17.3 Nondeductible Medical Expenses

The most common nondeductible medical expense is the cost of over-the-counter medicines and drugs, such as aspirin and other cold remedies. A deduction for over-the-counter medicines is disallowed even if you have a doctor’s prescription (17.2). Expenses incurred to improve your general health, such as exercise programs not related to a specific condition, are not deductible (17.2 and Table 17-2).

Table 17-2 Nondeductible Medical Expenses

Antiseptic diaper service
Athletic club expenses
Babysitting fees to enable you to make doctor’s visits
Boarding school fees paid for healthy child while parent is recuperating from illness
Bottled water bought to avoid drinking fluoridated city water
Cost of divorce recommended by a psychiatrist
Cost of hotel room suggested for sex therapy
Cost of moving away from airport noise by person suffering a nervous breakdown
Cost of trips prescribed by a doctor for a “change of environment” to boost an ailing person’s morale
Dance lessons advised by a doctor as general physical and mental therapy
Divorced spouse’s medical bills
Domestic help; but see 17.12 if nursing duties are performed.
Ear piercing
Funeral, cremation, burial, cemetery plot, monument, or mausoleum
Health programs offered by resort hotels, health clubs, and gyms
Illegal operations and drugs
Marijuana, even if prescribed by a physician in a state permitting the prescription		 Marriage counseling fees
Massages recommended by physician for general stress reduction
Maternity clothes
Premiums on policies guaranteeing you a specified amount of money each week in the event hospitalization
Scientology fees
Special food or beverage substitutes; but see 17.2.
Tattooing
Teeth whitening to reverse age-related discoloration
Toothpaste
Transportation costs of a disabled person to and from work
Travel costs to favorable climate when you can live there permanently
Travel costs to look for a new place to live—on a doctor’s advice
Tuition and travel expenses to send a problem child to a particular school for a beneficial change in environment (17.10).
Weight-loss program to improve general health (17.2).
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image Court Decision
Sex Reassignment Surgery Is Deductible Expense
The IRS has agreed to follow a 2010 decision in which a Tax Court majority held, over a rigorous dissent, that Gender Identity Disorder (GID) is a disease for medical deduction purposes. A taxpayer, born male, was allowed to deduct expenses for cross-gender hormone therapy and sex reassignment surgery (SRS). Expert testimony confirmed that the taxpayer suffered from severe GID, and hormone therapy and SRS are essential elements of a widely accepted treatment protocol for that condition. The cost of breast augmentation surgery was potentially deductible, but under the facts here, the procedure was not shown to be medically necessary under accepted treatment protocols.
The IRS acquiescence to the decision means that it will no longer dispute that GID is a disease and that expenses for its treatment, including sex reassignment surgery and hormone therapy, are deductible medical expenses where there is medical documentation of GID.
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Cosmetic procedures.

A medical expense deduction is allowed for cosmetic surgery if it is necessary to improve a disfigurement related to a congenital abnormality, disfiguring disease, or an accidental injury.

You may not deduct the cost of cosmetic surgery or other procedures that do not have a medical purpose. Thus, face lifts, hair transplants, electrolysis, teeth-whitening procedures, and liposuction intended to improve appearance are generally not deductible. However, in one case, the Tax Court allowed an exotic dancer to claim a depreciation deduction for breast implants essential for her business (19.8).

Future medical care.

Generally, you cannot include as a current medical expense payment for medical care that is to be provided substantially beyond the end of the year. However, advance payments for the care of a disabled dependent or the portion of a life-care fee or “founder’s fee” to a retirement community that is allocable to future medical care is a currently deductible expense (17.2).

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