Important Changes
Standard mileage rate.
The standard mileage rate allowed for out-of-pocket expenses for your car when you use your car for medical reasons is now 13 cents a mile. See
Transportation under What Medical Expenses Are Deductible.
Self-employed health insurance deduction rate increase.
For 2002, the rate increased from 60% to 70%.
Obesity as a disease.
The cost of participation in a weight-loss program as a treatment for the disease of obesity is an amount paid for medical care. However, the cost
of purchasing reduced-calorie diet foods is not a medical expense if these foods substitute for food you would normally consume to satisfy your
nutritional requirements. For more information, see Weight-Loss Program under What Medical Expenses are Deductible and under
What Expenses Are Not Deductible.
New health insurance credit.
There is a new credit for health insurance premiums paid by certain workers who are displaced by foreign trade or who are receiving a pension from
the Pension Benefit Guarantee Corporation. For more information, see Health Insurance Credit near the end of this publication.
Important Reminder
Photographs of missing children.
The Internal Revenue Service is a proud partner with the National Center for Missing and Exploited Children. 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 defines medical and dental care expenses. It contains an alphabetical list of items that you can or cannot include in figuring
your deduction. It explains how to treat insurance reimbursements and other reimbursements you may receive for medical care. It also explains how to
claim your medical and dental expense deduction.
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 e-mail us while visiting our web site at
www.irs.gov.
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Internal Revenue Service
Tax Forms and Publications
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1111 Constitution Ave. NW
Washington, DC 20224
We respond to many letters by telephone. Therefore, it would be helpful if you would include your daytime phone number, including the area code, in
your correspondence.
What Is the Definition of Medical Care?
Medical care means amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, and for treatments affecting any part or
function of the body. The medical care expenses must be primarily to alleviate or prevent a physical or mental defect or illness.
Medical care 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 care expenses also include 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, later, 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 on-line 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. You can include medical expenses you
charge to your credit card in the year the charge is made. It does not matter when you actually pay the amount charged.
If you did not claim a medical or dental expense that would have been deductible in an earlier year, you can file Form 1040X, Amended U.S.
Individual Income Tax Return,
for the year in which you overlooked the expense. Do not 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 cannot include medical expenses that were paid by an insurance company 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.
When do you include a decedent's medical expenses?
Medical expenses for a decedent that are paid from his or her estate are treated as paid at the time the medical services were provided if they are
paid within the one-year period beginning with the day after the date of death. See Decedent under Whose Medical Expenses Can You
Include, later.
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.
Qualified medical expenses paid before death by the decedent are not deductible if paid with a tax-free distribution from any Archer MSA or
Medicare+Choice MSA.
How Much of the Expense Can You Deduct?
You can deduct only the amount of your medical and dental expenses that is more than 7.5% of your adjusted gross income (line 36, Form
1040).
In this publication, the term 7.5% limit
is used to refer to 7.5% of your adjusted gross income. The phrase subject to the 7.5% limit is also used.
This phrase means that you must subtract 7.5% (.075) of your adjusted gross income from your medical expenses to figure your medical expense
deduction.
Example.
Your adjusted gross income is $20,000, 7.5% of which is $1,500. You paid medical expenses of $800. You cannot deduct any of your medical expenses
because they are not more than 7.5% of your adjusted gross income.
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, any medical expenses paid out of community funds are divided
equally. Each of you should include half the expenses. If medical expenses are paid out of the separate funds of one spouse, only the spouse who paid
the medical expenses can include them. If you live in a community property state, are married, and file a separate return, see Publication 555,
Community Property.
Whose Medical Expenses Can You Include?
You can include medical expenses you pay for yourself and for the individuals discussed in this section.
Spouse.
You can include medical expenses you paid for your spouse. To claim 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 before she and Bill married, Bill could not 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 incurred the medical expenses, he can include those expenses in figuring his medical deduction for this year.
Dependent.
You can include medical expenses you paid for your dependent. To claim 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:
- That person lived with you for the entire year as a member of your household or is related to you,
- That person was a U.S. citizen or resident, or a resident of Canada or Mexico for some part of the calendar year in which your tax year
began, and
- You provided over half of that person's total support for the calendar year.
You can include the medical expenses of any person who is your dependent even if you cannot claim an exemption for him or her on your return.
Example.
In 2001 your son was your dependent. In 2002 he no longer qualified as your dependent. However, you paid $800 in 2002 for medical expenses your son
incurred in 2001, when he was your dependent. You can include the $800 in figuring your medical expense deduction for 2002. You cannot include this
amount on your 2001 tax return.
Adopted child.
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 back medical expenses incurred and paid before adoption negotiations began, you cannot include them as medical expenses.
You may be able to take a credit or exclusion for other expenses related to adoption. See Publication 968, Tax Benefits for Adoption,
for more information.
Child of divorced or separated parents.
If either parent can claim a child as a dependent under the rules for divorced or separated parents, each parent can include the medical expenses
he or she pays for the child even if an exemption for the child is claimed by the other parent.
Support claimed under a multiple support agreement.
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. If you are considered to have provided more than half of a person's support under such an agreement, you can include medical expenses you pay
for that person, even if you cannot claim the person as a dependent.
Any medical expenses paid by others who joined you in the agreement cannot 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 claim your mother as a
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 cannot 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 amount you paid
for her medical expenses in your medical expenses.
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 one-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 have not been and will not be claimed on the estate tax return.
Qualified medical expenses paid before death by the decedent are not deductible if paid with a tax-free distribution from any Archer MSA or
Medicare+Choice MSA.
What if the decedent's return had been filed and the medical expenses were not included?
Form 1040X can be filed for the year or years the expenses are treated as paid, unless the period for filing an amended return for that year has
passed. 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 2001 income tax return. He died in 2002 with unpaid medical expenses of $1,500 from 2001 and $1,800 in 2002. His survivor
or personal representative can file an amended return for 2001 claiming the $1,500 medical expenses. The $1,800 of medical expenses from 2002 can be
included on the decedent's final return for 2002.
What if you pay medical expenses of a deceased spouse or dependent?
If you paid medical expenses for your deceased spouse or dependent, include them as medical expenses on your Form 1040 in the year paid, whether
they are paid before or after the decedent's death. 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 Deductible?
Following is a list of items that you can include in figuring your medical expense deduction. The items are listed in alphabetical
order.
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 transportation costs you pay to attend meetings of an Alcoholics Anonymous Club in your community if your
attendance is pursuant to medical advice that membership in the Alcoholics Anonymous Club 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.
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.
Autoette
See Wheelchair, later.
Birth Control Pills
You can include in medical expenses the amount you pay for birth control pills prescribed by a doctor.
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.
Capital Expenses
You can include in medical expenses amounts you pay for special equipment installed in your home, or for improvements, if their main purpose is
medical care for you, your spouse, or a dependent. The cost of permanent improvements that increase the value of the property may be partly included
as a medical expense. The cost of the improvement is reduced by the increase in the value of the property. The difference is a medical expense. If the
value of the property is not increased by the improvement, the entire cost is included as a medical expense.
Certain improvements made to accommodate your home to your disabled condition, or that of your spouse or your dependents who live with you, do not
usually increase the value of the home and the cost can be included in full as medical expenses. These improvements include, but are not 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 generally not elevators.
- 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, are not medical expenses.
Capital expense worksheet.
Use Worksheet 1 to figure the amount of your capital expense to include in your medical expenses.
Example.
You have a heart ailment. On your doctor's advice, you install an elevator in your home so that you will not have to climb stairs. The elevator
costs $8,000. An appraisal shows that the elevator increases the value of your home by $4,400. You figure your medical expense as shown in the
illustrated example of Worksheet 1.
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
is so even if none or only part of the original cost of the capital asset qualified as a medical care expense.
Example.
If, in the previous example, the elevator increased the value of your home by $8,000, you would have no medical expense for the cost of the
elevator. However, the cost of electricity to operate the elevator and any costs to maintain it are medical expenses as long as the medical reason for
the elevator exists.
Improvements to property rented by a person with a disability.
Amounts paid by a person with a disability to buy and install special plumbing fixtures, mainly for medical reasons, in a rented house are medical
expenses.
Example.
John has arthritis and a heart condition. He cannot 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 did not pay any of the cost of buying and installing the special plumbing
and did not lower the rent. John can include in medical expenses the entire amount he paid.
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