Filing Your Taxes Online is Fast, Easy and Secure.
Start now and receive your tax refund in as little as 7 days.

1. Get Answers

Your online questions are customized to your unique tax situation.

2. Maximize your Refund

Find tax credits for everything from school tuition to buying a hybri

3. E-File for FREE

E-file free with direct deposit to get your refund in as few as 7 days.

Filing your taxes with paper mail can be difficult and it could take weeks for your refund to arrive. IRS e-file is easy, fast and secure. There is no paperwork going to the IRS so tax refunds can be processed in as little as 7 days with direct deposit. As you prepare your taxes online, you can see your tax refund in real time.

FREE audit support and representation from an enrolled agent – NEW and only from H&R Block

1040z

Amendment To Tax Return 2013State Tax Return FormAmending Your TaxesTurbo Tax AmendmentIrs Gov 2011 Tax FormsTax Form 1040Amended 2010 Tax ReturnPriortaxFree Tax Preparation2014 1040ez Tax FormsHow Do I Amend My 2011 Tax ReturnIrs Free FileIrs E File Application2012 Form 1040a2011 Tax Software1042nr EzIrs Forms 1040H And R Block1040x Form For 20102011 Taxes DueFederal Income Tax Rates 2012Www Irs Gov Efile Index HtmlFile LateTax Forms 20091040ez Tax Forms DownloadsState Income TaxFile A 2011 Tax Return OnlineStandard Deduction For Form 1040Irs Gov Form 1040nrHow Can I File My 2010 TaxesFederal Income Tax Ez FormFree Tax E FileAmended FormHappens If I Didn't File Taxes Last Year1041 Ez Form2012 Irs Forms 1040Where Can I Find State Tax FormsFree E File 2013H&r Block At Home 2011 Deluxe Federal State EfileTax Amendment Form

1040z

1040z Publication 502 - Main Content Table of Contents What Are Medical Expenses? What Expenses Can You Include This Year?Community property states. 1040z How Much of the Expenses Can You Deduct? Whose Medical Expenses Can You Include?Spouse Dependent Decedent What Medical Expenses Are Includible?Abortion Acupuncture Alcoholism Ambulance Annual Physical Examination Artificial Limb Artificial Teeth Bandages Birth Control Pills Body Scan Braille Books and Magazines Breast Pumps and Supplies Breast Reconstruction Surgery Capital Expenses Car Chiropractor Christian Science Practitioner Contact Lenses Crutches Dental Treatment Diagnostic Devices Disabled Dependent Care Expenses Drug Addiction Drugs Eye Exam Eyeglasses Eye Surgery Fertility Enhancement Founder's Fee Guide Dog or Other Service Animal Health Institute Health Maintenance Organization (HMO) Hearing Aids Home Care Home Improvements Hospital Services Insurance Premiums Intellectually and Developmentally Disabled, Special Home for Laboratory Fees Lactation Expenses Lead-Based Paint Removal Learning Disability Legal Fees Lifetime Care—Advance Payments Lodging Long-Term Care Meals Medical Conferences Medical Information Plan Medicines Nursing Home Nursing Services Operations Optometrist Organ Donors Osteopath Oxygen Physical Examination Pregnancy Test Kit Prosthesis Psychiatric Care Psychoanalysis Psychologist Special Education Sterilization Stop-Smoking Programs Surgery Telephone Television Therapy Transplants Transportation Trips Tuition Vasectomy Vision Correction Surgery Weight-Loss Program Wheelchair Wig X-ray What Expenses Are Not Includible?Baby Sitting, Childcare, and Nursing Services for a Normal, Healthy Baby Controlled Substances Cosmetic Surgery Dancing Lessons Diaper Service Electrolysis or Hair Removal Flexible Spending Account Funeral Expenses Future Medical Care Hair Transplant Health Club Dues Health Coverage Tax Credit Health Savings Accounts Household Help Illegal Operations and Treatments Insurance Premiums Maternity Clothes Medical Savings Account (MSA) Medicines and Drugs From Other Countries Nonprescription Drugs and Medicines Nutritional Supplements Personal Use Items Swimming Lessons Teeth Whitening Veterinary Fees Weight-Loss Program How Do You Treat Reimbursements?Insurance Reimbursement How Do You Figure and Report the Deduction on Your Tax Return?What Tax Form Do You Use? Sale of Medical Equipment or Property Damages for Personal Injuries Impairment-Related Work Expenses Health Insurance Costs for Self-Employed Persons COBRA Premium Assistance Health Coverage Tax CreditWho Can Take This Credit? Qualifying Family Member Qualified Health Insurance Nonqualified Health Insurance Eligible Coverage Month How To Take the Credit How To Get Tax HelpLow Income Taxpayer Clinics What Are Medical Expenses? Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body. 1040z These expenses include payments for legal medical services rendered by physicians, surgeons, dentists, and other medical practitioners. 1040z They include the costs of equipment, supplies, and diagnostic devices needed for these purposes. 1040z Medical care expenses must be primarily to alleviate or prevent a physical or mental defect or illness. 1040z They do not include expenses that are merely beneficial to general health, such as vitamins or a vacation. 1040z Medical expenses include the premiums you pay for insurance that covers the expenses of medical care, and the amounts you pay for transportation to get medical care. 1040z Medical expenses also include amounts paid for qualified long-term care services and limited amounts paid for any qualified long-term care insurance contract. 1040z What Expenses Can You Include This Year? You can include only the medical and dental expenses you paid this year, regardless of when the services were provided. 1040z (But see Decedent under Whose Medical Expenses Can You Include, for an exception. 1040z ) If you pay medical expenses by check, the day you mail or deliver the check generally is the date of payment. 1040z If you use a “pay-by-phone” or “online” account to pay your medical expenses, the date reported on the statement of the financial institution showing when payment was made is the date of payment. 1040z 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. 1040z If you did not claim a medical or dental expense that would have been deductible in an earlier year, you can file Form 1040X, Amended U. 1040z S. 1040z Individual Income Tax Return, for the year in which you overlooked the expense. 1040z Do not claim the expense on this year's return. 1040z Generally, an amended return 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. 1040z You cannot include medical expenses that were paid by insurance companies or other sources. 1040z This is true whether the payments were made directly to you, to the patient, or to the provider of the medical services. 1040z Separate returns. 1040z   If you and your spouse live in a noncommunity property state and file separate returns, each of you can include only the medical expenses each actually paid. 1040z 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. 1040z Community property states. 1040z   If you and your spouse live in a community property state and file separate returns or are registered domestic partners in Nevada, Washington, or California, any medical expenses paid out of community funds are divided equally. 1040z Generally, each of you should include half the expenses. 1040z If medical expenses are paid out of the separate funds of one individual, only the individual who paid the medical expenses can include them. 1040z If you live in a community property state and are not filing a joint return, see Publication 555, Community Property. 1040z 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 10% of your AGI. 1040z But if either you or your spouse was born before January 2, 1949, you can deduct the amount of your medical and dental expenses that is more than 7. 1040z 5% of your AGI. 1040z Example. 1040z You are unmarried and were born after January 2, 1949, and your AGI is $40,000, 10% of which is $4,000. 1040z You paid medical expenses of $2,500. 1040z You cannot deduct any of your medical expenses because they are not more than 10% of your AGI. 1040z 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. 1040z There are different rules for decedents and for individuals who are the subject of multiple support agreements. 1040z See Support claimed under a multiple support agreement , later under Qualifying Relative. 1040z Spouse You can include medical expenses you paid for your spouse. 1040z To include these expenses, you must have been married either at the time your spouse received the medical services or at the time you paid the medical expenses. 1040z Example 1. 1040z Mary received medical treatment before she married Bill. 1040z Bill paid for the treatment after they married. 1040z Bill can include these expenses in figuring his medical expense deduction even if Bill and Mary file separate returns. 1040z If Mary had paid the expenses, Bill could not include Mary's expenses in his separate return. 1040z Mary would include the amounts she paid during the year in her separate return. 1040z If they filed a joint return, the medical expenses both paid during the year would be used to figure their medical expense deduction. 1040z Example 2. 1040z This year, John paid medical expenses for his wife Louise, who died last year. 1040z John married Belle this year and they file a joint return. 1040z Because John was married to Louise when she received the medical services, he can include those expenses in figuring his medical expense deduction for this year. 1040z Dependent You can include medical expenses you paid for your dependent. 1040z 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. 1040z A person generally qualifies as your dependent for purposes of the medical expense deduction if both of the following requirements are met. 1040z The person was a qualifying child (defined later) or a qualifying relative (defined later), and The person was a U. 1040z S. 1040z citizen or national or a resident of the United States, Canada, or Mexico. 1040z If your qualifying child was adopted, see Exception for adopted child , later. 1040z You can include medical expenses you paid for an individual that would have been your dependent except that: He or she received gross income of $3,900 or more in 2013, He or she filed a joint return for 2013, or You, or your spouse if filing jointly, could be claimed as a dependent on someone else's 2013 return. 1040z Exception for adopted child. 1040z   If you are a U. 1040z S. 1040z citizen or national and your adopted child lived with you as a member of your household for 2013, that child does not have to be a U. 1040z S. 1040z citizen or national, or a resident of the United States, Canada, or Mexico. 1040z Qualifying Child A qualifying child is a child who: 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), Was: Under age 19 at the end of 2013 and younger than you (or your spouse, if filing jointly), Under age 24 at the end of 2013, a full-time student, and younger than you (or your spouse, if filing jointly), or Any age and permanently and totally disabled, Lived with you for more than half of 2013, Did not provide over half of his or her own support for 2013, and Did not file a joint return, other than to claim a refund. 1040z Adopted child. 1040z   A legally adopted child is treated as your own child. 1040z This child includes a child lawfully placed with you for legal adoption. 1040z   You can include medical expenses that you paid for a child before adoption if the child qualified as your dependent when the medical services were provided or when the expenses were paid. 1040z   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 attributable to the medical care of the child. 1040z   But if you pay the agency or other person for medical care that was provided and paid for before adoption negotiations began, you cannot include them as medical expenses. 1040z    You may be able to take a credit for other expenses related to an adoption. 1040z See the Instructions for Form 8839, Qualified Adoption Expenses, for more information. 1040z Child of divorced or separated parents. 1040z   For purposes of the medical and dental expenses deduction, a child of divorced or separated parents can be treated as a dependent of both parents. 1040z Each parent can include the medical expenses he or she pays for the child, even if the other parent claims the child's dependency exemption, if: The child is in the custody of one or both parents for more than half the year, The child receives over half of his or her support during the year from his or her parents, and The child's parents: Are divorced or legally separated under a decree of divorce or separate maintenance, Are separated under a written separation agreement, or Live apart at all times during the last 6 months of the year. 1040z This does not apply if the child's exemption is being claimed under a multiple support agreement (discussed later). 1040z Qualifying Relative A qualifying relative is a person: Who is your: Son, daughter, stepchild, or foster child, or a descendant of any of them (for example, your grandchild), Brother, sister, half brother, half sister, or a son or daughter of any of them, Father, mother, or an ancestor or sibling of either of them (for example, your grandmother, grandfather, aunt, or uncle), Stepbrother, stepsister, stepfather, stepmother, son-in-law, daughter-in-law, father-in-law, mother-in-law, brother-in-law, or sister-in-law, or Any other person (other than your spouse) who lived with you all year as a member of your household if your relationship did not violate local law, Who was not a qualifying child (see Qualifying Child, earlier) of any taxpayer for 2013, and For whom you provided over half of the support in 2013. 1040z But see Child of divorced or separated parents , earlier, Support claimed under a multiple support agreement, next, and Kidnapped child under Qualifying Relative in Publication 501. 1040z Support claimed under a multiple support agreement. 1040z   If you are considered to have provided more than half of a qualifying relative's support under a multiple support agreement, you can include medical expenses you pay for that person. 1040z A multiple support agreement is used when two or more people provide more than half of a person's support, but no one alone provides more than half. 1040z   Any medical expenses paid by others who joined you in the agreement cannot be included as medical expenses by anyone. 1040z However, you can include the entire unreimbursed amount you paid for medical expenses. 1040z Example. 1040z You and your three brothers each provide one-fourth of your mother's total support. 1040z Under a multiple support agreement, you treat your mother as your dependent. 1040z You paid all of her medical expenses. 1040z Your brothers repaid you for three-fourths of these expenses. 1040z In figuring your medical expense deduction, you can include only one-fourth of your mother's medical expenses. 1040z Your brothers cannot include any part of the expenses. 1040z However, if you and your brothers share the nonmedical support items and you separately pay all of your mother's medical expenses, you can include the unreimbursed amount you paid for her medical expenses in your medical expenses. 1040z 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. 1040z This includes expenses for the decedent's spouse and dependents as well as for the decedent. 1040z The survivor or personal representative of a decedent can choose to treat certain expenses paid by the decedent's estate for the decedent's medical care as paid by the decedent at the time the medical services were provided. 1040z The expenses must be paid within the 1-year period beginning with the day after the date of death. 1040z If you are the survivor or personal representative making this choice, you must attach a statement to the decedent's Form 1040 (or the decedent's amended return, Form 1040X) saying that the expenses have not been and will not be claimed on the estate tax return. 1040z Qualified medical expenses paid before death by the decedent are not deductible if paid with a tax-free distribution from any Archer MSA, Medicare Advantage MSA, or health savings account. 1040z What if the decedent's return had been filed and the medical expenses were not included?   Form 1040X can be filed for the year or years the expenses are treated as paid, unless the period for filing an amended return for that year has passed. 1040z Generally, an amended return 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. 1040z Example. 1040z John properly filed his 2012 income tax return. 1040z He died in 2013 with unpaid medical expenses of $1,500 from 2012 and $1,800 in 2013. 1040z If the expenses are paid within the 1-year period, his survivor or personal representative can file an amended return for 2012 claiming a deduction based on the $1,500 medical expenses. 1040z The $1,800 of medical expenses from 2013 can be included on the decedent's final return for 2013. 1040z 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 Form 1040 in the year paid, whether they are paid before or after the decedent's death. 1040z The expenses can be included if the person was your spouse or dependent either at the time the medical services were provided or at the time you paid the expenses. 1040z What Medical Expenses Are Includible? Following is a list of items that you can include in figuring your medical expense deduction. 1040z The items are listed in alphabetical order. 1040z This list does not include all possible medical expenses. 1040z To determine if an expense not listed can be included in figuring your medical expense deduction, see What Are Medical Expenses , earlier. 1040z Abortion You can include in medical expenses the amount you pay for a legal abortion. 1040z Acupuncture You can include in medical expenses the amount you pay for acupuncture. 1040z Alcoholism You can include in medical expenses amounts you pay for an inpatient's treatment at a therapeutic center for alcohol addiction. 1040z This includes meals and lodging provided by the center during treatment. 1040z You can also include in medical expenses amounts you pay for transportation to and from Alcoholics Anonymous meetings in your community if the attendance is pursuant to medical advice that membership in Alcoholics Anonymous is necessary for the treatment of a disease involving the excessive use of alcoholic liquors. 1040z Ambulance You can include in medical expenses amounts you pay for ambulance service. 1040z Annual Physical Examination See Physical Examination , later. 1040z Artificial Limb You can include in medical expenses the amount you pay for an artificial limb. 1040z Artificial Teeth You can include in medical expenses the amount you pay for artificial teeth. 1040z Bandages You can include in medical expenses the cost of medical supplies such as bandages. 1040z Birth Control Pills You can include in medical expenses the amount you pay for birth control pills prescribed by a doctor. 1040z Body Scan You can include in medical expenses the cost of an electronic body scan. 1040z 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 impaired person that is more than the cost of regular printed editions. 1040z Breast Pumps and Supplies You can include in medical expenses the cost of breast pumps and supplies that assist lactation. 1040z Breast Reconstruction Surgery You can include in medical expenses the amounts you pay for breast reconstruction surgery, as well as breast prosthesis, following a mastectomy for cancer. 1040z See Cosmetic Surgery , later. 1040z Capital Expenses You can include in medical expenses amounts you pay for special equipment installed in a home, or for improvements, if their main purpose is medical care for you, your spouse, or your dependent. 1040z The cost of permanent improvements that increase the value of your property may be partly included as a medical expense. 1040z The cost of the improvement is reduced by the increase in the value of your property. 1040z The difference is a medical expense. 1040z If the value of your property is not increased by the improvement, the entire cost is included as a medical expense. 1040z Certain improvements made to accommodate a home to your disabled condition, or that of your spouse or your dependents who live with you, do not usually increase the value of the home and the cost can be included in full as medical expenses. 1040z These improvements include, but are not limited to, the following items. 1040z Constructing entrance or exit ramps for your home. 1040z Widening doorways at entrances or exits to your home. 1040z Widening or otherwise modifying hallways and interior doorways. 1040z Installing railings, support bars, or other modifications to bathrooms. 1040z Lowering or modifying kitchen cabinets and equipment. 1040z Moving or modifying electrical outlets and fixtures. 1040z Installing porch lifts and other forms of lifts (but elevators generally add value to the house). 1040z Modifying fire alarms, smoke detectors, and other warning systems. 1040z Modifying stairways. 1040z Adding handrails or grab bars anywhere (whether or not in bathrooms). 1040z Modifying hardware on doors. 1040z Modifying areas in front of entrance and exit doorways. 1040z Grading the ground to provide access to the residence. 1040z Only reasonable costs to accommodate a home to a disabled condition are considered medical care. 1040z Additional costs for personal motives, such as for architectural or aesthetic reasons, are not medical expenses. 1040z Capital expense worksheet. 1040z   Use Worksheet A to figure the amount of your capital expense to include in your medical expenses. 1040z Worksheet A. 1040z Capital Expense Worksheet Instructions: Use this worksheet to figure the amount, if any, of your medical expenses due to a home improvement. 1040z 1. 1040z Enter the amount you paid for the home improvement 1. 1040z   2. 1040z Enter the value of your home immediately after the improvement 2. 1040z       3. 1040z Enter the value of your home immediately before the improvement 3. 1040z       4. 1040z Subtract line 3 from line 2. 1040z This is the increase in the value of your home due to the improvement 4. 1040z     • If line 4 is more than or equal to line 1, you have no medical expenses due to the home improvement; stop here. 1040z       • If line 4 is less than line 1, go to line 5. 1040z     5. 1040z Subtract line 4 from line 1. 1040z These are your medical expenses due to the home improvement 5. 1040z   Operation and upkeep. 1040z   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. 1040z This rule applies even if none or only part of the original cost of the capital asset qualified as a medical care expense. 1040z Improvements to property rented by a person with a disability. 1040z   Amounts paid to buy and install special plumbing fixtures for a person with a disability, mainly for medical reasons, in a rented house are medical expenses. 1040z Example. 1040z John has arthritis and a heart condition. 1040z He cannot climb stairs or get into a bathtub. 1040z On his doctor's advice, he installs a bathroom with a shower stall on the first floor of his two-story rented house. 1040z The landlord did not pay any of the cost of buying and installing the special plumbing and did not lower the rent. 1040z John can include in medical expenses the entire amount he paid. 1040z 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. 1040z Special design. 1040z   You can include in medical expenses the difference between the cost of a regular car and a car specially designed to hold a wheelchair. 1040z Cost of operation. 1040z   The includible costs of using a car for medical reasons are explained under Transportation , later. 1040z Chiropractor You can include in medical expenses fees you pay to a chiropractor for medical care. 1040z Christian Science Practitioner You can include in medical expenses fees you pay to Christian Science practitioners for medical care. 1040z Contact Lenses You can include in medical expenses amounts you pay for contact lenses needed for medical reasons. 1040z You can also include the cost of equipment and materials required for using contact lenses, such as saline solution and enzyme cleaner. 1040z See Eyeglasses and Eye Surgery , later. 1040z Crutches You can include in medical expenses the amount you pay to buy or rent crutches. 1040z Dental Treatment You can include in medical expenses the amounts you pay for the prevention and alleviation of dental disease. 1040z Preventive treatment includes the services of a dental hygienist or dentist for such procedures as teeth cleaning, the application of sealants, and fluoride treatments to prevent tooth decay. 1040z Treatment to alleviate dental disease include services of a dentist for procedures such as X-rays, fillings, braces, extractions, dentures, and other dental ailments. 1040z But see Teeth Whitening under What Expenses Are Not Includible, later. 1040z Diagnostic Devices You can include in medical expenses the cost of devices used in diagnosing and treating illness and disease. 1040z Example. 1040z You have diabetes and use a blood sugar test kit to monitor your blood sugar level. 1040z You can include the cost of the blood sugar test kit in your medical expenses. 1040z 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. 1040z (See Publication 503, Child and Dependent Care Expenses. 1040z ) You can choose to apply them either way as long as you do not use the same expenses to claim both a credit and a medical expense deduction. 1040z Drug Addiction You can include in medical expenses amounts you pay for an inpatient's treatment at a therapeutic center for drug addiction. 1040z This includes meals and lodging at the center during treatment. 1040z Drugs See Medicines , later. 1040z Eye Exam You can include in medical expenses the amount you pay for eye examinations. 1040z Eyeglasses You can include in medical expenses amounts you pay for eyeglasses and contact lenses needed for medical reasons. 1040z See Contact Lenses , earlier, for more information. 1040z 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. 1040z Fertility Enhancement You can include in medical expenses the cost of the following procedures to overcome an inability to have children. 1040z Procedures such as in vitro fertilization (including temporary storage of eggs or sperm). 1040z Surgery, including an operation to reverse prior surgery that prevented the person operated on from having children. 1040z Founder's Fee See Lifetime Care—Advance Payments , later. 1040z 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 animal to assist a visually impaired or hearing disabled person, or a person with other physical disabilities. 1040z In general, this includes any costs, such as food, grooming, and veterinary care, incurred in maintaining the health and vitality of the service animal so that it may perform its duties. 1040z Health Institute You can include in medical expenses fees you pay for treatment at a health institute only if the treatment is prescribed by a physician and the physician issues a statement that the treatment is necessary to alleviate a physical or mental defect or illness of the individual receiving the treatment. 1040z Health Maintenance Organization (HMO) You can include in medical expenses amounts you pay to entitle you, your spouse, or a dependent to receive medical care from an HMO. 1040z These amounts are treated as medical insurance premiums. 1040z See Insurance Premiums , later. 1040z Hearing Aids You can include in medical expenses the cost of a hearing aid and batteries, repairs, and maintenance needed to operate it. 1040z Home Care See Nursing Services , later. 1040z Home Improvements See Capital Expenses , earlier. 1040z 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. 1040z This includes amounts paid for meals and lodging. 1040z Also see Lodging , later. 1040z Insurance Premiums You can include in medical expenses insurance premiums you pay for policies that cover medical care. 1040z 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). 1040z See Qualified Long-Term Care Insurance Contracts under Long-Term Care, later. 1040z 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 medical part is reasonable. 1040z The cost of the medical part must be separately stated in the insurance contract or given to you in a separate statement. 1040z Health coverage tax credit. 1040z   If, during 2013, you were an eligible trade adjustment assistance (TAA) recipient, alternative TAA (ATAA) recipient, reemployment TAA (RTAA) recipient, or Pension Benefit Guaranty Corporation (PBGC) pension recipient, you must complete Form 8885 before completing Schedule A. 1040z When figuring the amount of insurance premiums you can deduct on Schedule A, do not include: Any amounts you included on Form 8885, Any qualified health insurance premiums you paid to “U. 1040z S. 1040z Treasury–HCTC,” or Any health coverage tax credit advance payments shown on Form 1099-H, Health Coverage Tax Credit (HCTC) Advance Payments. 1040z Employer-Sponsored Health Insurance Plan Do not include in your medical and dental expenses any insurance premiums paid by an employer-sponsored health insurance plan unless the premiums are included on your Form W-2, Wage and Tax Statement. 1040z Also, do not include any other medical and dental expenses paid by the plan unless the amount paid is included on your Form W-2. 1040z Example. 1040z You are a federal employee participating in the premium conversion plan of the Federal Employee Health Benefits (FEHB) program. 1040z Your share of the FEHB premium is paid by making a pre-tax reduction in your salary. 1040z Because you are an employee whose insurance premiums are paid with money that is never included in your gross income, you cannot deduct the premiums paid with that money. 1040z Long-term care services. 1040z   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. 1040z This amount will be reported as wages on your Form W-2. 1040z Retired public safety officers. 1040z   If you are a retired public safety officer, do not include as medical expenses any health or long-term care insurance premiums that you elected to have paid with tax-free distributions from a retirement plan. 1040z This applies only to distributions that would otherwise be included in income. 1040z Health reimbursement arrangement (HRA). 1040z   If you have medical expenses that are reimbursed by a health reimbursement arrangement, you cannot include those expenses in your medical expenses. 1040z This is because an HRA is funded solely by the employer. 1040z Medicare A If you are covered under social security (or if you are a government employee who paid Medicare tax), you are enrolled in Medicare A. 1040z The payroll tax paid for Medicare A is not a medical expense. 1040z If you are not covered under social security (or were not a government employee who paid Medicare tax), you can voluntarily enroll in Medicare A. 1040z In this situation you can include the premiums you paid for Medicare A as a medical expense. 1040z Medicare B Medicare B is a supplemental medical insurance. 1040z Premiums you pay for Medicare B are a medical expense. 1040z Check the information you received from the Social Security Administration to find out your premium. 1040z Medicare D Medicare D is a voluntary prescription drug insurance program for persons with Medicare A or B. 1040z You can include as a medical expense premiums you pay for Medicare D. 1040z Prepaid Insurance Premiums Premiums you pay before you are age 65 for insurance for medical care for yourself, your spouse, or your dependents after you reach age 65 are medical care expenses in the year paid if they are: Payable in equal yearly installments or more often, and Payable for at least 10 years, or until you reach age 65 (but not for less than 5 years). 1040z Unused Sick Leave Used To Pay Premiums You must include in gross income cash payments you receive at the time of retirement for unused sick leave. 1040z You also must 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. 1040z You can include this cost of continuing participation in the health plan as a medical expense. 1040z 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 do not have the option to receive cash), do not include the value of the unused sick leave in gross income. 1040z You cannot include this cost of continuing participation in that health plan as a medical expense. 1040z Insurance Premiums You Cannot Include You cannot include premiums you pay for: Life insurance policies, Policies providing payment for loss of earnings, Policies for loss of life, limb, sight, etc. 1040z , 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 is not 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 provider and these distributions would otherwise have been included in income. 1040z Taxes imposed by any governmental unit, such as Medicare taxes, are not insurance premiums. 1040z Coverage for nondependents. 1040z   Generally, you cannot deduct any additional premium you pay as the result of including on your policy someone who is not your spouse or dependent, even if that person is your child under age 27. 1040z However, you can deduct the additional premium if that person is: Your child whom you do not claim as a dependent because of the rules for children of divorced or separated parents, Any person you could have claimed as a dependent on your return except that person received $3,900 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 2013 return. 1040z  Also, if you had family coverage when you added this individual to your policy and your premiums did not increase, you can enter on Schedule A (Form 1040) the full amount of your medical and dental insurance premiums. 1040z 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 recommendation of a psychiatrist to help the person adjust from life in a mental hospital to community living. 1040z Laboratory Fees You can include in medical expenses the amounts you pay for laboratory fees that are part of medical care. 1040z Lactation Expenses See Breast Pumps and Supplies , earlier. 1040z 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. 1040z These surfaces must be in poor repair (peeling or cracking) or within the child's reach. 1040z The cost of repainting the scraped area is not a medical expense. 1040z If, instead of removing the paint, you cover the area with wallboard or paneling, treat these items as capital expenses. 1040z See Capital Expenses , earlier. 1040z Do not include the cost of painting the wallboard as a medical expense. 1040z Learning Disability See Special Education , later. 1040z Legal Fees You can include in medical expenses legal fees you paid that are necessary to authorize treatment for mental illness. 1040z However, you cannot 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 are not necessary for medical care. 1040z 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. 1040z The part of the payment you include is the amount properly allocable to medical care. 1040z 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. 1040z You can use a statement from the retirement home to prove the amount properly allocable to medical care. 1040z The statement must be based either on the home's prior experience or on information from a comparable home. 1040z Dependents with disabilities. 1040z   You can include in medical 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 become unable to provide care. 1040z The payments must be a condition for the institution's future acceptance of your child and must not be refundable. 1040z Payments for future medical care. 1040z   Generally, you cannot include in medical expenses current payments for medical care (including medical insurance) to be provided substantially beyond the end of the year. 1040z This rule does not apply in situations where the future care is purchased in connection with obtaining lifetime care of the type described earlier. 1040z 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. 1040z See Nursing Home , later. 1040z You may be able to include in medical expenses the cost of lodging not provided in a hospital or similar institution. 1040z You can include the cost of such lodging while away from home if all of the following requirements are met. 1040z The lodging is primarily for and essential to medical care. 1040z 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. 1040z The lodging is not lavish or extravagant under the circumstances. 1040z There is no significant element of personal pleasure, recreation, or vacation in the travel away from home. 1040z The amount you include in medical expenses for lodging cannot be more than $50 for each night for each person. 1040z You can include lodging for a person traveling with the person receiving the medical care. 1040z For example, if a parent is traveling with a sick child, up to $100 per night can be included as a medical expense for lodging. 1040z Meals are not included. 1040z Do not include the cost of lodging while away from home for medical treatment if that treatment is not received from a doctor in a licensed hospital or in a medical care facility related to, or the equivalent of, a licensed hospital or if that lodging is not primarily for or essential to the medical care received. 1040z Long-Term Care You can include in medical expenses amounts paid for qualified long-term care services and premiums paid for qualified long-term care insurance contracts. 1040z Qualified Long-Term Care Services Qualified long-term care services are necessary diagnostic, preventive, therapeutic, curing, treating, mitigating, rehabilitative services, and maintenance and personal care services (defined later) that are: Required by a chronically ill individual, and Provided pursuant to a plan of care prescribed by a licensed health care practitioner. 1040z Chronically ill individual. 1040z   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. 1040z He or she is unable to perform at least two activities of daily living without substantial assistance from another individual for at least 90 days, due to a loss of functional capacity. 1040z Activities of daily living are eating, toileting, transferring, bathing, dressing, and continence. 1040z He or she requires substantial supervision to be protected from threats to health and safety due to severe cognitive impairment. 1040z Maintenance and personal care services. 1040z    Maintenance or personal care services is care which has as its primary purpose the providing of a chronically ill individual with needed assistance with his or her disabilities (including protection from threats to health and safety due to severe cognitive impairment). 1040z Qualified Long-Term Care Insurance Contracts A qualified long-term care insurance contract is an insurance contract that provides only coverage of qualified long-term care services. 1040z The contract must: Be guaranteed renewable, Not provide for a cash surrender value or other money that can be paid, assigned, pledged, or borrowed, 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 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 periodic payments without regard to expenses. 1040z The amount of qualified long-term care premiums you can include is limited. 1040z You can include the following as medical expenses on Schedule A (Form 1040). 1040z Qualified long-term care premiums up to the following amounts. 1040z Age 40 or under – $360. 1040z Age 41 to 50 – $680. 1040z Age 51 to 60 – $1,360. 1040z Age 61 to 70 – $3,640. 1040z Age 71 or over – $4,550. 1040z Unreimbursed expenses for qualified long-term care services. 1040z Note. 1040z The limit on premiums is for each person. 1040z Also, if you are an eligible retired public safety officer, you cannot include premiums for long-term care insurance if you elected to pay these premiums with tax-free distributions from a qualified retirement plan made directly to the insurance provider and these distributions would otherwise have been included in your income. 1040z Meals You can include in medical expenses the cost of meals at a hospital or similar institution if a principal reason for being there is to get medical care. 1040z You cannot include in medical expenses the cost of meals that are not part of inpatient care. 1040z Also see Weight-Loss Program and Nutritional Supplements , later. 1040z Medical Conferences You can include in medical expenses amounts paid for admission and transportation to a medical conference if the medical conference concerns the chronic illness of yourself, your spouse, or your dependent. 1040z The costs of the medical conference must be primarily for and necessary to the medical care of you, your spouse, or your dependent. 1040z The majority of the time spent at the conference must be spent attending sessions on medical information. 1040z The cost of meals and lodging while attending the conference is not deductible as a medical expense. 1040z Medical Information Plan You can include in medical expenses amounts paid to a plan that keeps medical information in a computer data bank and retrieves and furnishes the information upon request to an attending physician. 1040z Medicines You can include in medical expenses amounts you pay for prescribed medicines and drugs. 1040z A prescribed drug is one that requires a prescription by a doctor for its use by an individual. 1040z You can also include amounts you pay for insulin. 1040z Except for insulin, you cannot include in medical expenses amounts you pay for a drug that is not prescribed. 1040z Imported medicines and drugs. 1040z   If you imported medicines or drugs from other countries, see Medicines and Drugs From Other Countries , under What Expenses Are Not Includible, later. 1040z Nursing Home You can include in medical expenses the cost of medical care in a nursing home, home for the aged, or similar institution, for yourself, your spouse, or your dependents. 1040z This includes the cost of meals and lodging in the home if a principal reason for being there is to get medical care. 1040z Do not include the cost of meals and lodging if the reason for being in the home is personal. 1040z You can, however, include in medical expenses the part of the cost that is for medical or nursing care. 1040z Nursing Services You can include in medical expenses wages and other amounts you pay for nursing services. 1040z The services need not be performed by a nurse as long as the services are of a kind generally performed by a nurse. 1040z This includes services connected with caring for the patient's condition, such as giving medication or changing dressings, as well as bathing and grooming the patient. 1040z These services can be provided in your home or another care facility. 1040z Generally, only the amount spent for nursing services is a medical expense. 1040z 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. 1040z For example, because of your medical condition you pay a visiting nurse $300 per week for medical and household services. 1040z She spends 10% of her time doing household services such as washing dishes and laundry. 1040z You can include only $270 per week as medical expenses. 1040z The $30 (10% × $300) allocated to household services cannot be included. 1040z However, certain maintenance or personal care services provided for qualified long-term care can be included in medical expenses. 1040z See Maintenance and personal care services under Long-Term Care, earlier. 1040z Additionally, certain expenses for household services or for the care of a qualifying individual incurred to allow you to work may qualify for the child and dependent care credit. 1040z See Publication 503. 1040z You can also include in medical expenses part of the amount you pay for that attendant's meals. 1040z Divide the food expense among the household members to find the cost of the attendant's food. 1040z Then divide that cost in the same manner as in the preceding paragraph. 1040z If you had to pay additional amounts for household upkeep because of the attendant, you can include the extra amounts with your medical expenses. 1040z This includes extra rent or utilities you pay because you moved to a larger apartment to provide space for the attendant. 1040z Employment taxes. 1040z   You can include as a medical expense social security tax, FUTA, Medicare tax, and state employment taxes you pay for an attendant who provides medical care. 1040z If the attendant also provides personal and household services, you can include as a medical expense only the amount of employment taxes paid for medical services as explained earlier. 1040z For information on employment tax responsibilities of household employers, see Publication 926, Household Employer's Tax Guide. 1040z Operations You can include in medical expenses amounts you pay for legal operations that are not for unnecessary cosmetic surgery. 1040z See Cosmetic Surgery under What Expenses Are Not Includible, later. 1040z Optometrist See Eyeglasses , earlier. 1040z Organ Donors See Transplants , later. 1040z Osteopath You can include in medical expenses amounts you pay to an osteopath for medical care. 1040z Oxygen You can include in medical expenses amounts you pay for oxygen and oxygen equipment to relieve breathing problems caused by a medical condition. 1040z Physical Examination You can include in medical expenses the amount you pay for an annual physical examination and diagnostic tests by a physician. 1040z You do not have to be ill at the time of the examination. 1040z 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. 1040z Prosthesis See Artificial Limb and Breast Reconstruction Surgery , earlier. 1040z Psychiatric Care You can include in medical expenses amounts you pay for psychiatric care. 1040z This includes the cost of supporting a mentally ill dependent at a specially equipped medical center where the dependent receives medical care. 1040z See Psychoanalysis, next, and Transportation , later. 1040z Psychoanalysis You can include in medical expenses payments for psychoanalysis. 1040z However, you cannot include payments for psychoanalysis that is part of required training to be a psychoanalyst. 1040z Psychologist You can include in medical expenses amounts you pay to a psychologist for medical care. 1040z 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 disorders. 1040z 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 disabilities. 1040z A doctor must recommend that the child attend the school. 1040z Overcoming the learning disabilities must be a principal reason for attending the school, and any ordinary education received must be incidental to the special education provided. 1040z 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 condition caused by a birth defect. 1040z Sterilization You can include in medical expenses the cost of a legal sterilization (a legally performed operation to make a person unable to have children). 1040z Also see Vasectomy , later. 1040z Stop-Smoking Programs You can include in medical expenses amounts you pay for a program to stop smoking. 1040z However, you cannot include in medical expenses amounts you pay for drugs that do not require a prescription, such as nicotine gum or patches, that are designed to help stop smoking. 1040z Surgery See Operations , earlier. 1040z 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. 1040z This includes teletypewriter (TTY) and telecommunications device for the deaf (TDD) equipment. 1040z You can also include the cost of repairing the equipment. 1040z Television You can include in medical expenses the cost of equipment that displays the audio part of television programs as subtitles for persons with a hearing disability. 1040z This may be the cost of an adapter that attaches to a regular set. 1040z It also may be the part of the cost of a specially equipped television that exceeds the cost of the same model regular television set. 1040z Therapy You can include in medical expenses amounts you pay for therapy received as medical treatment. 1040z 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. 1040z This includes transportation. 1040z You can include any expenses you pay for the medical care of a donor in connection with the donating of an organ. 1040z This includes transportation. 1040z Transportation You can include in medical expenses amounts paid for transportation primarily for, and essential to, medical care. 1040z 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 treatment required by a patient who is traveling to get medical care and is unable to travel alone, and Transportation expenses for regular visits to see a mentally ill dependent, if these visits are recommended as a part of treatment. 1040z Car expenses. 1040z   You can include out-of-pocket expenses, such as the cost of gas and oil, when you use a car for medical reasons. 1040z You cannot include depreciation, insurance, general repair, or maintenance expenses. 1040z   If you do not want to use your actual expenses for 2013, you can use the standard medical mileage rate of 24 cents a mile. 1040z    You can also include parking fees and tolls. 1040z You can add these fees and tolls to your medical expenses whether you use actual expenses or the standard mileage rate. 1040z Example. 1040z In 2013, Bill Jones drove 2,800 miles for medical reasons. 1040z He spent $500 for gas, $30 for oil, and $100 for tolls and parking. 1040z He wants to figure the amount he can include in medical expenses both ways to see which gives him the greater deduction. 1040z He figures the actual expenses first. 1040z He adds the $500 for gas, the $30 for oil, and the $100 for tolls and parking for a total of $630. 1040z He then figures the standard mileage amount. 1040z He multiplies 2,800 miles by 24 cents a mile for a total of $672. 1040z He then adds the $100 tolls and parking for a total of $772. 1040z Bill includes the $772 of car expenses with his other medical expenses for the year because the $772 is more than the $630 he figured using actual expenses. 1040z Transportation expenses you cannot include. 1040z    You cannot include in medical expenses the cost of transportation in the following situations. 1040z Going to and from work, even if your condition requires an unusual means of transportation. 1040z Travel for purely personal reasons to another city for an operation or other medical care. 1040z Travel that is merely for the general improvement of one's health. 1040z The costs of operating a specially equipped car for other than medical reasons. 1040z 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. 1040z You may be able to include up to $50 for each night for each person. 1040z You can include lodging for a person traveling with the person receiving the medical care. 1040z For example, if a parent is traveling with a sick child, up to $100 per night can be included as a medical expense for lodging. 1040z Meals are not included. 1040z See Lodging , earlier. 1040z You cannot 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. 1040z However, see Medical Conferences , earlier. 1040z Tuition Under special circumstances, you can include charges for tuition in medical expenses. 1040z See Special Education , earlier. 1040z 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. 1040z Vasectomy You can include in medical expenses the amount you pay for a vasectomy. 1040z Vision Correction Surgery See Eye Surgery , earlier. 1040z Weight-Loss Program You can include in medical expenses amounts you pay to lose weight if it is a treatment for a specific disease diagnosed by a physician (such as obesity, hypertension, or heart disease). 1040z This includes fees you pay for membership in a weight reduction group as well as fees for attendance at periodic meetings. 1040z You cannot 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. 1040z You cannot 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 nutritional needs. 1040z You can include the cost of special food in medical expenses only if: The food does not satisfy normal nutritional needs, The food alleviates or treats an illness, and The need for the food is substantiated by a physician. 1040z The amount you can include in medical expenses is limited to the amount by which the cost of the special food exceeds the cost of a normal diet. 1040z See also Weight-Loss Program under What Expenses Are Not Includible, later. 1040z Wheelchair You can include in medical expenses amounts you pay for a wheelchair used mainly for the relief of sickness or disability, and not just to provide transportation to and from work. 1040z The cost of operating and maintaining the wheelchair is also a medical expense. 1040z Wig You can include in medical expenses the cost of a wig purchased upon the advice of a physician for the mental health of a patient who has lost all of his or her hair from disease. 1040z X-ray You can include in medical expenses amounts you pay for X-rays for medical reasons. 1040z What Expenses Are Not Includible? Following is a list of some items that you cannot include in figuring your medical expense deduction. 1040z The items are listed in alphabetical order. 1040z Baby Sitting, Childcare, and Nursing Services for a Normal, Healthy Baby You cannot 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. 1040z Also, any expense allowed as a childcare credit cannot be treated as an expense paid for medical care. 1040z Controlled Substances You cannot include in medical expenses amounts you pay for controlled substances (such as marijuana, laetrile, etc. 1040z ), even if such substances are legalized by state law. 1040z Such substances are not legal under federal law and cannot be included in medical expenses. 1040z Cosmetic Surgery Generally, you cannot include in medical expenses the amount you pay for unnecessary cosmetic surgery. 1040z This includes any procedure that is directed at improving the patient's appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease. 1040z You generally cannot include in medical expenses the amount you pay for procedures such as face lifts, hair transplants, hair removal (electrolysis), and liposuction. 1040z You can include in medical expenses the amount you pay for cosmetic surgery if it is necessary to improve a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease. 1040z Example. 1040z An individual undergoes surgery that removes a breast as part of treatment for cancer. 1040z She pays a surgeon to reconstruct the breast. 1040z The surgery to reconstruct the breast corrects a deformity directly related to the disease. 1040z The cost of the surgery is includible in her medical expenses. 1040z Dancing Lessons You cannot include in medical expenses the cost of dancing lessons, swimming lessons, etc. 1040z , even if they are recommended by a doctor, if they are only for the improvement of general health. 1040z Diaper Service You cannot 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. 1040z Electrolysis or Hair Removal See Cosmetic Surgery , earlier. 1040z Flexible Spending Account You cannot include in medical expenses amounts for which you are fully reimbursed by your flexible spending account if you contribute a part of your income on a pre-tax basis to pay for the qualified benefit. 1040z Funeral Expenses You cannot include in medical expenses amounts you pay for funerals. 1040z Future Medical Care Generally, you cannot include in medical expenses current payments for medical care (including medical insurance) to be provided substantially beyond the end of the year. 1040z This rule does not apply in situations where the future care is purchased in connection with obtaining lifetime care or long-term care of the type described at Lifetime Care—Advance Payments or Long-Term Care, earlier under What Medical Expenses Are Includible. 1040z Hair Transplant See Cosmetic Surgery , earlier. 1040z Health Club Dues You cannot 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. 1040z You cannot include in medical expenses the cost of membership in any club organized for business, pleasure, recreation, or other social purpose. 1040z Health Coverage Tax Credit You cannot include in medical expenses amounts you pay for health insurance that you use in figuring your health coverage tax credit. 1040z For more information, see Health Coverage Tax Credit , later. 1040z Health Savings Accounts You cannot include in medical expenses any payment or distribution for medical expenses out of a health savings account. 1040z Contributions to health savings accounts are deducted separately. 1040z See Publication 969. 1040z Household Help You cannot include in medical expenses the cost of household help, even if such help is recommended by a doctor. 1040z This is a personal expense that is not deductible. 1040z However, you may be able to include certain expenses paid to a person providing nursing-type services. 1040z For more information, see Nursing Services , earlier under What Medical Expenses Are Includible. 1040z Also, certain maintenance or personal care services provided for qualified long-term care can be included in medical expenses. 1040z For more information, see Long-Term Care , earlier under What Medical Expenses Are Includible. 1040z Illegal Operations and Treatments You cannot include in medical expenses amounts you pay for illegal operations, treatments, or controlled substances whether rendered or prescribed by licensed or unlicensed practitioners. 1040z Insurance Premiums See Insurance Premiums under What Medical Expenses Are Includible, earlier. 1040z Maternity Clothes You cannot include in medical expenses amounts you pay for maternity clothes. 1040z Medical Savings Account (MSA) You cannot include in medical expenses amounts you contribute to an Archer MSA. 1040z You cannot include expenses you pay for with a tax-free distribution from your Archer MSA. 1040z You also cannot use other funds equal to the amount of the distribution and include the expenses. 1040z For more information on Archer MSAs, see Publication 969. 1040z Medicines and Drugs From Other Countries In general, you cannot include in your medical expenses the cost of a prescribed drug brought in (or ordered shipped) from another country. 1040z You can only include the cost of a drug that was imported legally. 1040z For example, you can include the cost of a prescribed drug the Food and Drug Administration announces can be legally imported by individuals. 1040z You can include the cost of a prescribed drug you purchase and consume in another country if the drug is legal in both the other country and the United States. 1040z Nonprescription Drugs and Medicines Except for insulin, you cannot include in medical expenses amounts you pay for a drug that is not prescribed. 1040z Example. 1040z Your doctor recommends that you take aspirin. 1040z Because aspirin is a drug that does not require a physician's prescription, you cannot include its cost in your medical expenses. 1040z Nutritional Supplements You cannot include in medical expenses the cost of nutritional supplements, vitamins, herbal supplements, “natural medicines,” etc. 1040z unless they are recommended by a medical practitioner as treatment for a specific medical condition diagnosed by a physician. 1040z Otherwise, these items are taken to maintain your ordinary good health, and are not for medical care. 1040z Personal Use Items You cannot include in medical expenses the cost of an item ordinarily used for personal, living, or family purposes unless it is used primarily to prevent or alleviate a physical or mental defect or illness. 1040z For example, the cost of a toothbrush and toothpaste is a nondeductible personal expense. 1040z In order to accommodate an individual with a physical defect, you may have to purchase an item ordinarily used as a personal, living, or family item in a special form. 1040z You can include the excess of the cost of the item in a special form over the cost of the item in normal form as a medical expense. 1040z (See Braille Books and Magazines under What Medical Expenses Are Includible, earlier. 1040z ) Swimming Lessons See Dancing Lessons , earlier. 1040z Teeth Whitening You cannot include in medical expenses amounts paid to whiten teeth. 1040z See Cosmetic Surgery , earlier. 1040z Veterinary Fees You generally cannot include veterinary fees in your medical expenses, but see Guide Dog or Other Service Animal under What Medical Expenses Are Includible, earlier. 1040z Weight-Loss Program You cannot 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. 1040z You cannot 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, hypertension, or heart disease). 1040z If the weight-loss treatment is not for a specific disease diagnosed by a physician, you cannot include either the fees you pay for membership in a weight reduction group or fees for attendance at periodic meetings. 1040z Also, you cannot include membership dues in a gym, health club, or spa. 1040z You cannot 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 nutritional needs. 1040z See Weight-Loss Program under What Medical Expenses Are Includible, earlier. 1040z How Do You Treat Reimbursements? You can include in medical expenses only those amounts paid during the tax year for which you received no insurance or other reimbursement. 1040z Insurance Reimbursement You must reduce your total medical expenses for the year by all reimbursements for medical expenses that you receive from insurance or other sources during the year. 1040z This includes payments from Medicare. 1040z Even if a policy provides reimbursement only for certain specific medical expenses, you must use amounts you receive from that policy to reduce your total medical expenses, including those it does not reimburse. 1040z Example. 1040z You have insurance policies that cover your hospital and doctors' bills but not your nursing bills. 1040z The insurance you receive for the hospital and doctors' bills is more than their charges. 1040z In figuring your medical deduction, you must reduce the total amount you spent for medical care by the total amount of insurance you received, even if the policies do not cover some of your medical expenses. 1040z Health reimbursement arrange
Print - Click this link to Print this page

Understanding Your CP20 Notice

We believe you incorrectly claimed one or more deductions or credits. As a result, your refund is less than you expected.


What you need to do

  • Review your notice and compare our changes to your tax return.
  • Complete and return the Response form.

You may want to...

  • Review this notice with your tax preparer.
  • Read about the deduction or credit in Publication 17.
  • Call us for clarification at the number listed on your notice.

Answers to Common Questions

What is the notice telling me?
Based on the information shown on your tax return, it appears you have not met the requirements for claiming one or more deductions or credits. As a result, your refund is less than you expected.

What do I have to do?
Review the requirements for the deduction or credit we adjusted. Return the Response form indicating thereon your agreement or disagreement with the changes we made.

If you feel your tax return was correct as filed, send us the documentation listed on page 2 of the notice to verify you qualify for the exemption or credit.


Tips for next year

Consider filing your taxes electronically. Filing online can help you avoid mistakes and find credits and deductions that you may qualify for. In many cases you can file for free. Learn more about e-file.

Page Last Reviewed or Updated: 20-Feb-2014

Printable samples of this notice (PDF)

 

 

How to get help

  • Call the 1-800 number listed on the top right corner of your notice.
  • Authorize someone (e.g., accountant) to contact the IRS on your behalf using Form 2848.
  • See if you qualify for help from a Low Income Taxpayer Clinic.
     

The 1040z

1040z 16. 1040z   How To Get Tax Help Table of Contents Go online, use a smart phone, call or walk in to an office near you. 1040z Whether it's help with a tax issue, preparing your tax return or picking up a free publication or form, get the help you need the way you want it. 1040z Free help with your tax return. 1040z   Free help in preparing your return is available nationwide from IRS-certified volunteers. 1040z The Volunteer Income Tax Assistance (VITA) program is designed to help low-to-moderate income, elderly, persons with disabilities, and limited English proficient taxpayers. 1040z The Tax Counseling for the Elderly (TCE) program is designed to assist taxpayers age 60 and older with their tax returns. 1040z Most VITA and TCE sites offer free electronic filing and all volunteers will let you know about credits and deductions you may be entitled to claim. 1040z Some VITA and TCE sites provide taxpayers the opportunity to prepare their return with the assistance of an IRS-certified volunteer. 1040z To find the nearest VITA or TCE site, visit IRS. 1040z gov or call 1-800-906-9887. 1040z   As part of the TCE program, AARP offers the Tax-Aide counseling program. 1040z To find the nearest AARP Tax-Aide site, visit AARP's website at www. 1040z aarp. 1040z org/money/taxaide or call 1-888-227-7669. 1040z   For more information on these programs, go to IRS. 1040z gov and enter “VITA” in the search box. 1040z Internet. 1040z IRS. 1040z gov and IRS2Go are ready when you are — every day, every night, 24 hours a day, 7 days a week. 1040z Apply for an Employer Identification Number (EIN). 1040z Go to IRS. 1040z gov and enter Apply for an EIN in the search box. 1040z Request an Electronic Filing PIN by going to IRS. 1040z gov and entering Electronic Filing PIN in the search box. 1040z Check the status of your 2013 refund with Where's My Refund? Go to IRS. 1040z gov or the IRS2Go app, and click on Where's My Refund? You'll get a personalized refund date as soon as the IRS processes your tax return and approves your refund. 1040z If you e-file, your refund status is usually available within 24 hours after the IRS receives your tax return or 4 weeks after you've mailed a paper return. 1040z Checking the status of your amended return. 1040z Go to IRS. 1040z gov and enter Where's My Amended Return in the search box. 1040z Download forms, instructions, and publications, including some accessible versions. 1040z Order free transcripts of your tax returns or tax account using the Order a Transcript tool on IRS. 1040z gov or IRS2Go. 1040z Tax return and tax account transcripts are generally available for the current year and past three years. 1040z Figure your income tax withholding with the IRS Withholding Calculator on IRS. 1040z gov. 1040z Use it if you've had too much or too little withheld, your personal situation has changed, you're starting a new job or you just want to see if you're having the right amount withheld. 1040z Determine if you might be subject to the Alternative Minimum Tax by using the Alternative Minimum Tax Assistant on IRS. 1040z gov. 1040z Locate the nearest Taxpayer Assistance Center using the Office Locator tool on IRS. 1040z gov or IRS2Go. 1040z Stop by most business days for face-to-face tax help, no appointment necessary — just walk in. 1040z An employee can explain IRS letters, request adjustments to your tax account or help you set up a payment plan. 1040z Before you visit, check the Office Locator for the address, phone number, hours of operation and the services provided. 1040z If you have an ongoing tax account problem or a special need, such as a disability, you can request an appointment. 1040z Call the local number listed in the Office Locator, or look in the phone book under United States Government, Internal Revenue Service. 1040z Locate the nearest volunteer help site with the VITA Locator Tool on IRS. 1040z gov. 1040z Low-to-moderate income, elderly, persons with disabilities, and limited English proficient taxpayers can get free help with their tax return from the nationwide Volunteer Income Tax Assistance (VITA) program. 1040z The Tax Counseling for the Elderly (TCE) program helps taxpayers 60 and older with their tax returns. 1040z Most VITA and TCE sites offer free electronic filing and some provide IRS-certified volunteers who can help prepare your tax return. 1040z AARP offers the Tax-Aide counseling program as part of the TCE program. 1040z Visit AARP's website to find the nearest Tax-Aide location. 1040z Research your tax questions. 1040z Search publications and instructions by topic or keyword. 1040z Read the Internal Revenue Code, regulations, or other official guidance. 1040z Read Internal Revenue Bulletins. 1040z Sign up to receive local and national tax news by email. 1040z Phone. 1040z You can call the IRS, or you can carry it in your pocket with the IRS2Go app on your smart phone or tablet. 1040z Download the free IRS2Go mobile app from the iTunes app store or from Google Play. 1040z Use it to watch the IRS YouTube channel, get IRS news as soon as it's released to the public, order transcripts of your tax returns or tax account, check your refund status, subscribe to filing season updates or daily tax tips, and follow the IRS Twitter news feed, @IRSnews, to get the latest federal tax news, including information about tax law changes and important IRS programs. 1040z Call to locate the nearest volunteer help site, 1-800-906-9887. 1040z Low-to-moderate income, elderly, persons with disabilities, and limited English proficient taxpayers can get free help with their tax return from the nationwide Volunteer Income Tax Assistance (VITA) program. 1040z The Tax Counseling for the Elderly (TCE) program helps taxpayers 60 and older with their tax returns. 1040z Most VITA and TCE sites offer free electronic filing. 1040z Some VITA and TCE sites provide IRS-certified volunteers who can help prepare your tax return. 1040z Through the TCE program, AARP offers the Tax-Aide counseling program; call 1-888-227-7669 to find the nearest Tax-Aide location. 1040z Call to check the status of your 2013 refund, 1-800-829-1954 or 1-800-829-4477. 1040z The automated Where's My Refund? information is available 24 hours a day, 7 days a week. 1040z If you e-file, your refund status is usually available within 24 hours after the IRS receives your tax return or 4 weeks after you've mailed a paper return. 1040z Before you call, have your 2013 tax return handy so you can provide your social security number, your filing status, and the exact whole dollar amount of your refund. 1040z Where's My Refund? can give you a personalized refund date as soon as the IRS processes your tax return and approves your refund. 1040z Where's My Refund? includes information for the most recent return filed in the current year and does not include information about amended returns. 1040z Call the Amended Return Hotline, 1-866-464-2050, to check the status of your amended return. 1040z Call to order forms, instructions and publications, 1-800-TAX-FORM (1-800-829-3676) to order current-year forms, instructions and publications, and prior-year forms and instructions (limited to 5 years). 1040z You should receive your order within 10 business days. 1040z Call to order transcripts of your tax returns or tax account, 1-800-908-9946. 1040z Follow the prompts to provide your Social Security Number or Individual Taxpayer Identification Number, date of birth, street address and ZIP code. 1040z Call for TeleTax topics, 1-800-829-4477, to listen to pre-recorded messages covering various tax topics. 1040z Call to ask tax questions, 1-800-829-1040. 1040z Call using TTY/TDD equipment, 1-800-829-4059 to ask tax questions or order forms and publications. 1040z The TTY/TDD telephone number is for people who are deaf, hard of hearing, or have a speech disability. 1040z These individuals can also contact the IRS through relay services such as the Federal Relay Service available at www. 1040z gsa. 1040z gov/fedrelay. 1040z Walk-in. 1040z You can find a selection of forms, publications and services — in-person, face-to-face. 1040z Products. 1040z You can walk in to some post offices, libraries, and IRS offices to pick up certain forms, instructions, and publications. 1040z Some IRS offices, libraries, and city and county government offices have a collection of products available to photocopy from reproducible proofs. 1040z Services. 1040z You can walk in to your local TAC most business days for personal, face-to-face tax help. 1040z An employee can explain IRS letters, request adjustments to your tax account, or help you set up a payment plan. 1040z If you need to resolve a tax problem, have questions about how the tax law applies to your individual tax return, or you are more comfortable talking with someone in person, visit your local TAC where you can talk with an IRS representative face-to-face. 1040z No appointment is necessary—just walk in. 1040z Before visiting, check www. 1040z irs. 1040z gov/localcontacts for hours of operation and services provided. 1040z Mail. 1040z You can send your order for forms, instructions, and publications to the address below. 1040z You should receive a response within 10 business days after your request is received. 1040z  Internal Revenue Service 1201 N. 1040z Mitsubishi Motorway Bloomington, IL 61705-6613 The Taxpayer Advocate Service Is Here to Help You. 1040z   The Taxpayer Advocate Service (TAS) is your voice at the IRS. 1040z Our job is to ensure that every taxpayer is treated fairly and that you know and understand your rights. 1040z What can TAS do for you?   We can offer you free help with IRS problems that you can't resolve on your own. 1040z We know this process can be confusing, but the worst thing you can do is nothing at all! TAS can help if you can't resolve your tax problem and: Your problem is causing financial difficulties for you, your family, or your business. 1040z You face (or your business is facing) an immediate threat of adverse action. 1040z You've tried repeatedly to contact the IRS but no one has responded, or the IRS hasn't responded by the date promised. 1040z   If you qualify for our help, you'll be assigned to one advocate who'll be with you at every turn and will do everything possible to resolve your problem. 1040z Here's why we can help: TAS is an independent organization within the IRS. 1040z Our advocates know how to work with the IRS. 1040z Our services are free and tailored to meet your needs. 1040z We have offices in every state, the District of Columbia, and Puerto Rico. 1040z How can you reach us?   If you think TAS can help you, call your local advocate, whose number is in your local directory and at www. 1040z irs. 1040z gov/advocate, or call us toll-free at 1-877-777-4778. 1040z How else does TAS help taxpayers?   TAS also works to resolve large-scale, systemic problems that affect many taxpayers. 1040z If you know of one of these broad issues, please report it to us through our Systemic Advocacy Management System at www. 1040z irs. 1040z gov/sams. 1040z Low Income Taxpayer Clinics. 1040z   Low Income Taxpayer Clinics (LITCs) serve individuals whose income is below a certain level and need to resolve tax problems such as audits, appeals, and tax collection disputes. 1040z Some clinics can provide information about taxpayer rights and responsibilities in different languages for individuals who speak English as a second language. 1040z Visit www. 1040z TaxpayerAdvocate. 1040z irs. 1040z gov or see IRS Publication 4134, Low Income Taxpayer Clinic List. 1040z Prev  Up  Next   Home   More Online Publications