HSA Qualified Medical Expenses
The Following List are HSA Qualified Medical Expenses
Learn more about Health Savings Accounts here.
You can include in medical expenses the amount you pay for acupuncture.
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 alcohol recovery support organization (for example, 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 alcohol.
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.
You can include in medical expenses the amount you pay for artificial teeth.
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.
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. This doesn’t include the costs of excess bottles for food storage.
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.
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 your disabled condition are considered medical care. Additional costs for personal motives, such as for architectural or aesthetic reasons, aren’t medical expenses.
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.
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.
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.
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.
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, Child and Dependent Care Expenses. 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 AddictionYou 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 provided by the center during treatment. You can also include in medical expenses amounts you pay for transportation to and from drug treatment meetings in your community if the attendance is pursuant to medical advice that the membership is necessary for the treatment of a disease involving the excessive use of drugs.DrugsSee Medicines, later. Eye ExamYou can include in medical expenses the amount you pay for eye examinations.EyeglassesYou 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 SurgeryYou 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 EnhancementYou can include in medical expenses the cost of the following procedures performed on yourself, your spouse, or your dependent to overcome an inability to have children.
- Procedures such as in vitro fertilization (including temporary storage of eggs or sperm).
- Surgery, including an operation to reverse prior surgery that prevented the person operated on from having children.
You can include in medical expenses the amount you pay to buy or rent crutches.
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.
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.
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.
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.
You can include in medical expenses the cost of a hearing aid and batteries, repairs, and maintenance needed to operate it.
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.
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 Contracts under Long-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, 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.
• 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.
Medicare Part A
If you are covered under social security (or if you are a government employee who paid Medicare tax), you are enrolled in Medicare Part A. The payroll tax paid for Medicare Part 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 Part A. In this situation, you can include the premiums you paid for Medicare Part A as a medical expense.
Medicare Part B
Medicare Part B is a supplemental medical insurance. Premiums you pay for Medicare Part B are a medical ex- pense. Check the information you received from the So- cial Security Administration to find out your premium.
Medicare Part D
Medicare Part D is a voluntary prescription drug insurance program for persons with Medicare Part A or B. You can include as a medical expense premiums you pay for Medi- care Part D.
Prepaid Insurance Premiums
Premiums you pay before you are age 65 for insurance for medical care for yourself, your spouse, or your depend- ents after you reach age 65 are medical care expenses in the year paid if they are:
1. Payable in equal yearly installments or more often; and
2. 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 re- ceive at the time of retirement for unused sick leave. You must also 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 ex- pense.
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 in- clude 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 in- surance 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 pro- vider and these distributions would otherwise have been included in income.Taxes imposed by any governmental unit, such as Medi- care taxes, aren’t insurance premiums.Coverage for nondependents. Generally, you can’t de- duct any additional premium you pay as the result of in- cluding 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 be- cause of the rules for children of divorced or separa- ted parents;• Any person you could have claimed as a dependent on your return except that person received $4,300 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
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claimed as a dependent on someone else’s 2021 re- turn.
Also, if you had family coverage when you added this indi- vidual 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 disa- bled in a special home, not the home of a relative, on the recommendation of a psychiatrist to help the person ad- just from life in a mental hospital to community living.
You can include in medical expenses the amounts you pay for laboratory fees that are part of medical care.
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 medi- cal 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 be- come 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 sub- stantially beyond the end of the year. This rule doesn’t ap- ply in situations where the future care is purchased in con- nection with obtaining lifetime care of the type described earlier.
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 institu- tion. 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 cir- cumstances.
- 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 lodg- ing 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 pa- rent 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.
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 crack- ing) 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 ex- penses. See Capital Expenses, earlier. Don’t include the cost of painting the wallboard as a medical expense.
See Special Education, later. Legal Fees
You can include in medical expenses legal fees you paid that are necessary to authorize treatment for mental ill- ness. 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 alloca- ble to medical care. The agreement must require that you pay a specific fee as a condition for the home’s promise to
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You can include in medical expenses amounts paid for qualified long-term care services and certain amounts of premiums paid for qualified long-term care insurance con- tracts.
Qualified Long-Term Care Services
Qualified long-term care services are necessary diagnos- tic, preventive, therapeutic, curing, treating, mitigating, re- habilitative 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 li- censed 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 an- other individual for at least 90 days, due to a loss of functional capacity. Activities of daily living are eating, toileting, transferring, bathing, dressing, and conti- nence.
- He or she requires substantial supervision to be pro- tected from threats to health and safety due to severe cognitive impairment.
Maintenance and personal care services. Mainte- nance 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 (includ- ing protection from threats to health and safety due to se- vere cognitive impairment).
Qualified Long-Term Care Insurance Contracts
A qualified long-term care insurance contract is an insur- ance 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 diem or other peri- odic 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).
1. Qualified long-term care premiums up to the following amounts.
a. Age 40 or under—$450. b. Age 41 to 50—$850.
c. Age 51 to 60—$1,690. d. Age 61 to 70—$4,520. e. Age 71 or over—$5,640.
2. 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 distribu- tions from a qualified retirement plan made directly to the insurance provider and these distributions would other- wise have been included in your income.
You can include in medical expenses the cost of meals at a hospital or similar institution if a principal reason for be- ing 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.
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 neces- sary to the medical care of you, your spouse, or your de- pendent. 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 re- quest to an attending physician.
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
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individual. You can also include amounts you pay for insu- lin. Except for insulin, you can’t include in medical expen- ses amounts you pay for a drug that isn’t prescribed.
Imported medicines and drugs. If you imported medi- cines or drugs from other countries, see Medicines and Drugs From Other Countries under What Expenses Aren’t Includible, later.
Employment taxes. You can include as a medical ex- pense 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 ex- pense only the amount of employment taxes paid for med- ical services, as explained earlier. For information on em- ployment tax responsibilities of household employers, see Pub. 926.
You can include in medical expenses amounts you pay for legal operations that aren’t for cosmetic surgery. See Cos- metic Surgery under What Expenses Aren’t Includible, later.
See Eyeglasses, earlier. Organ Donors
See Transplants, later. Osteopath
You can include in medical expenses amounts you pay to an osteopath for medical care.
You can include in medical expenses amounts you pay for oxygen and oxygen equipment to relieve breathing prob- lems caused by a medical condition.
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 pre- mium tax credit. You also can’t include in medical expen- ses 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.
You can include in medical expenses the cost of medical care in a nursing home, home for the aged, or similar insti- tution, 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 rea- son 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.
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 serv- ices 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 per- sonal and household services, amounts paid to the at- tendant must be divided between the time spent perform- ing household and personal services and the time spent for nursing services. For example, because of your medi- cal 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 med- ical expenses. The $30 (10% × $300) allocated to house- hold services can’t be included. However, certain mainte- nance 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 indi- vidual 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.
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Example 1. Amy is under age 65 and unmarried. The cost of her health insurance premiums in 2021 is $8,700. Advance payments of the premium tax credit of $4,200 are made to the insurance company and Amy pays premi- ums of $4,500. On her 2021 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 repay- ment limitation). Amy is treated as paying $5,100 ($8,700 less the allowed premium tax credit of $3,600) for health insurance premiums in 2021. When Amy 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 al- lowed premium tax credit of $4,900) for health insurance premiums in 2021. When Amy fills out her Schedule A, she enters $3,800 on line 1.
See Artificial Limb and Breast Reconstruction Surgery, earlier.
education received must be incidental to the special edu- cation 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 condi- tion caused by a birth defect.
You can’t include in medical expenses the cost of send- ing a child with behavioral problems to a school where the course of study and the disciplinary methods have a ben- eficial 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.
You can include in medical expenses the cost of a legal sterilization (a legally performed operation to make a per- son unable to have children). Also see Vasectomy, later.
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.
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.
You can include in medical expenses the cost of equip- ment 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 may also be the part of the cost of a specially equipped televi- sion that exceeds the cost of the same model regular tele- vision set.
You can include in medical expenses amounts you pay for therapy received as medical treatment.
You can include in medical expenses amounts paid for medical care you receive because you are a donor or a
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.
You can include in medical expenses payments for psy- choanalysis. However, you can’t include payments for psychoanalysis that is part of required training to be a psy- choanalyst.
You can include in medical expenses amounts you pay to a psychologist for medical care.
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 disor- ders.
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 dis- abilities. Overcoming the learning disabilities must be the primary reason for attending the school, and any ordinary
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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 donation of an or- gan to you, your spouse, or dependent. This includes 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 treat- ment required by a patient who is traveling to get med- ical care and is unable to travel alone; and
- Transportation expenses for regular visits to see a mentally ill dependent, if these visits are recommen- ded as a part of treatment.
• 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.
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 in- cluded as a medical expense for lodging. Meals aren’t in- cluded. 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.
Under special circumstances, you can include charges for tuition in medical expenses. See Special Education, ear- lier.
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.
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 diag- nosed by a physician (such as obesity, hypertension, or heart disease). This includes fees you pay for member- ship in a weight reduction group as well as fees for attend- ance 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
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, insur- ance, general repair, or maintenance expenses.
If you don’t want to use your actual expenses for 2021, you can use the standard medical mileage rate of 16 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 2021, 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 multi- plies 2,800 miles by 16 cents a mile for a total of $448. He then adds the $100 tolls and parking for a total of $548.
Bill includes the $548 of car expenses with his other medical expenses for the year because the $548 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 re- quires an unusual means of transportation.
- Travel for purely personal reasons to another city for an operation or other medical care.
Publication 502 (2021)
nutritional needs. You can include the cost of special food in medical expenses only if:
1. The food doesn’t satisfy normal nutritional needs,
2. The food alleviates or treats an illness, and
3. The need for the food is substantiated by a physician.
The amount you can include in medical expenses is limi- ted to the amount by which the cost of the special food ex- ceeds the cost of a normal diet. See also Weight-Loss Program under What Expenses Aren’t Includible, later.
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.
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.
You can include in medical expenses amounts you pay for X-rays for medical reasons.
Note: These expenses are taken directly from IRS Publication 502 Updated 2021.