Medical and Dental Expenses – A Commonly Overlooked Deduction

Doctor’s bill weighing you down? Don’t sweat it! They might be deductible. In fact, there are a lot of clients that we work with who are not aware of the fact that those costly doctor’s visits can benefit you come tax time. Here is a list provided by the IRS to see if your medical and dental expenses are deductible. This version is simplified so that you do not have to be a tax professional like me to understand terms like “AGI threshold” and “qualified expenses”:

1. All “qualified” medical and dental bills paid out of pocket that are above 7.5% of your Adjusted Gross Income(calculated on Line 37 of Form 1040). Qualified bills will be explained below.

2. The first qualification test is that YOU must pay the expenses. They cannot be paid by your employer or insurance company. Such examples would be deductibles, co-pays or health insurance premiums that are not withheld from your paycheck.

3. The second qualification test is that your expenses MUST be paid for you, your spouse or anyone you claim on your tax return such as: children, friends/relatives that you support financially and live with you or elderly/disabled relatives that you support, but live outside of your household. In addition, if you are divorced or separated and the other parent claims your child, you can still deduct any qualified expenses you pay out of pocket for the child.

4. The third qualification test is that the expenses need to be “paid for the prevention or alleviation of a physical or mental defect or illness.” This can include a variety of expenses, ranging from doctor prescribed weight-loss or smoking cessation programs to any prescription medication you are taking. This does NOT include any voluntary weight-loss programs or over the counter medications(except for insulin).

5. In addition to the expenses above, mileage and/or transportation costs for medical care are also deductible. For example if you have to use public transportation to get to the doctor, save those receipts. Likewise, if you drive your own car, keep track of the mileage, especially if you have to drive out of state to receive medical care. In addition, tolls and parking fees are deductible. What is not covered is any international medical travel, so if you live near the Canadian or Mexican border and get your medications or treatment there, you cannot deduct these expenses.

6. If you have a Health Savings Account or Flex Spending Arrangement at work and have to withdraw any money for medical purposes you can do so without having to pay any tax on this distribution.

So to summarize – the health expenses must be above 7.5% of your AGI, they must be out-of-pocket expenses that are not reimbursed, they must be for yourself or anyone else listed or claimed on your tax return(or your child if you are divorced and still pay for their medical care), they must be to prevent or alleviate a physical or mental defect or illness, you can deduct mileage and/or transportation costs and finally, any distributions from Health Savings plans used for the qualified expenses explained above will not be taxable.

Please note that this list is only a recommendation and is not a substitute for a one on one consultation with your tax professional. If you would like to consult with myself or one of my fellow Tax Patriots, please contact us and we will assist you in any of your tax issues.

Alternative Minimum Tax – Medical and Dental Expenses

The itemized deduction for medical and dental expenses is an item that affects a significant number of individuals who are stuck in the Alternative Minimum Tax. Depending on the type of health insurance an individual has (high deductible plan with a Health Savings Account versus a high amount of coverage with a small copay), and the type of expense incurred (elective procedures versus immediate medical needs), there may be some fairly easy opportunities for AMT savings. The key to this is in the timing of when the medical bills are paid.

For the Regular Tax, an itemized deduction is allowed for medical expenses paid during the year. A tax benefit is received, however, only to the extent the expenses exceed more than 7.5% of the taxpayer’s adjusted gross income (AGI). AGI is the number on the last line (Line 37 for 2009) of page one of the Form 1040.

For purposes of the AMT, however, there is a slight difference – the threshold a taxpayer must exceed is 10% of AGI, instead of 7.5%. This difference in the computation is the AMT item reported on the Form 6251. The tax-saving strategy for medical expenses is essentially the same for the AMT as it is for the Regular Tax, but it also requires keeping an eye on that 2.5% difference. As mentioned above, the key is when the medical expenses are incurred and, most importantly, when those expenses actually are paid.

If an individual currently is in the AMT, to the extent any elective surgery, dental, vision work, etc. could be delayed until next year (so long as these expenses are not covered by medical insurance, and are not cosmetic improvements that would not be deductible medical expenses in the first place), consideration should be given to doing so. If the taxpayer is not in the AMT next year, a tax benefit might be achieved that would not be obtained this year. Also note that, even if the individual is in the AMT again next year, to the extent a grouping of medical expenses results in exceeding the10% threshold, the taxpayer will at least get a benefit for that amount.

For example, assume AGI is $100,000 and that it will be the same next year. The taxpayer decides to get “fixed-up” a bit, and the list includes a physical exam with diagnostic tests and x-rays, seeing the dentist for braces, and Lasik eye surgery – all together, $20,000 in medical expenses. For a taxpayer in the AMT, it would be a disaster to do half of this now and half next year – the total after-tax cost would be the full $20,000. If instead all the work is done in one year, the IRS offers a nice subsidy – as much as $2,800 for an AMT payer ($20,000 less $10,000 (10% of AGI), multiplied by the 28% AMT bracket).

Even better, if in this example the taxpayer is in the AMT this year but through tax planning will not be in it again next year, the IRS’ subsidy possibly could be $5,000 ($20,000 less the 7.5% of AGI, times the 39.6% bracket – the expected highest Regular Tax bracket in 2011).

Lack of Medical and Dental Care Can Hurt Your Business

I have heard people theorize that the reason men tend to die at a younger age than women is because they do not take care of their health. Many men have told me that they do not go to a doctor or dentist unless they are sick or have a horrible toothache.

Because of this, the physicians and dentists do not have an opportunity to do proper assessments or teach preventative measures that will lead to an ongoing healthy condition.

A lack of medical and dental care can hurt your business in a number of ways:

1. You feel poorly longer than necessary – Have you ever had a cold that goes on and on and on. Your head feels full and it is not only difficult to concentrate but also to keep going because you ache all over. Sometimes a problem tooth can leave you hurting or you have eye strain because you need a new prescription lens in your glasses.

It is not always wise to try to persevere. In fact, sometimes you leave an untreated condition so long that it worsens and actually takes longer to recover. When you are ill, you and your business suffer. You are not able to work with the same efficiency and stamina as when you were at full potential.

2. You might miss out on early detection – Often people wait until they are seriously ill before seeing a medical professional. They think that if they just wait long enough, they will get over the problem.

We live in a wonderful world where there are so many tests and procedures that can assess and identify illnesses that can be treated in the very early stages of their development. The longer you wait, however, the more chance you have of allowing the condition to worsen.

3. You might not know about good self-care practices – I remember what life was like before we had simple techniques such as flossing. I know that my mother would have preferred to practice this rather than be subjected to the painful dental surgery she experienced because of gum disease.

Research is constantly uncovering and developing new strategies for self-care. Your medical and dental team will help you to learn about them.

If a solo professional is ill, the business cannot operate. You, as a solo professional, are the business.

It is therefore extremely important that you take care of yourself so that you do not risk your own health or the health. Have regular checkups will assist you to protect your health and detect any problems so that they can be treated in the early stages. That way you will be well on your way to being a healthy person with a healthy business.