2023 Publication 502

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Department of the Treasury

Internal Revenue Service

Publication 502

Cat. No. 15002Q

Medical and

Dental

Expenses

For use in preparing

2023 Returns

Get forms and other information faster and easier at:

• IRS.gov (English)

• IRS.gov/Spanish (Español)

•

IRS.gov/Chinese (中文)

•

IRS.gov/Korean (한국어)

• IRS.gov/Russian (Pусский)

• IRS.gov/Vietnamese (Tiếng Việt)

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

Standard mileage rate. The standard mileage rate al-

lowed for operating expenses for a car when you use it for

medical reasons is 22 cents a mile. See Transportation

under What Medical Expenses Are Includible, later.

Reminders

Photographs of missing children. The IRS is a proud

partner with the National Center for Missing & Exploited

Children® (NCMEC). Photographs of missing children se-

lected by the Center may appear in this publication on pa-

ges that would otherwise be blank. You can help bring

these children home by looking at the photographs and

calling 800-THE-LOST (800-843-5678) if you recognize a

child.

Introduction

This publication explains the itemized deduction for medi-

cal and dental expenses that you claim on Schedule A

(Form 1040). It discusses what expenses, and whose ex-

penses, you can and can't include in figuring the deduc-

tion. It explains how to treat reimbursements and how to

figure the deduction. It also tells you how to report the de-

duction on your tax return and what to do if you sell medi-

cal 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 7.5% of your adjusted gross income (AGI).

This publication also explains how to treat impair-

ment-related work expenses and health insurance premi-

ums if you are self-employed.

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 medi-

cal expenses under What Are Medical Expenses, later.

See How To Get Tax Help near the end of this publica-

tion for information about getting publications and forms.

Comments and suggestions. We welcome your com-

ments about this publication and suggestions for future

editions.

You can send us comments through IRS.gov/

FormComments. Or, you can write to the Internal Revenue

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Service, Tax Forms and Publications, 1111 Constitution

Ave. NW, IR-6526, Washington, DC 20224.

Although we can’t respond individually to each com-

ment received, we do appreciate your feedback and will

consider your comments and suggestions as we revise

our tax forms, instructions, and publications. Don’t send

tax questions, tax returns, or payments to the above ad-

dress.

Getting answers to your tax questions. If you have

a tax question not answered by this publication or the How

To Get Tax Help section at the end of this publication, go

to the IRS Interactive Tax Assistant page at IRS.gov/

Help/ITA where you can find topics by using the search

feature or viewing the categories listed.

Getting tax forms, instructions, and publications.

Go to IRS.gov/Forms to download current and prior-year

forms, instructions, and publications.

Ordering tax forms, instructions, and publications.

Go to IRS.gov/OrderForms to order current forms, instruc-

tions, and publications; call 800-829-3676 to order

prior-year forms and instructions. The IRS will process

your order for forms and publications as soon as possible.

Don’t resubmit requests you’ve already sent us. You can

get forms and publications faster online.

Useful Items

You may want to see:

Publication

969 Health Savings Accounts and Other

Tax-Favored Health Plans

Forms (and Instructions)

1040 U.S. Individual Income Tax Return

1040-SR U.S. Tax Return for Seniors

Schedule A (Form 1040) Itemized Deductions

8962 Premium Tax Credit (PTC)

What Are Medical Expenses?

Medical expenses are the costs of diagnosis, cure, mitiga-

tion, treatment, or prevention of disease, and for the pur-

pose of 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 equip-

ment, 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 gen-

eral health, such as vitamins or a vacation.

Medical expenses include the premiums you pay for in-

surance that covers the expenses of medical care, and the

amounts you pay for transportation to get medical care.

969

1040

1040-SR

Schedule A (Form 1040)

8962

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, but generally not payments for medical

or dental care you will receive in a future year. (But see

Decedent under Whose Medical Expenses Can You In-

clude, later, for an exception.) This is not the rule for deter-

mining whether an expense can be reimbursed by a flexi-

ble spending arrangement (FSA). If you pay medical

expenses by check, the day you mail or deliver the check

is generally 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 finan-

cial 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 1040-X, Amended U.S. Individual Income Tax Re-

turn, to claim a refund for the year in which you overlooked

the expense. Don't claim the expense on this year's return.

Generally, a claim for refund 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 non-

community property state and file separate returns, each

of you can include only the medical expenses each ac-

tually 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 re-

turns 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, Community Property.

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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 7.5% 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 differ-

ent 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 medi-

cal services or at the time you paid the medical expenses.

Example 1. Your spouse received medical treatment

before you were married. You paid for the treatment after

getting married. You can include these expenses in figur-

ing your medical expense deduction even if you and your

spouse file separate returns.

If your spouse had paid the expenses, you couldn't in-

clude your spouse’s expenses on your separate return.

The amounts your spouse paid during the year would be

included on their separate return. If you filed a joint return,

the medical expenses both of you paid during the year

would be used to figure the medical expense deduction.

Example 2. This year, you paid medical expenses for

your spouse, Kitt, who died last year. You married Royal

this year and the two of you file a joint return. Because you

were married to Kitt when Kitt received the medical serv-

ices, you can include those expenses in figuring your

medical expense deduction for this year.

Dependent

You can include medical expenses you paid for your de-

pendent. 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.

1. The person was a qualifying child (defined later) or a

qualifying relative (defined later).

2. The person was a U.S. citizen or national or a resident

of the United States, Canada, or Mexico. If your quali-

fying child was adopted, see Exception for adopted

child, later.

You can include medical expenses you paid for an individ-

ual that would have been your dependent except that:

1. The person received gross income of $4,700 or more

in 2023;

2. The person filed a joint return for 2023; or

3. You, or your spouse if filing jointly, could be claimed

as a dependent on someone else's 2023 return.

Exception for adopted child. If you are a U.S. citizen or

national and your adopted child lived with you as a mem-

ber of your household for 2023, 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:

1. 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);

2. Was:

a. Under age 19 at the end of 2023 and younger than

you (or your spouse if filing jointly),

b. Under age 24 at the end of 2023, a full-time stu-

dent, and younger than you (or your spouse if filing

jointly), or

c. Any age and permanently and totally disabled;

3. Lived with you for more than half of 2023;

4. Didn't provide over half of their own support for 2023;

and

5. 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 depend-

ent 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 attrib-

utable 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 nego-

tiations began, you can't include them as medical expen-

ses.

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You may be able to take a credit for other expen-

ses 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 de-

pendent of both parents. Each parent can include the

medical expenses they pay for the child if:

1. The child is in the custody of one or both parents for

more than half the year;

2. The child receives over half of the child’s support dur-

ing the year from the parents; and

3. The child's parents:

a. Are divorced or legally separated under a decree

of divorce or separate maintenance,

b. Are separated under a written separation agree-

ment, or

c. Live apart at all times during the last 6 months of

the year.

This doesn't apply if the child's dependency is being

claimed under a multiple support agreement (discussed

later).

Qualifying Relative

A qualifying relative is a person:

1. Who is your:

a. Son, daughter, stepchild, or foster child, or a de-

scendant of any of them (for example, your grand-

child),

b. Brother, sister, half brother, half sister, or a son or

daughter of any of them,

c. Father, mother, or an ancestor or sibling of either

of them (for example, your grandmother, grandfa-

ther, aunt, or uncle),

d. Stepbrother, stepsister, stepfather, stepmother,

son-in-law, daughter-in-law, father-in-law,

mother-in-law, brother-in-law, or sister-in-law, or

e. Any other person (other than your spouse) who

lived with you all year as a member of your house-

hold if your relationship didn't violate local law,

2. Who wasn't a qualifying child (see Qualifying Child,

earlier) of any taxpayer for 2023, and

3. For whom you provided over half of the support in

2023. But see Child of divorced or separated parents,

earlier, Support claimed under a multiple support

agreement next, and Kidnapped child under Qualify-

ing Relative in Pub. 501, Dependents, Standard De-

duction, and Filing Information.

Support claimed under a multiple support agree-

ment. If you are considered to have provided more than

TIP

half of a qualifying relative's support under a multiple sup-

port 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 per-

son'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 unreim-

bursed amount you paid for medical expenses.

Example. You and your three siblings each provide

one-fourth of your parent’s total support. Under a multiple

support agreement, you treat your parent as your depend-

ent. You paid all of your parent’s medical expenses. Your

siblings repaid you for three-fourths of these expenses. In

figuring your medical expense deduction, you can include

only one-fourth of your parent’s medical expenses. Your

siblings can't include any part of the expenses. However, if

you and your siblings share the nonmedical support items

and you separately pay all of your parent’s medical expen-

ses, you can include the unreimbursed amount you paid

for your parent’s medical expenses in your medical expen-

ses.

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 de-

pendents as well as for the decedent.

The survivor or personal representative of a decedent

can choose to treat certain expenses paid by the dece-

dent's estate for the decedent's medical care as paid by

the decedent at the time the medical services were provi-

ded. 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 1040-SR (or the decedent's amended return, Form

1040-X) 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, Medi-

care Advantage MSA, or health savings account.

What if the decedent's return had been filed and the

medical expenses weren't included? Form 1040-X

can be filed for the year or years the expenses are treated

as paid, unless the period for claiming a refund has

passed. Generally, a claim for refund 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. Hudson properly filed a 2022 income tax re-

turn. Hudson died in 2023 with unpaid medical expenses

of $1,500 from 2022 and $1,800 in 2023. If the expenses

are paid within the 1-year period, Hudson’s survivor or

CAUTION

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personal representative can file an amended return for

2022 claiming a deduction based on the $1,500 medical

expenses. The $1,800 of medical expenses from 2023

can be included on the decedent's final return for 2023.

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 dece-

dent's death. The expenses can be included if the person

was your spouse or dependent either at the time the medi-

cal services were provided or at the time you paid the ex-

penses.

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 alcohol recovery sup-

port organization (for example, Alcoholics Anonymous)

meetings in your community if the attendance is pursuant

to competent medical advice that membership in the alco-

hol recovery support organization is necessary for the

treatment of a disease involving the excessive use of alco-

hol.

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 elec-

tronic 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 im-

paired 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 in-

clude 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 pros-

thesis, 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 improve-

ments, if their main purpose is medical care for you, your

spouse, or your dependent. The cost of permanent im-

provements 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

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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 equip-

ment.

•

Moving or modifying electrical outlets and fixtures.

•

Installing porch lifts and other forms of lifts (but eleva-

tors 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 door-

ways.

•

Grading the ground to provide access to the resi-

dence.

Only reasonable costs to accommodate a home to your

disabled condition are considered medical care. Addi-

tional 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.

Capital Expense

Worksheet

Worksheet A.

Keep for Your Records

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 ...............

3. Enter the value of your home

immediately before the

improvement ...............

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 plumb-

ing fixtures for a person with a disability, mainly for medi-

cal reasons, in a rented house are medical expenses.

Example. You have arthritis and a heart condition. You

can't climb stairs or get into a bathtub. On the doctor's ad-

vice, you install a bathroom with a shower stall on the first

floor of your 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. You can include the

entire amount you paid as medical expenses.

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.

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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. Pre-

ventive treatment includes the services of a dental hygien-

ist 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, fil-

lings, braces, extractions, dentures, and other dental ail-

ments. 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 expen-

ses.

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 Depend-

ent 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 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 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 compe-

tent medical advice that the membership is necessary for

the treatment of a disease involving the excessive use of

drugs.

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 rea-

sons. 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 fol-

lowing procedures performed on yourself, your spouse, or

your dependent to overcome an inability to have children.

•

Procedures such as in vitro fertilization (including tem-

porary storage of eggs or sperm).

•

Surgery, including an operation to reverse prior sur-

gery that prevented the person operated on from hav-

ing children.

But see Surrogacy Expenses under What Expenses

Aren’t Includible, later.

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 ani-

mal to assist a visually impaired or hearing disabled per-

son, or a person with other physical disabilities. In general,

this includes any costs, such as food, grooming, and

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veterinary care, incurred in maintaining the health and vi-

tality 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 pre-

scribed by a physician and the physician issues a state-

ment 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 medi-

cal 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 op-

erate 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 in-

clude 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 medi-

cal 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.

Employer-Sponsored Health Insurance Plan

Don't include in your medical and dental expenses any in-

surance 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 sal-

ary. Because you are an employee whose insurance pre-

miums 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 re-

ported as wages on your Form W-2.

Retired public safety officers. If you are a retired pub-

lic 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 re-

tirement 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 ex-

penses 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 Medi-

care 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 Social

Security Administration to find out your premium.

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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.

Personal Protective Equipment

You can include in medical expenses the amounts you pay

for personal protective equipment, such as masks, hand

sanitizer and hand sanitizing wipes, for the primary pur-

pose of preventing the spread of Coronavirus Disease

2019 (COVID-19). For more information, see IRS An-

nouncement 2021-7.

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 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 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 $4,700 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 2023 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 disabled

in a special home, not the home of a relative, on the rec-

ommendation 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 crack-

ing) or within the child's reach. The cost of repainting the

scraped area isn't a medical expense.

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If, instead of removing the paint, you cover the area with

wallboard or paneling, treat these items as capital expen-

ses. 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 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

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.

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 institu-

tion. You can include the cost of such lodging while away

from home if all of the following requirements are met.

1. The lodging is primarily for and essential to medical

care.

2. 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.

3. The lodging isn't lavish or extravagant under the cir-

cumstances.

4. 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 per-

son 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.

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 re-

lated 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 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:

1. Required by a chronically ill individual, and

2. 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.

1. The individual is unable to perform at least two activi-

ties 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 conti-

nence.

2. The individual requires substantial supervision to be

protected from threats to health and safety due to se-

vere 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 the individual’s disabilities

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(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 insur-

ance contract that provides only coverage of qualified

long-term care services. The contract must:

1. Be guaranteed renewable;

2. Not provide for a cash surrender value or other money

that can be paid, assigned, pledged, or borrowed;

3. 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

4. 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—$480.

b. Age 41 to 50—$890.

c. Age 51 to 60—$1,790.

d. Age 61 to 70—$4,770.

e. Age 71 or over—$5,960.

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.

Meals

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.

Medical Conferences

You can include in medical expenses amounts paid for ad-

mission and transportation to a medical conference if the

medical conference concerns the chronic illness of your-

self, 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 depend-

ent. 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.

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 in-

dividual. 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 medi-

cines 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 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.

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 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 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 med-

ical and household services. Ten percent of the nurse’s

time is spent doing household services such as washing

dishes and laundry. You can include only $270 per week

CAUTION

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as medical expenses. The $30 (10% × $300) allocated to

household services can't be included. However, certain

maintenance or personal care services provided for quali-

fied 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 individ-

ual 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 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.

Operations

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.

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 prob-

lems 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 ex-

amination.

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.

Example 1. You are under age 65 and unmarried. The

cost of your health insurance premiums in 2023 is $8,700.

Advance payments of the premium tax credit of $4,200

are made to the insurance company and you pay premi-

ums of $4,500. On your 2023 tax return, you are allowed a

premium tax credit of $3,600 and must repay $600 excess

advance credit payments (which is less than the repay-

ment limitation). You are treated as paying $5,100 ($8,700

less the allowed premium tax credit of $3,600) for health

insurance premiums in 2023. You will enter $5,100 on

Schedule A, line 1.

Example 2. The facts are the same as in Example 1,

except you are allowed a premium tax credit of $4,900 on

your tax return and receive a net premium tax credit of

$700. You are treated as paying $3,800 ($8,700 less the

allowed premium tax credit of $4,900) for health insurance

premiums in 2023. You will enter $3,800 on Schedule A,

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 psy-

choanalysis. However, you can't include payments for psy-

choanalysis that is part of required training to be a psycho-

analyst.

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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 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

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 med-

ical 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 per-

son 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 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.

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

the cost of medical care for the donor, in connection with

the donation of an organ to you, your spouse, or depend-

ent. This also includes transportation expenses.

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.

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 2023,

you can use the standard medical mileage rate of 22 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 2023, you drove 2,800 miles for medical

reasons. You spent $400 for gas, $30 for oil, and $100 for

tolls and parking. You want to figure the amount to include

in medical expenses both ways to see which gives the

greater deduction.

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You figure the actual expenses first. You add the $400

for gas, the $30 for oil, and the $100 for tolls and parking

for a total of $530.

You then figure the standard mileage amount. You mul-

tiply 2,800 miles by 22 cents a mile for a total of $616.

Then you add the $100 tolls and parking and mileage for a

total of $716 (616 + 100).

You include the $716 of car expenses with the other

medical expenses for the year because the $716 is more

than the $530 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.

•

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 trav-

eling with a sick child, up to $100 per night can be inclu-

ded as a medical expense for lodging. Meals aren't inclu-

ded. 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, 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.

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 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 nutri-

tional 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.

Wheelchair

You can include in medical expenses the amounts you pay

for a wheelchair used for the relief of a sickness or disabil-

ity. 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 pur-

chased upon the advice of a physician for the mental

health of a patient who has lost all of their hair from dis-

ease.

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.

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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 sub-

stances are legalized by state law.

Cosmetic Surgery

Generally, you can't include in medical expenses the

amount you pay for cosmetic surgery. This includes any

procedure that is directed at improving the patient's ap-

pearance 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 de-

formity arising from, or directly related to, a congenital ab-

normality, a personal injury resulting from an accident or

trauma, or a disfiguring disease.

Example. An individual undergoes surgery that re-

moves a breast as part of treatment for cancer. The indi-

vidual pays a surgeon to reconstruct the breast. The sur-

gery to reconstruct the breast corrects a deformity directly

related to the disease. The cost of the surgery is includible

in the individual’s medical expenses.

Dancing Lessons

You can't include in medical expenses the cost of dancing

lessons, swimming lessons, etc., even if they are recom-

mended 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 Arrangement

You can't include in medical expenses amounts for which

you are fully reimbursed by your flexible spending

arrangement 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

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, as

explained under Lifetime Care—Advance Payments, or

qualified long-term care insurance contracts, as explained

under Long-Term Care, earlier.

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 mem-

bership in any club organized for business, pleasure, rec-

reation, or other social purpose.

Health Savings Accounts

You can’t include in medical expenses amounts you con-

tribute to a health savings account. You can’t include ex-

penses you pay for with a tax-free distribution from your

health savings account. You also can’t use other funds

equal to the amount of the distribution and include the ex-

penses. For more information, see Pub. 969.

Household Help

You can't include in medical expenses the cost of house-

hold 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 per-

son providing nursing-type services. For more information,

see Nursing Services, earlier, under What Medical Expen-

ses 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

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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 con-

tribute 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 informa-

tion 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 and ship-

ped) 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 indi-

viduals.

You can include the cost of a prescribed drug you pur-

chase 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. A prescri-

bed drug is one that requires a prescription by a doctor for

its use by an individual.

Example. Your doctor recommends that you take as-

pirin. Because aspirin is a drug that doesn't require a

physician's prescription for its use by an individual, you

can't include its cost in your medical expenses.

Nutritional Supplements

You can't include in medical expenses the cost of nutri-

tional supplements, vitamins, herbal supplements, “natural

medicines,” etc., unless they are recommended by a med-

ical practitioner as treatment for a specific medical condi-

tion 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 un-

less 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 ex-

pense.

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 spe-

cial form over the cost of the item in normal form as a

medical expense. See Braille Books and Magazines un-

der What Medical Expenses Are Includible, earlier.

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.

Surrogacy Expenses

You can't include in medical expenses the amounts you

pay for the identification, retention, compensation, and

medical care of a gestational surrogate because they are

paid for an unrelated party who is not you, your spouse, or

your dependent.

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 Animal un-

der 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, hyper-

tension, or heart disease). If the weight-loss treatment isn't

for a specific disease diagnosed by a physician, you can't

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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 nutri-

tional needs.

See Weight-Loss Program under What Medical Expen-

ses 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 insur-

ance or other reimbursement.

Insurance Reimbursement

You must reduce your total medical expenses for the year

by all reimbursements for medical expenses that you re-

ceive 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 re-

ceive from that policy to reduce your total medical expen-

ses, 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 deduc-

tion, you must reduce the total amount you spent for medi-

cal care by the total amount of insurance you received,

even if the policies don't cover some of your medical ex-

penses.

Health reimbursement arrangement (HRA). An HRA

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 in-

cluded 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 disfig-

urement to the extent the payment is based on the na-

ture 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 reim-

bursement is taxable.

Figure 1.

*See Premiums paid by you and your employer.

Was any part of

your premiums

paid by your

employer?

Were your

employer’s

contributions to

your premiums

included in your

income?

Did you pay any

part of the

premiums?

NONE of the

excess

reimbursement is

taxable.

ALL of the excess

reimbursement is

taxable.

PART of the

excess

reimbursement is

taxable.*

䊴

䊳

䊲

Yes

䊲

䊳

Is Your Excess Medical

Reimbursement Taxable?

Premiums paid by you. If you pay either the entire pre-

mium 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 $420 a day ($153,300 for

2023) for qualified long-term care services.

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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 cov-

ered under more than one policy, see More than one pol-

icy, later.

Excess Reimbursement

Includible in Income

When You Have Only

One Policy

Worksheet B.

Keep for Your Records

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 ...............

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 or 1040-SR ........... 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 in-

cluded 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 med-

ical expenses among the policies to figure the excess re-

imbursement 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 reim-

bursement 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 Work-

sheet C. Use Worksheet C only if both you and your em-

ployer 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.

Excess Reimbursement

Includible in Income

When You Have More

Than One Policy

Worksheet C.

Keep for Your Records

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 ....................

4. Divide line 1 by line 3 ................

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 ...............

7. Subtract line 6 from line 1 .............

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 or 1040-SR ......

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 must generally report

the reimbursement as income up to the amount you previ-

ously deducted as medical expenses.

However, don't report as income the amount of reim-

bursement 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.

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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

7.5% of your AGI or because you didn't itemize deduc-

tions, 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 Re-

imbursement Is More Than Your Medical Expenses, ear-

lier.

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 Sched-

ule A (Form 1040). 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 de-

duction. 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 7.5% or 10% AGI limit used to figure your medical de-

duction. Refer to your Schedule A for the year the cost

was included to determine which limit applied to you. Use

Worksheet D to figure the adjusted basis of the equipment

or property.

RECORDS

Adjusted Basis of

Medical Equipment or

Property Sold

Worksheet D.

Keep for Your Records

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 ............

4. Enter 7.5% or 10% of your AGI

(whichever applies) 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 ........

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 ............

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.

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Gain or Loss on the

Sale of Medical

Equipment or Property

Worksheet E.

Keep for Your Records

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 ......

2. Enter your selling expenses .........

3. Subtract line 2 from line 1 ...........

4. Enter the adjusted basis of the

equipment or property from Worksheet

D, line 5, or line 12, if applicable ......

5. Subtract line 4 from line 3. This is the

total gain or loss from the sale of the

medical equipment or property ......

If you have a loss, it isn't deductible. If you have a gain,

it’s 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 or 1040-SR.

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 ex-

tent 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 Reim-

bursements.

Example. You sued this year for injuries you suffered

in an accident last year. You sought $10,000 for your inju-

ries 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 item-

ize 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 inju-

ries 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' com-

pensation 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 expen-

ses related to that injury, don't include the workers' com-

pensation in your income.

Impairment-Related Work

Expenses

If you are a person with disabilities, you can take a busi-

ness 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 7.5% 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 em-

ployed; 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-re-

lated expenses are those ordinary and necessary busi-

ness 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,

E, or F) used to report your business income and expen-

ses.

If you are an employee, complete Form 2106, Em-

ployee Business Expenses. Enter on Schedule A (Form

1040) that part of the amount on Form 2106 that is related

to your impairment.

Example. You are blind. You must use a reader to do

your work. You use the reader both during your regular

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working hours at your place of work and outside your reg-

ular 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 in-

surance on behalf of yourself, your spouse, your depend-

ents, and your children who were under age 27 at the end

of 2023. For this purpose, you were self-employed if you

were a general partner (or a limited partner receiving guar-

anteed payments) or you received wages from an S cor-

poration 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 2023. You can't deduct pay-

ments 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 em-

ployer or your spouse's employer.

If you qualify to take the deduction, use the Self-Em-

ployed Health Insurance Deduction Worksheet in the In-

structions for Form 1040 to figure the amount you can de-

duct. 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.

•

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 Form 7206, Self-Employed Health Deduction,

to figure your deduction.

Use Pub. 974, Premium Tax Credit, instead of the work-

sheet in the 2023 Instructions for Form 1040 if the insur-

ance plan established, or considered to be established,

under your business was obtained through the Health In-

surance 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 insur-

ance 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

or 1040-SR. If you itemize your deductions and don't claim

100% of your self-employed health insurance costs on

Form 1040 or 1040-SR, include any remaining premiums

with all other medical expenses on Schedule A (Form

1040) subject to the 7.5% limit.

Child under age 27. If the insurance policy covers your

nondependent child who was under age 27 at the end of

2023, you can claim the premiums for that coverage on

Form 1040 or 1040-SR. If you can't claim 100% of your

self-employed health insurance costs on Form 1040 or

1040-SR, 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 in-

crease if coverage for an additional child is added. If this is

the situation, no allocation would be necessary. If the pre-

miums did increase (such as where coverage was expan-

ded from single to family to add the nondependent child),

you can allocate the amount on Form 1040 or 1040-SR to

the nondependent child and any excess amounts not at-

tributable to that child would be eligible to be claimed on

Schedule A.

Example 1. You were self-employed in 2023 and had

self-only coverage for health insurance. Your premium for

that coverage was $5,000 for the year. You change to fam-

ily coverage only to add your 26-year-old nondependent

child to the plan. Your health insurance premium increases

to $10,000 for the year. After completing the Self-Em-

ployed Health Insurance Deduction Worksheet in the In-

structions for Form 1040, you can only deduct $4,000 on

Form 1040 or 1040-SR. The $4,000 is allocable to the

nondependent child. You can only claim the $5,000 allo-

cable to your coverage on Schedule A. The $1,000 excess

premiums allocable to the nondependent child can’t be

claimed by you.

Example 2. The facts are the same as in Example 1,

except that you had family coverage when you added your

26-year-old nondependent child to the policy. There was

no increase in the $10,000 premium. In this case, you

could claim $4,000 on Form 1040 or 1040-SR and $6,000

on Schedule A.

More information. For more information, see Pub. 535.

How To Get Tax Help

If you have questions about a tax issue; need help prepar-

ing your tax return; or want to download free publications,

forms, or instructions, go to IRS.gov to find resources that

can help you right away.

Preparing and filing your tax return. After receiving all

your wage and earnings statements (Forms W-2, W-2G,

1099-R, 1099-MISC, 1099-NEC, etc.); unemployment

compensation statements (by mail or in a digital format) or

other government payment statements (Form 1099-G);

and interest, dividend, and retirement statements from

banks and investment firms (Forms 1099), you have sev-

eral options to choose from to prepare and file your tax re-

turn. You can prepare the tax return yourself, see if you

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qualify for free tax preparation, or hire a tax professional to

prepare your return.

Free options for tax preparation. Your options for pre-

paring and filing your return online or in your local com-

munity, if you qualify, include the following.

•

Free File. This program lets you prepare and file your

federal individual income tax return for free using soft-

ware or Free File Fillable Forms. However, state tax

preparation may not be available through Free File. Go

to IRS.gov/FreeFile to see if you qualify for free online

federal tax preparation, e-filing, and direct deposit or

payment options.

•

VITA. The Volunteer Income Tax Assistance (VITA)

program offers free tax help to people with

low-to-moderate incomes, persons with disabilities,

and limited-English-speaking taxpayers who need

help preparing their own tax returns. Go to IRS.gov/

VITA, download the free IRS2Go app, or call

800-906-9887 for information on free tax return prepa-

ration.

•

TCE. The Tax Counseling for the Elderly (TCE) pro-

gram offers free tax help for all taxpayers, particularly

those who are 60 years of age and older. TCE volun-

teers specialize in answering questions about pen-

sions and retirement-related issues unique to seniors.

Go to IRS.gov/TCE or download the free IRS2Go app

for information on free tax return preparation.

•

MilTax. Members of the U.S. Armed Forces and quali-

fied veterans may use MilTax, a free tax service of-

fered by the Department of Defense through Military

OneSource. For more information, go to

MilitaryOneSource (MilitaryOneSource.mil/MilTax).

Also, the IRS offers Free Fillable Forms, which can

be completed online and then e-filed regardless of in-

come.

Using online tools to help prepare your return. Go to

IRS.gov/Tools for the following.

•

The Earned Income Tax Credit Assistant (IRS.gov/

EITCAssistant) determines if you’re eligible for the

earned income credit (EIC).

•

The Online EIN Application (IRS.gov/EIN) helps you

get an employer identification number (EIN) at no

cost.

•

The Tax Withholding Estimator (IRS.gov/W4App)

makes it easier for you to estimate the federal income

tax you want your employer to withhold from your pay-

check. This is tax withholding. See how your withhold-

ing affects your refund, take-home pay, or tax due.

•

The First-Time Homebuyer Credit Account Look-up

(IRS.gov/HomeBuyer) tool provides information on

your repayments and account balance.

•

The Sales Tax Deduction Calculator (IRS.gov/

SalesTax) figures the amount you can claim if you

itemize deductions on Schedule A (Form 1040).

Getting answers to your tax questions. On

IRS.gov, you can get up-to-date information on

current events and changes in tax law.

•

IRS.gov/Help: A variety of tools to help you get an-

swers to some of the most common tax questions.

•

IRS.gov/ITA: The Interactive Tax Assistant, a tool that

will ask you questions and, based on your input, pro-

vide answers on a number of tax topics.

•

IRS.gov/Forms: Find forms, instructions, and publica-

tions. You will find details on the most recent tax

changes and interactive links to help you find answers

to your questions.

•

You may also be able to access tax information in your

e-filing software.

Need someone to prepare your tax return? There are

various types of tax return preparers, including enrolled

agents, certified public accountants (CPAs), accountants,

and many others who don’t have professional credentials.

If you choose to have someone prepare your tax return,

choose that preparer wisely. A paid tax preparer is:

•

Primarily responsible for the overall substantive accu-

racy of your return,

•

Required to sign the return, and

•

Required to include their preparer tax identification

number (PTIN).

Although the tax preparer always signs the return,

you're ultimately responsible for providing all the

information required for the preparer to accurately

prepare your return and for the accuracy of every item re-

ported on the return. Anyone paid to prepare tax returns

for others should have a thorough understanding of tax

matters. For more information on how to choose a tax pre-

parer, go to Tips for Choosing a Tax Preparer on IRS.gov.

Employers can register to use Business Services On-

line. The Social Security Administration (SSA) offers on-

line service at SSA.gov/employer for fast, free, and secure

W-2 filing options to CPAs, accountants, enrolled agents,

and individuals who process Form W-2, Wage and Tax

Statement, and Form W-2c, Corrected Wage and Tax

Statement.

IRS social media. Go to IRS.gov/SocialMedia to see the

various social media tools the IRS uses to share the latest

information on tax changes, scam alerts, initiatives, prod-

ucts, and services. At the IRS, privacy and security are our

highest priority. We use these tools to share public infor-

mation with you. Don’t post your social security number

(SSN) or other confidential information on social media

sites. Always protect your identity when using any social

networking site.

The following IRS YouTube channels provide short, in-

formative videos on various tax-related topics in English,

Spanish, and ASL.

•

Youtube.com/irsvideos.

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•

Youtube.com/irsvideosmultilingua.

•

Youtube.com/irsvideosASL.

Watching IRS videos. The IRS Video portal

(IRSVideos.gov) contains video and audio presentations

for individuals, small businesses, and tax professionals.

Online tax information in other languages. You can

find information on IRS.gov/MyLanguage if English isn’t

your native language.

Free Over-the-Phone Interpreter (OPI) Service. The

IRS is committed to serving taxpayers with limited-English

proficiency (LEP) by offering OPI services. The OPI Serv-

ice is a federally funded program and is available at Tax-

payer Assistance Centers (TACs), most IRS offices, and

every VITA/TCE tax return site. The OPI Service is acces-

sible in more than 350 languages.

Accessibility Helpline available for taxpayers with

disabilities. Taxpayers who need information about ac-

cessibility services can call 833-690-0598. The Accessi-

bility Helpline can answer questions related to current and

future accessibility products and services available in al-

ternative media formats (for example, braille, large print,

audio, etc.). The Accessibility Helpline does not have ac-

cess to your IRS account. For help with tax law, refunds, or

account-related issues, go to IRS.gov/LetUsHelp.

Note. Form 9000, Alternative Media Preference, or

Form 9000(SP) allows you to elect to receive certain types

of written correspondence in the following formats.

•

Standard Print.

•

Large Print.

•

Braille.

•

Audio (MP3).

•

Plain Text File (TXT).

•

Braille Ready File (BRF).

Disasters. Go to IRS.gov/DisasterRelief to review the

available disaster tax relief.

Getting tax forms and publications. Go to IRS.gov/

Forms to view, download, or print all of the forms, instruc-

tions, and publications you may need. Or, you can go to

IRS.gov/OrderForms to place an order.

Getting tax publications and instructions in eBook

format. Download and view popular tax publications and

instructions (including the Instructions for Form 1040) on

mobile devices as eBooks at IRS.gov/eBooks.

Note. IRS eBooks have been tested using Apple's

iBooks for iPad. Our eBooks haven’t been tested on other

dedicated eBook readers, and eBook functionality may

not operate as intended.

Access your online account (individual taxpayers

only). Go to IRS.gov/Account to securely access infor-

mation about your federal tax account.

•

View the amount you owe and a breakdown by tax

year.

•

See payment plan details or apply for a new payment

plan.

•

Make a payment or view 5 years of payment history

and any pending or scheduled payments.

•

Access your tax records, including key data from your

most recent tax return, and transcripts.

•

View digital copies of select notices from the IRS.

•

Approve or reject authorization requests from tax pro-

fessionals.

•

View your address on file or manage your communica-

tion preferences.

Get a transcript of your return. With an online ac-

count, you can access a variety of information to help you

during the filing season. You can get a transcript, review

your most recently filed tax return, and get your adjusted

gross income. Create or access your online account at

IRS.gov/Account.

Tax Pro Account. This tool lets your tax professional

submit an authorization request to access your individual

taxpayer IRS online account. For more information, go to

IRS.gov/TaxProAccount.

Using direct deposit. The safest and easiest way to re-

ceive a tax refund is to e-file and choose direct deposit,

which securely and electronically transfers your refund di-

rectly into your financial account. Direct deposit also

avoids the possibility that your check could be lost, stolen,

destroyed, or returned undeliverable to the IRS. Eight in

10 taxpayers use direct deposit to receive their refunds. If

you don’t have a bank account, go to IRS.gov/

DirectDeposit for more information on where to find a bank

or credit union that can open an account online.

Reporting and resolving your tax-related identity

theft issues.

•

Tax-related identity theft happens when someone

steals your personal information to commit tax fraud.

Your taxes can be affected if your SSN is used to file a

fraudulent return or to claim a refund or credit.

•

The IRS doesn’t initiate contact with taxpayers by

email, text messages (including shortened links), tele-

phone calls, or social media channels to request or

verify personal or financial information. This includes

requests for personal identification numbers (PINs),

passwords, or similar information for credit cards,

banks, or other financial accounts.

•

Go to IRS.gov/IdentityTheft, the IRS Identity Theft

Central webpage, for information on identity theft and

data security protection for taxpayers, tax professio-

nals, and businesses. If your SSN has been lost or

stolen or you suspect you’re a victim of tax-related

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identity theft, you can learn what steps you should

take.

•

Get an Identity Protection PIN (IP PIN). IP PINs are

six-digit numbers assigned to taxpayers to help pre-

vent the misuse of their SSNs on fraudulent federal in-

come tax returns. When you have an IP PIN, it pre-

vents someone else from filing a tax return with your

SSN. To learn more, go to IRS.gov/IPPIN.

Ways to check on the status of your refund.

•

Go to IRS.gov/Refunds.

•

Download the official IRS2Go app to your mobile de-

vice to check your refund status.

•

Call the automated refund hotline at 800-829-1954.

The IRS can’t issue refunds before mid-February

for returns that claimed the EIC or the additional

child tax credit (ACTC). This applies to the entire

refund, not just the portion associated with these credits.

Making a tax payment. Payments of U.S. tax must be

remitted to the IRS in U.S. dollars. Digital assets are not

accepted. Go to IRS.gov/Payments for information on how

to make a payment using any of the following options.

•

IRS Direct Pay: Pay your individual tax bill or estimated

tax payment directly from your checking or savings ac-

count at no cost to you.

•

Debit Card, Credit Card, or Digital Wallet: Choose an

approved payment processor to pay online or by

phone.

•

Electronic Funds Withdrawal: Schedule a payment

when filing your federal taxes using tax return prepara-

tion software or through a tax professional.

•

Electronic Federal Tax Payment System: Best option

for businesses. Enrollment is required.

•

Check or Money Order: Mail your payment to the ad-

dress listed on the notice or instructions.

•

Cash: You may be able to pay your taxes with cash at

a participating retail store.

•

Same-Day Wire: You may be able to do same-day

wire from your financial institution. Contact your finan-

cial institution for availability, cost, and time frames.

Note. The IRS uses the latest encryption technology to

ensure that the electronic payments you make online, by

phone, or from a mobile device using the IRS2Go app are

safe and secure. Paying electronically is quick, easy, and

faster than mailing in a check or money order.

What if I can’t pay now? Go to IRS.gov/Payments for

more information about your options.

•

Apply for an online payment agreement (IRS.gov/

OPA) to meet your tax obligation in monthly install-

ments if you can’t pay your taxes in full today. Once

you complete the online process, you will receive im-

mediate notification of whether your agreement has

been approved.

CAUTION

•

Use the Offer in Compromise Pre-Qualifier to see if

you can settle your tax debt for less than the full

amount you owe. For more information on the Offer in

Compromise program, go to IRS.gov/OIC.

Filing an amended return. Go to IRS.gov/Form1040X

for information and updates.

Checking the status of your amended return. Go to

IRS.gov/WMAR to track the status of Form 1040-X amen-

ded returns.

It can take up to 3 weeks from the date you filed

your amended return for it to show up in our sys-

tem, and processing it can take up to 16 weeks.

Understanding an IRS notice or letter you’ve re-

ceived. Go to IRS.gov/Notices to find additional informa-

tion about responding to an IRS notice or letter.

Responding to an IRS notice or letter. You can now

upload responses to all notices and letters using the

Document Upload Tool. For notices that require additional

action, taxpayers will be redirected appropriately on

IRS.gov to take further action. To learn more about the

tool, go to IRS.gov/Upload.

Note. You can use Schedule LEP (Form 1040), Re-

quest for Change in Language Preference, to state a pref-

erence to receive notices, letters, or other written commu-

nications from the IRS in an alternative language. You may

not immediately receive written communications in the re-

quested language. The IRS’s commitment to LEP taxpay-

ers is part of a multi-year timeline that began providing

translations in 2023. You will continue to receive communi-

cations, including notices and letters, in English until they

are translated to your preferred language

Contacting your local TAC. Keep in mind, many ques-

tions can be answered on IRS.gov without visiting a TAC.

Go to IRS.gov/LetUsHelp for the topics people ask about

most. If you still need help, TACs provide tax help when a

tax issue can’t be handled online or by phone. All TACs

now provide service by appointment, so you’ll know in ad-

vance that you can get the service you need without long

wait times. Before you visit, go to IRS.gov/TACLocator to

find the nearest TAC and to check hours, available serv-

ices, and appointment options. Or, on the IRS2Go app,

under the Stay Connected tab, choose the Contact Us op-

tion and click on “Local Offices.”

The Taxpayer Advocate Service (TAS)

Is Here To Help You

What Is TAS?

TAS is an independent organization within the IRS that

helps taxpayers and protects taxpayer rights. Their job is

to ensure that every taxpayer is treated fairly and that you

know and understand your rights under the Taxpayer Bill

of Rights.

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How Can You Learn About Your Taxpayer

Rights?

The Taxpayer Bill of Rights describes 10 basic rights that

all taxpayers have when dealing with the IRS. Go to

TaxpayerAdvocate.IRS.gov to help you understand what

these rights mean to you and how they apply. These are

your rights. Know them. Use them.

What Can TAS Do for You?

TAS can help you resolve problems that you can’t resolve

with the IRS. And their service is free. If you qualify for

their assistance, you will be assigned to one advocate

who will work with you throughout the process and will do

everything possible to resolve your issue. TAS can help

you if:

•

Your problem is causing financial difficulty for you,

your family, or your business;

•

You face (or your business is facing) an immediate

threat of adverse action; or

•

You’ve tried repeatedly to contact the IRS but no one

has responded, or the IRS hasn’t responded by the

date promised.

How Can You Reach TAS?

TAS has offices in every state, the District of Columbia,

and Puerto Rico. To find your advocate’s number:

•

Go to TaxpayerAdvocate.IRS.gov/Contact-Us;

•

Download Pub. 1546, The Taxpayer Advocate Service

Is Your Voice at the IRS, available at IRS.gov/pub/irs-

pdf/p1546.pdf;

•

Call the IRS toll free at 800-TAX-FORM

(800-829-3676) to order a copy of Pub. 1546;

•

Check your local directory; or

•

Call TAS toll free at 877-777-4778.

How Else Does TAS Help Taxpayers?

TAS works to resolve large-scale problems that affect

many taxpayers. If you know of one of these broad issues,

report it to TAS at IRS.gov/SAMS. Be sure to not include

any personal taxpayer information.

Low Income Taxpayer Clinics (LITCs)

LITCs are independent from the IRS and TAS. LITCs rep-

resent individuals whose income is below a certain level

and who need to resolve tax problems with the IRS. LITCs

can represent taxpayers in audits, appeals, and tax collec-

tion disputes before the IRS and in court. In addition,

LITCs can provide information about taxpayer rights and

responsibilities in different languages for individuals who

speak English as a second language. Services are offered

for free or a small fee. For more information or to find an

LITC near you, go to the LITC page at

TaxpayerAdvocate.IRS.gov/LITC or see IRS Pub. 4134,

Low Income Taxpayer Clinic List, at IRS.gov/pub/irs-pdf/

p4134.pdf.

To help us develop a more useful index, please let us know if you have ideas for index entries.

See “Comments and Suggestions” in the “Introduction” for the ways you can reach us.

Index

Abortion 5

Acupuncture 5

Adopted child's medical

expenses 3

AGI limitation 1, 2

Alcoholism 5

Ambulances 5

Archer MSAs:

Medical expenses paid for decedent

from 4

Artificial limbs 5

Artificial teeth 5

Aspirin 16

Assistance (See Tax help)

Assisted living homes 11

Athletic club dues 15

Automobiles (See Cars)

Baby sitting 15

Bandages 5

Basis:

Medical equipment or property

(Worksheet D) 19

Birth control pills 5

Body scan 5

Braille books and magazines 5

Breast pumps and supplies 5

Breast reconstruction surgery 5

Calculation of deduction 19

Capital expenses 5

Improvements to rented property 6

Operation and upkeep 6

Worksheet A 6

Cars 6

Out-of-pocket expenses 13

Standard medical mileage rates 13

Child care 15

Children's medical expenses:

Adopted child 3

Dependents 3

Chiropractor 7

Christian Scientist practitioner 7

Chronically ill persons 10

Community property states 2

Contact lenses 7

Controlled substances 15

Cosmetic surgery 15

Crutches 7

Dancing lessons 15

Decedent's medical expenses 4, 5

Deductible amount 3

Deductible expenses 3-14

Definition of medical expenses:

Doctor 2

Physician 2

Dental treatment 7

Artificial teeth 5

Teeth whitening 16

Dentures 5

Dependent's medical expenses:

Adopted child 3

Multiple support agreement 4

Qualifying child 3

Qualifying relative 3

Dependents:

Disabled dependent care 7, 10

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Diagnostic devices 7

Diaper services 15

Disabilities, persons with:

Dependent care expenses 7, 10

Improvements to rented property 6

Special education 13

Divorced taxpayers:

Medical expenses of child 4

Drug addiction 7

Drugs (See Medicines)

Dues:

Health club 15

Education, special 13

Electrolysis 15

Employer-sponsored health

insurance plans 8

Employment taxes 12

Excluded expenses:

Insurance premiums 9

Eye exam 7

Eye surgery 7

Eyeglasses 7

Fertility enhancement:

Eggs, temporary storage of 7

Fertility 7

In vitro fertilization 7

Figuring the deduction 19

Final return for decedent:

Medical expenses paid 4

Flexible spending arrangement 15

Food (See Weight-loss programs)

Form 1040 or 1040-SR:

Self-employed persons, health

insurance costs 21

Form 1040-X:

Amended return 2

Deceased taxpayer 4

Form 1040, Schedule A:

Impairment-related work

expenses 20

Medical and dental expenses 1, 19

Self-employed persons, health

insurance costs 21

Form 1040, Schedule C:

Impairment-related work

expenses 20

Form 1040, Schedule E:

Impairment-related work

expenses 20

Form 1040, Schedule F:

Impairment-related work

expenses 20

Form 2106:

Impairment-related work

expenses 20

Form 2555:

Self-employed persons, health

insurance costs 21

Founder's fee (See Lifetime care,

advance payments)

Funeral expenses 15

Future medical care 10, 15

Glasses 7

Guide dog or other animal 7

Hair:

Removal 15

Transplants 15

Wigs 14

Health club dues 15

Health institutes 8

Health insurance:

Employer-sponsored plan 8

Pension Benefit Guaranty

Corporation (PBGC) recipient 21

Premiums:

Deductible 8

Nondeductible 9

Paid by employer 18

Paid by employer and you 18

Paid by you 17

Prepaid 9

Unused sick leave used to pay 9

Reimbursements

(See Reimbursements)

Self-employed persons 21

Health maintenance organizations

(HMOs) 8

Health reimbursement

arrangements (HRAs) 17

Health savings accounts (HSAs):

Payments from 15

Hearing aids 8

Hearing-impaired persons:

Guide dog or other animal for 7

HMOs (Health maintenance

organizations) 8

Home care (See Nursing services)

Home improvements (See Capital

expenses:)

Hospital services 8

Hotels 10

Household help 15

HRAs (Health reimbursement

arrangements) 17

Illegal operations and

treatments 15

Illegal substances 15

Impairment-related work

expenses 20

Reporting of 20

Insulin 16

Insurance (See Health insurance)

Intellectually and developmentally

disabled persons:

Mentally disabled 9

Special homes for 9

Laboratory fees 9

Lactation expenses (See Breast

pumps and supplies)

Laser eye surgery 7

Lead-based paint removal 9

Learning disabilities 13

Legal fees 10

Lessons, dancing and

swimming 15

Lifetime care:

Advance payments for 10

Lodging 10, 14

(See also Trips)

Long-term care 10

Chronically ill individuals 10

Maintenance and personal care

services 10

Qualified insurance contracts 11

Qualified services 10

Maintenance and personal care

services 10

Maternity clothes 16

Meals 11, 14

(See also Weight-loss programs)

Medical conferences 11

Medical equipment or property:

Adjusted basis (Worksheet D) 19

Medical expense records 19

Medical savings accounts

(MSAs) 16

Medicare:

Medicare Part A, deductible

expense 8

Medicare Part B, deductible

expense 8

Medicare Part D, deductible

expense 9

Medicines 11

Imported 11, 16

Nonprescription drugs and

medicines 16

Missing children, photographs of in

IRS publications 1

Multiple support agreement 4

Nondeductible expenses 14-16

Nonprescription drugs and

medicines 16

Nursing homes 11

Nursing services 11, 15

Chronically ill individuals 10

Nutritional supplements:

Natural medicines 16

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Operations 12

Cosmetic surgery 15

Illegal operations and

treatments 15

Optometrist 12

Organ donors 13

Osteopath 12

Oxygen 12

Parking fees and tolls 13

Personal injury damages 20

Personal protective equipment 9

Personal use items 16

Physical examination 12

Physical therapy 13

Plastic surgery 15

Pregnancy test kit 12

Premium Tax Credit 12

Premiums (See Health insurance)

Prepaid insurance premiums 9

Prosthesis 5

Psychiatric care 12

Psychoanalysis 12

Psychologists 13

Publications (See Tax help)

Radial keratotomy 7

Recordkeeping 19

Rehabilitation facilities 11

Reimbursements 17-19

Excess includible in income:

More than one policy (Worksheet

C) 18

One policy (Worksheet B) 18

Excess may be taxable (Figure

1) 17

Health Reimbursement

Arrangement (HRA) 17

Insurance 17

Medical expenses not deducted 18

More than one policy 18

Received in later year 19

Rental property:

Improvements to 6

Reporting:

Impairment-related work

expenses 20

Medical and dental expenses 19

Medical deduction (See Form 1040,

Schedule A)

Self-employed persons, health

insurance costs 21

Sale of medical equipment or

property 19

Adjusted basis (Worksheet D) 19

Schedules (See Form 1040 or 1040-

SR)

Seeing-eye dogs 7

Self-employed persons:

Health insurance costs 21

Senior housing 11

Separate returns:

Community property states 2

Medical and dental expenses 2

Separated taxpayers:

Medical expenses of child 4

Service animals 7

Sick leave:

Used to pay health insurance

premiums 9

Special education 13

Spouse's medical expenses 3

Deceased spouse 5

Sterilization 13

Stop-smoking programs 13

Surgery (See Operations)

Surrogacy expenses 16

Swimming lessons 15

Tables and figures:

Medical equipment or property:

Adjusted basis (Worksheet D) 19

Reimbursements, excess includible

in income:

More than one policy (Worksheet

C) 18

One policy (Worksheet B) 18

Reimbursements, excess may be

taxable (Figure 1) 17

Tax help 21

Teeth:

Artificial 5

Dental treatment 7

Whitening 16

Telephone 13

Television 13

Therapy 13

Transplants 13

Travel and transportation

expenses 13

Car expenses 13

Includible expenses 13, 14

Parking fees and tolls 13

Trips 14

Tuition 14

Vasectomy 14

Veterinary fees 16

Vision correction surgery 7

Visually impaired persons:

Guide dog or other animal for 7

Vitamins or minerals 16

Weight-loss programs 14, 16

What's new:

Standard medical mileage rate 1

Wheelchairs 14

Wigs 14

Work expenses:

Disabled dependent care 7

Impairment-related 20

Workers' compensation 20

Worksheets:

Capital expenses (Worksheet A) 6

Medical equipment or property:

Adjusted basis (Worksheet D) 19

Reimbursements, excess includible

in income:

More than one policy (Worksheet

C) 18

One policy (Worksheet B) 18

Publication 502 (2023) 27