stepsister, stepfather, stepmother, son-in-law, daughter-in-law, father-in-law, mother-in-law, brother-in-law, or sister-in-law, or
5. Any other person (other than your spouse) who lived with you all year as a member of your household if your relationship didn’t violate local law,
Who wasn’t a qualifying child (see Qualifying Child,earlier) of any taxpayer for 2017, and
For whom you provided over half of the support in 2017. But see Child of divorced or separated parents, earlier, Support claimed under a multiple support agreement, next, and Kidnapped child under Qualifying Relative in Pub. 501.

Support claimed under a multiple support agreement.

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. 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.

Any medical expenses paid by others who joined you in the agreement can’t be included as medical expenses by anyone. However, you can include the entire unreimbursed amount you paid for medical expenses.

Example.

You and your three brothers each provide one-fourth of your mother’s total support. Under a multiple support agreement, you treat your mother as your dependent. You paid all of her medical expenses. Your brothers repaid you for three-fourths of these expenses. In figuring your medical expense deduction, you can include only one-fourth of your mother’s medical expenses. Your brothers can’t include any part of the expenses. 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.

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. This includes expenses for the decedent’s spouse and dependents as well as for the decedent.

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. The expenses must be paid within the 1-year period beginning with the day after the date of death. 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 haven’t been and won’t be claimed on the estate tax return.

Qualified medical expenses paid before death by the decedent aren’t deductible if paid with a tax-free distribution from any Archer MSA, Medicare Advantage MSA, or health savings account.

What if the decedent’s return had been filed and the medical expenses weren’t 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. 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.

Example.

John properly filed his 2016 income tax return. He died in 2017 with unpaid medical expenses of $1,500 from 2016 and $1,800 in 2017. If the expenses are paid within the 1-year period, his survivor or personal representative can file an amended return for 2016 claiming a deduction based on the $1,500 medical expenses. The $1,800 of medical expenses from 2017 can be included on the decedent’s final return for 2017.

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 Schedule A (Form 1040) in the year paid, whether they are paid before or after the decedent’s death. 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.

What Medical Expenses Are Includible?

Following is a list of items that you can include in figuring your medical expense deduction. The items are listed in alphabetical order.

This list doesn’t include all possible medical expenses. To determine if an expense not listed can be included in figuring your medical expense deduction, see What Are Medical Expenses , earlier.

Abortion

You can include in medical expenses the amount you pay for a legal abortion.

Acupuncture

You can include in medical expenses the amount you pay for acupuncture.

Alcoholism

You can include in medical expenses amounts you pay for an inpatient’s treatment at a therapeutic center for alcohol addiction. This includes meals and lodging provided by the center during treatment.

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.

Ambulance

You can include in medical expenses amounts you pay for ambulance service.

Annual Physical Examination

See Physical Examination , later.

Artificial Limb

You can include in medical expenses the amount you pay for an artificial limb.

Artificial Teeth

You can include in medical expenses the amount you pay for artificial teeth.

Bandages

You can include in medical expenses the cost of medical supplies such as bandages.

Birth Control Pills

You can include in medical expenses the amount you pay for birth control pills prescribed by a doctor.

Body Scan

You can include in medical expenses the cost of an electronic body scan.

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.

Breast Pumps and Supplies

You can include in medical expenses the cost of breast pumps and supplies that assist lactation.

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. See Cosmetic Surgery , later.

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. The cost of permanent improvements that increase the value of your property may be partly included as a medical expense. The cost of the improvement is reduced by the increase in the value of your property. The difference is a medical expense. If the value of your property isn’t increased by the improvement, the entire cost is included as a medical expense.

Certain improvements made to accommodate a home to your disabled condition, or that of your spouse or your dependents who live with you, don’t usually increase the value of the home and the cost can be included in full as medical expenses. These improvements include, but aren’t limited to, the following items.

Constructing entrance or exit ramps for your home.
Widening doorways at entrances or exits to your home.
Widening or otherwise modifying hallways and interior doorways.
Installing railings, support bars, or other modifications to bathrooms.
Lowering or modifying kitchen cabinets and equipment.
Moving or modifying electrical outlets and fixtures.
Installing porch lifts and other forms of lifts (but elevators generally add value to the house).
Modifying fire alarms, smoke detectors, and other warning systems.
Modifying stairways.
Adding handrails or grab bars anywhere (whether or not in bathrooms).
Modifying hardware on doors.
Modifying areas in front of entrance and exit doorways.
Grading the ground to provide access to the residence.

Only reasonable costs to accommodate a home to a disabled condition are considered medical care. Additional costs for personal motives, such as for architectural or aesthetic reasons, aren’t medical expenses.

Capital expense worksheet.

Use Worksheet A to figure the amount of your capital expense to include in your medical expenses.

Worksheet A. Capital Expense Worksheet

Instructions: Use this worksheet to figure the amount, if any, of your medical expenses due to a home improvement.
1.	Enter the amount you paid for the home improvement		1.
2.	Enter the value of your home immediately after the improvement	2.
3.	Enter the value of your home immediately before the improvement	3.
4.	Subtract line 3 from line 2. This is the increase in the value of your home due to the improvement		4.
	• If line 4 is more than or equal to line 1, you have no medical expenses due to the home improvement; stop here.
	• If line 4 is less than line 1, go to line 5.
5.	Subtract line 4 from line 1. These are your medical expenses due to the home improvement		5.

Operation and upkeep.

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. This rule applies even if none or only part of the original cost of the capital asset qualified as a medical care expense.

Improvements to property rented by a person with a disability.

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.

Example.

John has arthritis and a heart condition. He can’t climb stairs or get into a bathtub. On his doctor’s advice, he installs a bathroom with a shower stall on the first floor of his two-story rented house. The landlord didn’t pay any of the cost of buying and installing the special plumbing and didn’t lower the rent. John can include in medical expenses the entire amount he paid.

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.

Special design.

You can include in medical expenses the difference between the cost of a regular car and a car specially designed to hold a wheelchair.

Cost of operation.

The includible costs of using a car for medical reasons are explained under Transportation , later.

Chiropractor

You can include in medical expenses fees you pay to a chiropractor for medical care.

Christian Science Practitioner

You can include in medical expenses fees you pay to Christian Science practitioners for medical care.

Contact Lenses

You can include in medical expenses amounts you pay for contact lenses needed for medical reasons. You can also include the cost of equipment and materials required for using contact lenses, such as saline solution and enzyme cleaner. See Eyeglasses and Eye Surgery , later.

Crutches

You can include in medical expenses the amount you pay to buy or rent crutches.

Dental Treatment

You can include in medical expenses the amounts you pay for the prevention and alleviation of dental disease. 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. Treatment to alleviate dental disease includes services of a dentist for procedures such as X-rays, fillings, braces, extractions, dentures, and other dental ailments. But see Teeth Whitening under What Expenses Aren’t Includible, later.

Diagnostic Devices

You can include in medical expenses the cost of devices used in diagnosing and treating illness and disease.

Example.

You have diabetes and use a blood sugar test kit to monitor your blood sugar level. You can include the cost of the blood sugar test kit in your medical expenses.

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. See Pub. 503.

You can choose to apply them either way as long as you don’t use the same expenses to claim both a credit and a medical expense deduction.

Drug Addiction

You can include in medical expenses amounts you pay for an inpatient’s treatment at a therapeutic center for drug addiction. This includes meals and lodging at the center during treatment.

Drugs

See Medicines , later.

Eye Exam

You can include in medical expenses the amount you pay for eye examinations.

Eyeglasses

You can include in medical expenses amounts you pay for eyeglasses and contact lenses needed for medical reasons. See Contact Lenses , earlier, for more information.

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.

Fertility Enhancement

You can include in medical expenses the cost of the following procedures to overcome an inability to have children.

Procedures such as in vitrofertilization (including temporary storage of eggs or sperm).
Surgery, including an operation to reverse prior surgery that prevented the person operated on from having children.

Founder’s Fee

See Lifetime Care—Advance Payments , later.

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. 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.

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 disability or illness of the individual receiving the treatment.

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. These amounts are treated as medical insurance premiums. See Insurance Premiums, later.

Hearing Aids

You can include in medical expenses the cost of a hearing aid and batteries, repairs, and maintenance needed to operate it.

Home Care

See Nursing Services , later.

Home Improvements

See Capital Expenses , earlier.

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. This includes amounts paid for meals and lodging. Also see Lodging , later.

Insurance Premiums

You can include in medical expenses insurance premiums you pay for policies that cover medical care. You can’t include in medical expenses insurance premiums that were paid and for which you are claiming a credit or deduction. 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). See Qualified Long-Term Care Insurance ContractsunderLong-Term Care, later.

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. The cost of the medical part must be separately stated in the insurance contract or given to you in a separate statement.

Health Coverage Tax Credit (HCTC)

If you were an eligible trade adjustment assistance (TAA) recipient, an alternative TAA (ATAA) recipient, reemployment TAA (RTAA) recipient, or Pension Benefit Guaranty Corporation (PBGC) payee, you must complete Form 8885 before completing Schedule A, line 1. When figuring the amount of insurance premiums you can deduct on Schedule A, don’t include any of the following.

Any amounts you included on Form 8885, line 4, or on Form 14095, The Health Coverage Tax Credit (HCTC) Reimbursement Request Form, to receive a reimbursement of the HCTC during the year,
Any qualified health insurance coverage premiums you paid to “U.S. Treasury–HCTC” for eligible coverage months for which you received the benefit of the advance monthly payment program, or
Any advance monthly payments from your health plan administrator received from the IRS, as shown on Form 1099-H, Health Coverage Tax credit (HCTC) Advance Payments.

If advance payments of the premium tax credit were made or you are eligible for both the premium tax credit and the HCTC and elect to take the HCTC, see the Instructions for Form 8885 to see how to figure your credit.

Employer-Sponsored Health Insurance Plan

Don’t 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. Also, don’t include any other medical and dental expenses paid by the plan unless the amount paid is included on your Form W-2.

Example.

You are a federal employee participating in the premium conversion plan of the Federal Employee Health Benefits (FEHB) program. Your share of the FEHB premium is paid by making a pre-tax reduction in your salary. Because you are an employee whose insurance premiums are paid with money that is never included in your gross income, you can’t deduct the premiums paid with that money.

Long-term care services.

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. This amount will be reported as wages on your Form W-2.

Retired public safety officers.

If you are a retired public safety officer, don’t 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. This applies only to distributions that would otherwise be included in income.

Health reimbursement arrangement (HRA).

If you have medical expenses that are reimbursed by a health reimbursement arrangement, you can’t include those expenses in your medical expenses. This is because an HRA is funded solely by the employer.

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. The payroll tax paid for Medicare A isn’t a medical expense.

If you aren’t covered under social security (or weren’t a government employee who paid Medicare tax), you can voluntarily enroll in Medicare A. In this situation you can include the premiums you paid for Medicare A as a medical expense.

Medicare B

Medicare B is a supplemental medical insurance. Premiums you pay for Medicare B are a medical expense. Check the information you received from the Social Security Administration to find out your premium.

Medicare D

Medicare D is a voluntary prescription drug insurance program for persons with Medicare A or B. You can include as a medical expense premiums you pay for Medicare D.

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).

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. 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. You can include this cost of continuing participation in the health plan as a medical expense.

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 don’t have the option to receive cash), don’t include the value of the unused sick leave in gross income. You can’t include this cost of continuing participation in that health plan as a medical expense.

Insurance Premiums You Can’t Include

You can’t include premiums you pay for:

Life insurance policies,
Policies providing payment for loss of earnings,
Policies for loss of life, limb, sight, etc.,
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 isn’t 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.

Taxes imposed by any governmental unit, such as Medicare taxes, aren’t insurance premiums.

Coverage for nondependents.

Generally, you can’t deduct any additional premium you pay as the result of including on your policy someone who isn’t your spouse or dependent, even if that person is your child under age 27. However, you can deduct the additional premium if that person is:

Your child whom you don’t 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 $4,050 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 2017 return.

Also, if you had family coverage when you added this individual to your policy and your premiums didn’t increase, you can enter on Schedule A (Form 1040) the full amount of your medical and dental insurance premiums.

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.

Laboratory Fees

You can include in medical expenses the amounts you pay for laboratory fees that are part of medical care.

Lactation Expenses

See Breast Pumps and Supplies , earlier.

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. These surfaces must be in poor repair (peeling or cracking) or within the child’s reach. The cost of repainting the scraped area isn’t a medical expense.

If, instead of removing the paint, you cover the area with wallboard or paneling, treat these items as capital expenses. See Capital Expenses , earlier. Don’t include the cost of painting the wallboard as a medical expense.

Learning Disability

See Special Education , later.

Legal Fees

You can include in medical expenses legal fees you paid that are necessary to authorize treatment for mental illness. However, you can’t 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 aren’t necessary for medical care.

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. The part of the payment you include is the amount properly allocable to medical care. 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. You can use a statement from the retirement home to prove the amount properly allocable to medical care. The statement must be based either on the home’s prior experience or on information from a comparable home.

Dependents with disabilities.

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. The payments must be a condition for the institution’s future acceptance of your child and must not be refundable.

Payments for future medical care.

Generally, you can’t include in medical expenses current payments for medical care (including medical insurance) to be provided substantially beyond the end of the year. This rule doesn’t apply in situations where the future care is purchased in connection with obtaining lifetime care of the type described earlier.

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. See Nursing Home , later.

You may be able to include in medical expenses the cost of lodging not provided in a hospital or similar institution. You can include the cost of such lodging while away from home if all of the following requirements are met.

The lodging is primarily for and essential to medical care.
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.
The lodging isn’t lavish or extravagant under the circumstances.
There is no significant element of personal pleasure, recreation, or vacation in the travel away from home.

The amount you include in medical expenses for lodging can’t be more than $50 for each night for each person. You can include lodging for a person traveling with the person receiving the medical care. 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. Meals aren’t included.

Don’t include the cost of lodging while away from home for medical treatment if that treatment isn’t 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 isn’t primarily for or essential to the medical care received.

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.

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.

Chronically ill individual.

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.

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. Activities of daily living are eating, toileting, transferring, bathing, dressing, and continence.
He or she requires substantial supervision to be protected from threats to health and safety due to severe cognitive impairment.

Maintenance and personal care services.

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).

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. 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 diemor other periodic payments without regard to expenses.

The amount of qualified long-term care premiums you can include is limited. You can include the following as medical expenses on Schedule A (Form 1040).

Qualified long-term care premiums up to the following amounts.
1. Age 40 or under – $410.
2. Age 41 to 50 – $770.
3. Age 51 to 60 – $1,530.
4. Age 61 to 70 – $4,090.
5. Age 71 or over – $5,110.
Unreimbursed expenses for qualified long-term care services.

Note. The limit on premiums is for each person.

Also, if you are an eligible retired public safety officer, you can’t 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.

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.

You can’t include in medical expenses the cost of meals that aren’t part of inpatient care. Also see Weight-Loss Program and Nutritional Supplements , later.

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. The costs of the medical conference must be primarily for and necessary to the medical care of you, your spouse, or your dependent. The majority of the time spent at the conference must be spent attending sessions on medical information.

The cost of meals and lodging while attending the conference isn’t deductible as a medical expense.

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.

Medicines

You can include in medical expenses amounts you pay for prescribed medicines and drugs. A prescribed drug is one that requires a prescription by a doctor for its use by an individual. You can also include amounts you pay for insulin. Except for insulin, you can’t include in medical expenses amounts you pay for a drug that isn’t prescribed.

Imported medicines and drugs.

If you imported medicines or drugs from other countries, see Medicines and Drugs From Other Countries , under What Expenses Aren’t Includible, later.

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. This includes the cost of meals and lodging in the home if a principal reason for being there is to get medical care.

Don’t include the cost of meals and lodging if the reason for being in the home is personal. You can, however, include in medical expenses the part of the cost that is for medical or nursing care.

Nursing Services

You can include in medical expenses wages and other amounts you pay for nursing services. The services need not be performed by a nurse as long as the services are of a kind generally performed by a nurse. 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. These services can be provided in your home or another care facility.

Generally, only the amount spent for nursing services is a medical expense. 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. For example, because of your medical condition you pay a visiting nurse $300 per week for medical and household services. She spends 10% of her time doing household services such as washing dishes and laundry. You can include only $270 per week as medical expenses. The $30 (10% × $300) allocated to household services can’t be included. However, certain maintenance or personal care services provided for qualified long-term care can be included in medical expenses. See Maintenance and personal care services under Long-Term Care, earlier. 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. See Pub. 503.

You can also include in medical expenses part of the amount you pay for that attendant’s meals. Divide the food expense among the household members to find the cost of the attendant’s food. Then divide that cost in the same manner as in the preceding paragraph. If you had to pay additional amounts for household upkeep because of the attendant, you can include the extra amounts with your medical expenses. This includes extra rent or utilities you pay because you moved to a larger apartment to provide space for the attendant.

Employment taxes.

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. 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. For information on employment tax responsibilities of household employers, see Pub. 926.

Operations

You can include in medical expenses amounts you pay for legal operations that aren’t for unnecessary cosmetic surgery. See Cosmetic Surgery under What Expenses Aren’t Includible, later.

Optometrist

See Eyeglasses , earlier.

Organ Donors

See Transplants , later.

Osteopath

You can include in medical expenses amounts you pay to an osteopath for medical care.

Oxygen

You can include in medical expenses amounts you pay for oxygen and oxygen equipment to relieve breathing problems caused by a medical condition.

Physical Examination

You can include in medical expenses the amount you pay for an annual physical examination and diagnostic tests by a physician. You don’t have to be ill at the time of the examination.

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.

Premium Tax Credit

You can’t include in medical expenses the amount of health insurance premiums paid by or through the premium tax credit. You also can’t include in medical expenses any amount of advance payments of the premium tax credit made that you did not have to pay back. However, any amount of advance payments of the premium tax credit that you did have to pay back can be included in medical expenses.

Example 1.

Amy is under age 65 and unmarried. The cost of her health insurance premiums in 2017 is $8,700. Advance payments of the premium tax credit of $4,200 are made to the insurance company and Amy pays premiums of $4,500. On her 2017 tax return, Amy is allowed a premium tax credit of $3,600 and must repay $600 excess advance credit payments (which is less than the repayment limitation). Amy is treated as paying $5,100 ($8,700 less the allowed premium tax credit of $3,600) for health insurance premiums in 2017. Because $5,100 is more than 10% of Amy’s AGI, when she fills out her Schedule A, she enters $5,100 on line 1.

Example 2.

The facts are the same as in Example 1, except Amy is allowed a premium tax credit of $4,900 on her tax return and receives a net premium tax credit of $700. Amy is treated as paying $3,800 ($8,700 less the allowed premium tax credit of $4,900) for health insurance premiums in 2017. Because $3,800 is more than 10% of Amy’s AGI, when she fills out her Schedule A, she enters $3,800 on line 1.

Prosthesis

See Artificial Limb and Breast Reconstruction Surgery , earlier.

Psychiatric Care

You can include in medical expenses amounts you pay for psychiatric care. This includes the cost of supporting a mentally ill dependent at a specially equipped medical center where the dependent receives medical care. See Psychoanalysis, next, and Transportation , later.

Psychoanalysis

You can include in medical expenses payments for psychoanalysis. However, you can’t include payments for psychoanalysis that is part of required training to be a psychoanalyst.

Psychologist

You can include in medical expenses amounts you pay to a psychologist for medical care.

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.

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. For expenses to be deductible, a doctor must recommend that the child attend the school. 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. 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.

You can’t include in medical expenses the cost of sending a child with behavioral problems to a school where the course of study and the disciplinary methods have a beneficial effect on the child’s attitude if the availability of medical care in the school isn’t a principal reason for sending the student there.

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). Also see Vasectomy , later.

Stop-Smoking Programs

You can include in medical expenses amounts you pay for a program to stop smoking. However, you can’t include in medical expenses amounts you pay for drugs that don’t require a prescription, such as nicotine gum or patches, that are designed to help stop smoking.

Surgery

See Operations , earlier.

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. This includes teletypewriter (TTY) and telecommunications device for the deaf (TDD) equipment. You can also include the cost of repairing the equipment.

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. This may be the cost of an adapter that attaches to a regular set. 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.

Therapy

You can include in medical expenses amounts you pay for therapy received as medical treatment.

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. This includes transportation.

You can include any expenses you pay for the medical care of a donor in connection with the donating of an organ. This includes transportation.

Transportation

You can include in medical expenses amounts paid for transportation primarily for, and essential to, medical care.

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.

Car expenses.

You can include out-of-pocket expenses, such as the cost of gas and oil, when you use a car for medical reasons. You can’t include depreciation, insurance, general repair, or maintenance expenses.

If you don’t want to use your actual expenses for 2017, you can use the standard medical mileage rate of 17 cents a mile.

You can also include parking fees and tolls. You can add these fees and tolls to your medical expenses whether you use actual expenses or the standard mileage rate.

Example.

In 2017, Bill Jones drove 2,800 miles for medical reasons. He spent $400 for gas, $30 for oil, and $100 for tolls and parking. He wants to figure the amount he can include in medical expenses both ways to see which gives him the greater deduction.

He figures the actual expenses first. He adds the $400 for gas, the $30 for oil, and the $100 for tolls and parking for a total of $530.

He then figures the standard mileage amount. He multiplies 2,800 miles by 17 cents a mile for a total of $476. He then adds the $100 tolls and parking for a total of $576.

Bill includes the $576 of car expenses with his other medical expenses for the year because the $576 is more than the $530 he figured using actual expenses.

Transportation expenses you can’t include.

You can’t include in medical expenses the cost of transportation in the following situations.

Going to and from work, even if your condition requires an unusual means of transportation.
Travel for purely personal reasons to another city for an operation or other medical care.
Travel that is merely for the general improvement of one’s health.
The costs of operating a specially equipped car for other than medical reasons.

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. You may be able to include up to $50 for each night for each person. You can include lodging for a person traveling with the person receiving the medical care. 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. Meals aren’t included. See Lodging , earlier.

You can’t 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. However, see Medical Conferences , earlier.

Tuition

Under special circumstances, you can include charges for tuition in medical expenses. See Special Education , earlier.

A lump-sum fee which includes education, board, and medical care—without distinguishing which part of the fee results from medical care—is not considered an amount payable for medical care. However, 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.

Vasectomy

You can include in medical expenses the amount you pay for a vasectomy.

Vision Correction Surgery

See Eye Surgery , earlier.

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). This includes fees you pay for membership in a weight reduction group as well as fees for attendance at periodic meetings. You can’t 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.

You can’t 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. You can include the cost of special food in medical expenses only if:

The food doesn’t satisfy normal nutritional needs,
The food alleviates or treats an illness, and
The need for the food is substantiated by a physician.

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. See also Weight-Loss Program under What Expenses Aren’t Includible, later.

Wheelchair

You can include in medical expenses the amounts you pay for a wheelchair used for the relief of a sickness or disability. The cost of operating and maintaining the wheelchair is also a medical expense.

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.

X-ray

You can include in medical expenses amounts you pay for X-rays for medical reasons

What Expenses Aren’t Includible?

Following is a list of some items that you can’t include in figuring your medical expense deduction. The items are listed in alphabetical order.

Baby Sitting, Childcare, and Nursing Services for a Normal, Healthy Baby

You can’t 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. Also, any expense allowed as a childcare credit can’t be treated as an expense paid for medical care.

Controlled Substances

You can’t include in medical expenses amounts you pay for controlled substances (such as marijuana, laetrile, etc.) that aren’t legal under federal law, even if such substances are legalized by state law.

Cosmetic Surgery

Generally, you can’t include in medical expenses the amount you pay for unnecessary cosmetic surgery. This includes any procedure that is directed at improving the patient’s appearance and doesn’t meaningfully promote the proper function of the body or prevent or treat illness or disease. You generally can’t include in medical expenses the amount you pay for procedures such as face lifts, hair transplants, hair removal (electrolysis), and liposuction.

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.

Example.

An individual undergoes surgery that removes a breast as part of treatment for cancer. She pays a surgeon to reconstruct the breast. The surgery to reconstruct the breast corrects a deformity directly related to the disease. The cost of the surgery is includible in her medical expenses.

Dancing Lessons

You can’t include in medical expenses the cost of dancing lessons, swimming lessons, etc., even if they are recommended by a doctor, if they are only for the improvement of general health.

Diaper Service

You can’t 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.

Electrolysis or Hair Removal

See Cosmetic Surgery , earlier.

Flexible Spending Account

You can’t 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.

Funeral Expenses

You can’t include in medical expenses amounts you pay for funerals.

Future Medical Care

Hair Transplant

See Cosmetic Surgery , earlier.

Health Club Dues

You can’t 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.

You can’t include in medical expenses the cost of membership in any club organized for business, pleasure, recreation, or other social purpose.

Health Coverage Tax Credit

You can’t include in medical expenses amounts you pay for health insurance you use in figuring your health coverage tax credit. For more information, see the Instructions for Form 8885.

Health Savings Accounts

You can’t include in medical expenses any payment or distribution for medical expenses out of a health savings account. Contributions to health savings accounts are deducted separately. See Pub. 969.

Household Help

You can’t include in medical expenses the cost of household help, even if such help is recommended by a doctor. This is a personal expense that isn’t deductible. However, you may be able to include certain expenses paid to a person providing nursing-type services. For more information, see Nursing Services , earlier, under What Medical Expenses Are Includible. Also, certain maintenance or personal care services provided for qualified long-term care can be included in medical expenses. For more information, see Long-Term Care , earlier, under What Medical Expenses Are Includible.

Illegal Operations and Treatments

You can’t include in medical expenses amounts you pay for illegal operations, treatments, or controlled substances whether rendered or prescribed by licensed or unlicensed practitioners.

Insurance Premiums

See Insurance Premiums under What Medical Expenses Are Includible, earlier.

Maternity Clothes

You can’t include in medical expenses amounts you pay for maternity clothes.

Medical Savings Account (MSA)

You can’t include in medical expenses amounts you contribute to an Archer MSA. You can’t include expenses you pay for with a tax-free distribution from your Archer MSA. You also can’t use other funds equal to the amount of the distribution and include the expenses. For more information on Archer MSAs, see Pub. 969.

Medicines and Drugs From Other Countries

In general, you can’t include in your medical expenses the cost of a prescribed drug brought in (or ordered shipped) from another country. You can only include the cost of a drug that was imported legally. For example, you can include the cost of a prescribed drug the Food and Drug Administration announces can be legally imported by individuals.

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.

Nonprescription Drugs and Medicines

Except for insulin, you can’t include in medical expenses amounts you pay for a drug that isn’t prescribed.

Example.

Your doctor recommends that you take aspirin. Because aspirin is a drug that doesn’t require a physician’s prescription, you can’t include its cost in your medical expenses.

Nutritional Supplements

You can’t include in medical expenses the cost of nutritional supplements, vitamins, herbal supplements, “natural medicines,” etc. unless they are recommended by a medical practitioner as treatment for a specific medical condition diagnosed by a physician. These items are taken to maintain your ordinary good health and aren’t for medical care.

Personal Use Items

You can’t 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 disability or illness. For example, the cost of a toothbrush and toothpaste is a nondeductible personal expense.

In order to accommodate an individual with a physical disability, you may have to purchase an item ordinarily used as a personal, living, or family item in a special form. 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. See Braille Books and Magazinesunder What Medical Expenses Are Includible, earlier.

Premium Tax Credit

Swimming Lessons

See Dancing Lessons , earlier.

Teeth Whitening

You can’t include in medical expenses amounts paid to whiten teeth. See Cosmetic Surgery , earlier.

Veterinary Fees

You generally can’t include veterinary fees in your medical expenses, but see Guide Dog or Other Service Animalunder What Medical Expenses Are Includible, earlier.

Weight-Loss Program

You can’t 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. You can’t 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). If the weight-loss treatment isn’t for a specific disease diagnosed by a physician, you can’t include either the fees you pay for membership in a weight reduction group or fees for attendance at periodic meetings. Also, you can’t include membership dues in a gym, health club, or spa.

You can’t 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.

See Weight-Loss Program under What Medical Expenses Are Includible, earlier.

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.

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. This includes payments from Medicare.

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 doesn’t reimburse.

Example.

You have insurance policies that cover your hospital and doctors’ bills but not your nursing bills. The insurance you receive for the hospital and doctors’ bills is more than their charges. 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 don’t cover some of your medical expenses.

Health reimbursement arrangement (HRA).

A health reimbursement arrangement is an employer-funded plan that reimburses employees for medical care expenses and allows unused amounts to be carried forward. An HRA is funded solely by the employer and the reimbursements for medical expenses, up to a maximum dollar amount for a coverage period, aren’t included in your income.

Other reimbursements.

Generally, you don’t reduce medical expenses by payments you receive for:

Permanent loss or loss of use of a member or function of the body (loss of limb, sight, hearing, etc.) or disfigurement to the extent the payment is based on the nature of the injury without regard to the amount of time lost from work, or
Loss of earnings.

You must, however, reduce your medical expenses by any part of these payments that is designated for medical costs. See How Do You Figure and Report the Deduction on Your Tax Return , later.

For how to treat damages received for personal injury or sickness, see Damages for Personal Injuries , later.

What If Your Insurance Reimbursement Is More Than Your Medical Expenses?

If you are reimbursed more than your medical expenses, you may have to include the excess in income. You may want to use Figure 1 to help you decide if any of your reimbursement is taxable.

Reimbursement Taxable?

Please click here for the text description of the image.

Premiums paid by you.

If you pay either the entire premium for your medical insurance or all the costs of a plan similar to medical insurance and your insurance payments or other reimbursements are more than your total medical expenses for the year, you have excess reimbursement. Generally, you don’t include the excess reimbursement in your gross income. However, gross income does include total payments in excess of $360 a day ($131,400 for 2017) for qualified long-term care services.

Premiums paid by you and your employer.

If both you and your employer contribute to your medical insurance plan and your employer’s contributions aren’t included in your gross income, you must include in your gross income the part of your excess reimbursement that is from your employer’s contribution.

If you aren’t covered by more than one policy, you can figure the amount of the excess reimbursement you must include in gross income using Worksheet B. If you are covered under more than one policy, see More than one policy , later.

Worksheet B. Excess Reimbursement Includible in Income When You Have Only One Policy

Instructions: Use this worksheet to figure the amount of excess reimbursement you must include in income when both you and your employer contributed to your medical insurance and your employer’s contributions aren’t included in your gross income.
1.	Enter the amount contributed to your medical insurance for the year by your employer	1.
2.	Enter the total annual cost of the policy	2.
3.	Divide line 1 by line 2	3.
4.	Enter the amount of excess reimbursement	4.
5.	Multiply line 3 by line 4. This is the amount of the excess reimburse- ment you must include as other income on Form 1040	5.

Premiums paid by your employer.

If your employer or your former employer pays the total cost of your medical insurance plan and your employer’s contributions aren’t included in your income, you must report all of your excess reimbursement as other income.

More than one policy.

If you are covered under more than one policy, the cost of at least one of which is paid by both you and your employer, you must first divide the medical expenses among the policies to figure the excess reimbursement from each policy. Then divide the policy costs to figure the part of any excess reimbursement that is from your employer’s contribution. Any excess reimbursement that is due to your employer’s contributions is includible in your income.

You can figure the part of the excess reimbursement that is from your employer’s contribution by using Worksheet C. Use Worksheet C only if both you and your employer paid part of the cost of at least one policy. If you had more than one policy, but you didn’t share in the cost of at least one policy, don’t use Worksheet C.

Worksheet C. Excess Reimbursement Includible in Income When You Have More Than One Policy

Instructions: Use this worksheet to figure the amount of excess reimbursement you must include as income on your tax return when (a) you are reimbursed under two or more health insurance policies, (b) at least one of which is paid for by both you and your employer, and (c) your employer’s contributions aren’t included in your gross income. If you and your employer didn’t share in the cost of at least one policy, don’t use this worksheet.
1.	Enter the reimbursement from your employer’s policy	1.
2.	Enter the reimbursement from your own policy	2.
3.	Add lines 1 and 2	3.
4.	Divide line 1 by line 3	4.
5.	Enter the total medical expenses you paid during the year. If this amount is at least as much as the amount on line 3, stop here because there is no excess reimbursement	5.
6.	Multiply line 4 by line 5	6.
7.	Subtract line 6 from line 1	7.
8.	Enter employer’s contribution to the annual cost of the employer’s policy	8.
9.	Enter total annual cost of the employer’s policy	9.
10.	Divide line 8 by line 9. This is the percentage of your total excess reimbursement you must report as other income	10.
11.	Multiply line 7 by line 10. This is the amount of your total excess reimbursement you must report as other income on Form 1040	11.

What If You Receive Insurance Reimbursement in a Later Year?

If you are reimbursed in a later year for medical expenses you deducted in an earlier year, you generally must report the reimbursement as income up to the amount you previously deducted as medical expenses.

However, don’t report as income the amount of reimbursement you received up to the amount of your medical deductions that didn’t reduce your tax for the earlier year.

For more information about the recovery of an amount that you claimed as an itemized deduction in an earlier year, see Recoveries in Pub. 525, Taxable and Nontaxable Income.

What If You Are Reimbursed for Medical Expenses You Didn’t Deduct?

If you didn’t deduct a medical expense in the year you paid it because your medical expenses weren’t more than 10% of your AGI or because you didn’t itemize deductions, don’t include the reimbursement, up to the amount of the expense, in income. However, if the reimbursement is more than the expense, see What If Your Insurance Reimbursement Is More Than Your Medical Expenses , earlier.

How Do You Figure and Report the Deduction on Your Tax Return?

Once you have determined which medical expenses you can include, figure and report the deduction on your tax return.

What Tax Form Do You Use?

You report your medical expense deduction on Schedule A, Form 1040. You can’t claim medical expenses on Form 1040A or Form 1040EZ. See the Instructions for Schedule A (Form 1040) for more detailed information on figuring your medical and dental expense deduction.

Recordkeeping. You should keep records of your medical and dental expenses to support your deduction. Don’t send these records with your paper return.

Sale of Medical Equipment or Property

If you deduct the cost of medical equipment or property in one year and sell it in a later year, you may have a taxable gain. The taxable gain is the amount of the selling price that is more than the adjusted basis of the equipment or property.

The adjusted basis is the portion of the cost of the equipment or property that you couldn’t deduct because of the 10% limit used to compute the medical deduction. Use Worksheet D, later, to figure the adjusted basis of the equipment or property.

Worksheet D. Adjusted Basis of Medical Equipment or Property Sold

Instructions: Use this worksheet if you deducted the cost of medical equipment or property in one year and sold the equipment or property in a later year. This worksheet will give you the adjusted basis of the equipment or property you sold.
1.	Enter the cost of the equipment or property	1.
2.	Enter your total includible medical expenses for the year you included the cost in your medical expenses	2.
3.	Divide line 1 by line 2	3.
4.	Enter 10% of your AGI for the year the cost was included in your medical expenses	4.
5.	Multiply line 3 by line 4. If your allowable itemized deductions for the year you purchased the equipment or property weren’t more than your AGI for that year, stop here. This is the adjusted basis of the equipment or property. If your allowable itemized deductions for the year you purchased the equipment or property were more than your AGI for that year, complete lines 6 through 11	5.
6.	Subtract line 5 from line 1	6.
7.	Enter your total allowable itemized deductions for the year the cost was included in your medical expenses	7.
8.	Divide line 6 by line 7	8.
9.	Enter your AGI for the year the cost was included in your medical expenses	9.
10.	Subtract line 9 from line 7	10.
11.	Multiply line 8 by line 10	11.
12.	Add line 5 to line 11. If your allowable itemized deductions for the year you purchased the equipment or property were more than your AGI for that year, this is the adjusted basis of the equipment or property	12.

Next, use Worksheet E to figure the total gain or loss on the sale of the medical equipment or property.

Worksheet E. Gain or Loss On the Sale of Medical Equipment or Property

Instructions: Use the following worksheet to figure total gain or loss on the sale of medical equipment or property that you deducted in an earlier year.
1.	Enter the amount that the medical equipment or property sold for	1.
2.	Enter your selling expenses	2.
3.	Subtract line 2 from line 1	3.
4.	Enter the adjusted basis of the equipment or property from Worksheet D, line 5, or line 12, if applicable	4.
5.	Subtract line 4 from line 3. This is the total gain or loss from the sale of the medical equipment or property	5.

If you have a loss, it isn’t deductible. If you have a gain, it is includible in your income. The part of the gain that is a recovery of an amount you previously deducted is taxable as ordinary income. Enter it on Form 1040. Any part of the gain that is more than the recovery of an amount you previously deducted is taxable as a capital gain. Enter it on Form 8949, Sales and Other Dispositions of Capital Assets, and Schedule D (Form 1040), Capital Gains and Losses.

For more information about the recovery of an amount that you claimed as an itemized deduction in an earlier year, see Recoveries in Pub. 525.

Damages for Personal Injuries

If you receive an amount in settlement of a personal injury suit, part of that award may be for medical expenses that you deducted in an earlier year. If it is, you must include that part in your income in the year you receive it to the extent it reduced your taxable income in the earlier year. See What If You Receive Insurance Reimbursement in a Later Year , discussed earlier under How Do You Treat Reimbursements.

Example.

You sued this year for injuries you suffered in an accident last year. You sought $10,000 for your injuries and didn’t itemize your damages. Last year, you paid $500 for medical expenses for your injuries. You deducted those expenses on last year’s tax return. This year you settled your lawsuit for $2,000. Your settlement didn’t itemize or allocate the damages. The $2,000 is first presumed to be for the medical expenses that you deducted. The $500 is includible in your income this year because you deducted the entire $500 as a medical expense deduction last year.

Future medical expenses.

If you receive an amount in settlement of a damage suit for personal injuries, part of that award may be for future medical expenses. If it is, you must reduce any future medical expenses for these injuries until the amount you received has been completely used.

Example.

You were injured in an accident. You sued and sought a judgment of $50,000 for your injuries. You settled the suit for $45,000. The settlement provided that $10,000 of the $45,000 was for future medical expenses for your injuries. You can’t include the first $10,000 that you pay for medical expenses for those injuries.

Workers’ compensation.

If you received workers’ compensation and you deducted medical expenses related to that injury, you must include the workers’ compensation in income up to the amount you deducted. If you received workers’ compensation, but didn’t deduct medical expenses related to that injury, don’t include the workers’ compensation in your income.

Impairment-Related Work Expenses

If you are a person with disabilities, you can take a business deduction for expenses that are necessary for you to be able to work. If you take a business deduction for these impairment-related work expenses, they aren’t subject to the 10% limit that applies to medical expenses.

You have a disability if you have:

A physical or mental disability (for example, blindness or deafness) that functionally limits your being employed, or
A physical or mental impairment (for example, a sight or hearing impairment) that substantially limits one or more of your major life activities, such as performing manual tasks, walking, speaking, breathing, learning, or working.

Impairment-related expenses defined.

Impairment-related expenses are those ordinary and necessary business expenses that are:

Necessary for you to do your work satisfactorily,
For goods and services not required or used, other than incidentally, in your personal activities, and
Not specifically covered under other income tax laws.

Where to report.

If you are self-employed, deduct the business expenses on the appropriate form (Schedule C, C-EZ, E, or F) used to report your business income and expenses.

If you are an employee, complete Form 2106, Employee Business Expenses, or Form 2106-EZ, Unreimbursed Employee Business Expenses. Enter on Schedule A (Form 1040), that part of the amount on Form 2106, or Form 2106-EZ, that is related to your impairment. Enter the amount that is unrelated to your impairment on Schedule A (Form 1040). Your impairment-related work expenses aren’t subject to the 2%-of-adjusted-gross-income limit that applies to other employee business expenses.

Example.

You are blind. You must use a reader to do your work. You use the reader both during your regular working hours at your place of work and outside your regular working hours away from your place of work. The reader’s services are only for your work. You can deduct your expenses for the reader as business expenses.

Health Insurance Costs for Self-Employed Persons

If you were self-employed and had a net profit for the year, you may be able to deduct, as an adjustment to income, amounts paid for medical and qualified long-term care insurance on behalf of yourself, your spouse, your dependents, and your children who were under age 27 at the end of 2017. For this purpose, you were self-employed if you were a general partner (or a limited partner receiving guaranteed payments) or you received wages from an S corporation in which you were more than a 2% shareholder. The insurance plan must be established under your trade or business and the deduction can’t be more than your earned income from that trade or business.

You can’t deduct payments for medical insurance for any month in which you were eligible to participate in a health plan subsidized by your employer, your spouse’s employer, or an employer of your dependent, or your child under age 27, at the end of 2017. You can’t deduct payments for a qualified long-term care insurance contract for any month in which you were eligible to participate in a long-term care insurance plan subsidized by your employer or your spouse’s employer.

If you qualify to take the deduction, use the Self-Employed Health Insurance Deduction Worksheet in the Instructions for Form 1040 to figure the amount you can deduct. But if any of the following applies, don’t use that worksheet.

You had more than one source of income subject to self-employment tax.
You file Form 2555, Foreign Earned Income, or Form 2555-EZ, Foreign Earned Income Exclusion.
You are using amounts paid for qualified long-term care insurance to figure the deduction.

If you can’t use the worksheet in the Instructions for Form 1040, use the worksheet in Pub. 535, Business Expenses, to figure your deduction.

If you were an eligible TAA recipient, ATAA recipient, RTAA recipient, or PBGC payee, see the Instructions for Form 8885 to figure the amount to enter on the worksheet.

Use Pub. 974 instead of the worksheet in the 2017 Instructions for Form 1040 if the insurance plan established, or considered to be established, under your business was obtained through the Health Insurance Marketplace and you are claiming the premium tax credit.

When figuring the amount you can deduct for insurance premiums, don’t include amounts paid for health insurance coverage with retirement plan distributions that were tax-free because you are a retired public safety officer.

Where to report.

You take this deduction on Form 1040. If you itemize your deductions and don’t claim 100% of your self-employed health insurance costs on Form 1040, include any remaining premiums with all other medical expenses on Schedule A (Form 1040) subject to the 10% limit.

Child under age 27.

If the insurance policy covers your nondependent child who was under age 27 at the end of 2017, you can claim the premiums for that coverage on Form 1040. If you can’t claim 100% of your self-employed health insurance costs on Form 1040, any excess amounts attributable to that child aren’t eligible to be claimed on Schedule A (Form 1040).

Generally, family health insurance premiums don’t increase if coverage for an additional child is added. If this is the situation, no allocation would be necessary. If the premiums did increase (such as where coverage was expanded from single to family to add the nondependent child), you can allocate the amount on Form 1040 to the nondependent child and any excess amounts not attributable to that child would be eligible to be claimed on Schedule A.

Example 1.

Kate is self-employed in 2017 and has self-only coverage for health insurance. Her premium for that coverage was $5,000 for the year. She changes to family coverage only to add her 26-year-old nondependent child to the plan. Her health insurance premium increases to $10,000 for the year. After completing the Self-Employed Health Insurance Deduction Worksheet in the Instructions for Form 1040, she can only deduct $4,000 on Form 1040. The $4,000 is allocable to the nondependent child. On Schedule A, she can only claim the $5,000 allocable to her coverage. She can’t claim the $1,000 excess premiums allocable to the nondependent child.

Example 2.

The facts are the same as in Example 1, except that Kate had family coverage when she added her 26-year-old nondependent child to the policy. There was no increase in the $10,000 premium. In this case, she could claim $4,000 on Form 1040 and $6,000 on Schedule A.

More information.

For more information, see Pub. 535.

Health Coverage Tax Credit

The health coverage tax credit (HCTC) is a tax credit that pays 72.5% of qualified health insurance premiums for eligible individuals and their families. The HCTC acts as partial reimbursement for premiums paid for qualified health insurance coverage.

You must elect the HCTC. Once you make the election to take the HCTC for an eligible coverage month, you can’t take the premium tax credit for the same coverage in that coverage month and for all subsequent coverage months during your tax year in which you’re eligible to take the HCTC.

If you have qualified health insurance that covers anyone besides yourself and your qualifying family member(s), you may not be able to take into account all of your payments. You can’t treat an amount as paid for insurance for yourself and qualifying family members unless all of the following requirements are met.

The charge for insurance for yourself and qualifying family members is either separately stated in the contract or furnished to you by the insurance company in a separate statement.
The amount you paid for insurance for yourself and qualifying family members isn’t more than the charge that is stated in the contract or furnished by the insurance company.
The amount stated in the contract or furnished by the insurance company isn’t unreasonably large in relation to the total charges under the contract.

For more information on who is eligible to take the HCTC, which plans are qualified health plans for the HCTC, how to figure your credit if advance payments of the premium tax credit were made, as well as other changes to the HCTC, go to IRS.gov/HCTC. Also, see the Instructions for Form 8885.

(Including the Health Coverage Tax Credit)

Publication 502 – Introductory Material

Future Developments

What’s New

Reminders

Introduction

Internal Revenue Service Tax Forms and Publications 1111 Constitution Ave. NW, IR-6526 Washington, DC 20224

Useful Items – You may want to see:

Publication 502 – Main Content

What Are Medical Expenses?

What Expenses Can You Include This Year?

How Much of the Expenses Can You Deduct?

Whose Medical Expenses Can You Include?

Spouse

Dependent

Qualifying Child

Qualifying Relative

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

Worksheet A. Capital Expense Worksheet

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

Health Coverage Tax Credit (HCTC)

Employer-Sponsored Health Insurance Plan

Medicare A

Medicare B

Medicare D

Prepaid Insurance Premiums

Unused Sick Leave Used To Pay Premiums

Insurance Premiums You Can’t Include

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

Qualified Long-Term Care Services

Qualified Long-Term Care Insurance Contracts

Meals

Medical Conferences

Medical Information Plan

Medicines

Internal Revenue Service
Tax Forms and Publications
1111 Constitution Ave. NW, IR-6526
Washington, DC 20224