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Medical tax breaks’ 10% and FSA year-end considerations

December 16, 2013

My brother and I tended to get sick around Christmas.

Maybe we wore ourselves out with all the excitement. Maybe the sharing of Christmas cards and trinkets with our classmates and neighborhood kids included shared germs. Maybe we were allergic to the decorated pine tree that filled up our living room.

Whatever the cause, colds and coughs were part of the holiday tradition at the Bell homestead. We learned to live with it and have a Merry Christmas anyway.

As an adult, I still take extra measures — and extra zinc and vitamin C — to avoid late-year sniffles.

And I still think about medical issues at holiday time partly because of the fifth song in our Christmas Tax Tip Tunes series, All I Want for Christmas is My Two Front Teeth.

I wasn't familiar with the Al Alberts Showcase until I found the video clip above on YouTube. But I love this youngster's rendition of the humorous holiday classic. I also love that her mom dressed her in the very same type of Christmas outfit my mother picked out for me when I was that age.

But enough reminiscing. The other reason medical matters come to mind around the holidays is that there are some tax-related moves you might want to consider.

Spending down your FSA: I've already discussed the possible ways to spend remaining medical flexible spending account (FSA) money so that you don't lose it, so I'll be brief in this recap.

In most cases, employees who put pre-tax money via automatic payroll deposits into an FSA must spend all the account cash by the end of the benefit year. That's Dec. 31 for most plans. If you don't, your boss gets the excess.

Dental work is a popular way to wipe out excess FSA money. My post of a couple weeks ago has more suggestions of items to add to your medical FSA spending list.

Clearing the 10 percent deduction hurdle: If you itemize deductions, you'll also want to look at medical costs.

You now must have medical and dental costs that exceed 10 percent of your adjusted gross income (AGI). That means if your AGI is $50,000 you must have more than $5,000 in medical/dental costs before they're worth anything on Schedule A.

Note the "more than" requirement. If you have $5,500 in medical costs, you can deduct only the $500 that's above your AGI threshold.

That 10 percent mark, which went up beginning with the 2013 tax year from the previous 7.5 percent cutoff, is a tough one to meet for most folks.

You might be able to clear it, though, if you bunch your medical costs. Bunching is making the tax-deductible expenditures (in this case medical costs) in one tax year when they'll be more tax useful.

You only have a few weeks to make allowable medical expenditures. You also might be able to make some that you don't usually think about. These include not only the usual co-pays for prescriptions and doctor's office visits, but other more specialized medical expenditures.

Travel costs to and from medical treatment, to pick up prescriptions and even in some instances medical conferences is deductible. Christmas carol inspired orthodontia counts. So do weight loss programs that are medically necessary.

Sorry. That medical necessity rule is firm. You can't write off your special Weight Watchers meals that you've been eating for months so that you can indulge on December goodies.

But you can find more, and atypical, ways to maximize medical tax deductions in my post-operative post from October.

My holiday wish for you today is that you have a healthy and happy holiday season. But do take a few minutes away from your Christmas shopping and before the end of the year to make sure you don't waste any tax-saving medical moves.

You also might find these items of interest:

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The More Tax Posts tab at the top of this page will take you to, well, more tax posts. You also can search below for a tax topic. 

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TO WRAP UP 2026

It’s over! With October’s extended filing deadline behind us, it is now time to focus on year-end moves to reduce your 2026 tax bill. 

You’ll find ways to do just that on the Tax Tips page (see the More Tax Posts drop-down menu at the top of the blog), as well as the separate tax tip pages for each month, notably October through December. If you’re on the Tax Tips page, you’ll find a monthly list at the end of this column. If you’re on another blog page, you can head straight to the October tips; at the bottom of that tips page you’ll find links to all the other 11 months’ collections of tax advice.

Not to spoil what you’ll find in that tax advice, but it does cover such things as tax deductions for charitable donations, investment moves that could reduce tax due, and ways to max out your tax-favored retirement savings. 

Finally, as the year winds down, things get hectic. There are lots of other things to occupy our time, like the much more fun upcoming holidays. But don’t lose sight of taxes, since timing is key. To be of use, most tax moves must be made by the end of the tax year. That’s Thursday, Dec. 31, which also is the last business day of the year. 

So that you don’t miss that final tax year deadline, also keep an eye on the countdown clock below. It will keep you on top of just how much time is left to make important, tax-saving moves. (Note: I’m in the Central Time Zone, so adjust accordingly for where you live.)

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