Thumbing through the IRS’ medical deduction (or not) list

Since I’m still recovering from my medical procedure last week, I’m following doctor’s orders and taking it as easy as possible. Translation: More milkshakes!

But I’m nothing if not a slightly obsessive-compulsive creature of habit. So I did want to get a Saturday Shout Out piece up today.

Solution: I’m combining both medical directions and blogging impulses and recommending related tax reading today.

Specifically, I’m going to the source, the Internal Revenue Service, for its comprehensive list of tax-deductible medical items and procedures.

That is, of course, IRS Publication 502.

IRS’ medical deductions codex: The only notable change in recent years to medical write-offs is the Tax Cuts and Jobs Acts provision that made itemized medical deductions easier to claim by keeping the adjusted gross income threshold at 7.5 percent. That percentage was extended further through 2020 by subsequent legislation.

IRS Publication 502 explains this itemized deduction for medical and dental expenses that you claim on Schedule A, which is where you tally all your allowable health-care expenses and send it along with your Form 1040 at tax time.

In addition, the publication:

• Discusses what expenses, and whose expenses, you can and cannot include in figuring the itemized medical deduction.
• Explains how to treat reimbursements and how to figure the deduction.

Even better, it’s a directory of the allowable deductions.

What you can deduct: Starting on page 5 of Pub. 502 under the heading What Medical Expenses Are Includible? is an alphabetic listing of items that you can include in figuring your medical expense deduction.

They range from the mundane, but medically important, annual physical exam costs to, as in my case and per the IRS “amounts you pay for legal operations that aren’t for unnecessary cosmetic surgery” to, 10 pages later, X-rays.

Of course, since taxes are personal there are so, so many permutations of potential medical expenses. If you don’t find yours in the list, the IRS says to refer back to the beginning of Publication 502, where it discusses just what it considers a medical expense.

You also might want to talk to a tax professional to help you determine your medical, and other, deduction options. These folks have seen a whole lot things in their tax careers and can give you good advice as to what to expect when making certain claims.

What you cannot deduct: Some things, obviously, are not going to ever clear the medical tax deduction threshold.

Most of those disallowed deductions are listed, starting on page 15 and again alphabetically, in the section following the deductible medical expenses list.

You’ve probably read about some folks trying to convince the IRS that, for example, their dancing lessons really do help relieve the paid in their arthritic knees, but Uncle Sam isn’t in most cases buying that argument.

And sorry, even though Fido or Fluffy is a member of your family, tax law does not generally allow you to include your pets’ veterinary fees in your medical expenses.

If you’re thinking about itemizing this tax year and expect your medical expenses to be a big part of your Schedule A, then spend some time with Publication 502.

It’s also handy for some tax-related trivia that could make you a hit at your next social gathering! OK, social gathering of tax geeks, but …

You also might find these items of interest:

• Items to add to your end-of-year FSA shopping list
• Comparing tax-favored HSA, HRA & FSA medical options
• Maximizing the many medical expenses that are still tax deductible