In the category of medical expenses, just about every dollar you spend can be deducted, but there are some exceptions and income limitations to consider. All doctors' visits are deductible: medical doctors, dentists, eye doctors, psychiatrists, psychologists, physical therapists, chiropractors, and even acupuncturists.
If you stay in a hospital, you can deduct the cost of the food and lodging. You can also deduct lab fees, medical insurance premiums (but not life insurance), Medicare withholding from Social Security benefits, glasses, dentures, and prescription drugs. That's prescription drugs. Vitamins and over-the-counter drugs are not deductible. Even if your doctor suggests it might do you some good to take a few vitamins, the I.R.S. says he has to write out a prescription if you want to take the deduction.
Preventive medicine doesn't carry much weight with the government, either. You can spend all the money you want to prevent an illness, but you can't deduct the expense. Repairing the damage of a reckless lifestyle is all you can claim.
And speaking of weight, health clubs, fat farms, and/or weight-reduction products don't qualify as a deduction, either, unless your weight is life-threatening. You can, however, deduct treatment at a drug- or alcohol-abuse center.
If your doctor says a trip to the mountains would do you a world of good, you can't deduct that, either. You can, however, deduct your medical miles. Trips to the doctor or the drug store to purchase your prescriptions are deductible at 10 cents a mile. And don't forget parking and tolls. If you have to go to another city to receive care, you may deduct the cost of the airfare and the hotel expenses (but not the food). Big-ticket items like wheelchairs, special baths, dialysis machines, and special handicap vehicles can also be a deduction, but they have to be depreciated over time. If you need a guide dog, you can deduct the cost of the dog and the food to feed him. Obviously, taking your dog out of town to see a doctor isn't recommended. He gets to deduct his food, but you can't.
If a nurse comes to your home, you may also deduct her wages, but if she washes the dishes and cleans your house, you have to determine which part is nursing care and claim only that amount. Here's another murky area: If you get her through an agency, the nurse is its employee, but if you hire her independently, she becomes your employee and you have to withdraw taxes from her wages and pay payroll taxes to the government. The caregiver doesn't have to be a registered nurse or doctor, and nurse's aides also qualify. The person need only qualify as a medical professional.
Any and all medical expenses you spend on a dependant are also totally deductible. If there's a person in your family who doesn't qualify as your dependant (your mother, for instance) but who would otherwise qualify were it not for an income limitation, you may also deduct any expenses you paid on her behalf.
Only out-of-pocket expenses are deductible. If the insurance company pays the bill or reimburses you, or you expect to receive a reimbursement in the future, you have no deduction. If you claim an expense and receive a settlement in a future year, you're required to report the refund as income and pay back the taxes you saved.
Other things that are not deductible are nursing care for a healthy baby or maternity clothes. Illegal operations or drugs aren't deductible, either. Even if you live in a state that allows the use of marijuana for medical purposes, the federal government won't let you deduct it. Funeral, burial, or cremation costs are also not deductible.
What about cosmetic surgery to enhance your career potential? The answer is no. One would think that if your income skyrocketed into the stratosphere due to some body reshaping, you'd have an automatic deduction, but the I.R.S. rules state that cosmetic surgeries are deductible only if they are life-saving or are to improve your health. The great contradiction is, you can spend and deduct all you want for dental work to get that beautiful commercial-ad smile, but nothing for improving your body.
Now that you've added up all your medical expenses, you get to reduce your deduction by 7.5 percent of your total income. So, if your income is $20,000 and your medical expenses are less than $1,500, you have nothing to claim.
Frank Wyman is a tax consultant for Amanda Tax and Financial Services.