Can You Claim Travel Expenses For Medical Purposes?

Are you wondering, “Can You Claim Travel Expenses For Medical Purposes?” Absolutely! This guide will walk you through the details, offering insights tailored for tourists exploring Vietnam with SIXT.VN and seeking to understand potential tax deductions.

1. What Qualifies As Medical Expenses For Tax Purposes?

For tax purposes, medical expenses are defined as the costs associated with the diagnosis, cure, mitigation, treatment, or prevention of disease, and expenses for treatments affecting any part or function of the body. These costs encompass payments for legal medical services rendered by physicians, surgeons, dentists, and other medical practitioners. They also include the costs of equipment, supplies, and diagnostic devices needed for these purposes. Medical care expenses must primarily be to alleviate or prevent a physical or mental disability or illness. They don’t include expenses that are merely beneficial to general health, such as vitamins or a vacation. According to the IRS, medical expenses also include premiums you pay for insurance that covers the expenses of medical care, and the amounts you pay for transportation to get medical care.

2. What Travel Expenses Can You Include This Year?

You can only include medical and dental expenses you paid this year, but generally not payments for medical or dental care you will receive in a future year. If you pay medical expenses by check, the day you mail or deliver the check is generally the date of payment. 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. 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.

2.1. What if You Didn’t Claim Expenses in an Earlier Year?

If you didn’t claim a medical or dental expense that would have been deductible in an earlier year, you can file Form 1040-X, Amended U.S. Individual Income Tax Return, to claim a refund for the year in which you overlooked the expense. Don’t claim the expense on this year’s return. Generally, a claim for refund 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.

You can’t include medical expenses that were paid by insurance companies or other sources. This is true whether the payments were made directly to you, to the patient, or to the provider of the medical services.

2.2. Separate Returns: Community vs. Non-Community Property States

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. 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.

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. Generally, each of you should include half the expenses. If medical expenses are paid out of the separate funds of one individual, only the individual who paid the medical expenses can include them. If you live in a community property state and aren’t filing a joint return, see Pub. 555.

3. 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 7.5% of your Adjusted Gross Income (AGI).

4. 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. There are different rules for decedents and for individuals who are the subject of multiple support agreements.

4.1. Can You Include Expenses For Your Spouse?

You can include medical expenses you paid for your spouse if you were married either at the time your spouse received the medical services or at the time you paid the medical expenses.

Example 1: Your spouse received medical treatment before you were married, and you paid for it after getting married. You can include these expenses in figuring your medical expense deduction, even if you and your spouse file separate returns.

If your spouse had paid the expenses, you couldn’t include your spouse’s expenses on your separate return. The amounts your spouse paid during the year would be included on their separate return. If you filed a joint return, the medical expenses both of you paid during the year would be used to figure the medical expense deduction.

Example 2: This year, you paid medical expenses for your spouse, Kitt, who died last year. You married Royal this year and the two of you file a joint return. Because you were married to Kitt when Kitt received the medical services, you can include those expenses in figuring your medical expense deduction for this year.

4.2. Can You Include Expenses For A Dependent?

You can include medical expenses you paid for your dependent if the person was your dependent either at the time the medical services were provided or at the time you paid the expenses. A person generally qualifies as your dependent for purposes of the medical expense deduction if both of the following requirements are met.

You can include medical expenses you paid for an individual that would have been your dependent except that:

1. The person received gross income of $5,050 or more in 2024;
2. The person filed a joint return for 2024; or
3. You, or your spouse if filing jointly, could be claimed as a dependent on someone else’s 2024 return.

Exception for adopted child: If you are a U.S. citizen or national and your adopted child lived with you as a member of your household for 2024, that child doesn’t have to be a U.S. citizen or national, or a resident of the United States, Canada, or Mexico.

4.2.1 Qualifying Child

A qualifying child is a child who:

1. 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);

2. Was:

   a. Under age 19 at the end of 2024 and younger than you (or your spouse if filing jointly),

   b. Under age 24 at the end of 2024, a full-time student, and younger than you (or your spouse if filing jointly), or

   c. Any age and permanently and totally disabled;

3. Lived with you for more than half of 2024;

4. Didn’t provide over half of their own support for 2024; and

5. Didn’t file a joint return, other than to claim a refund.

Adopted child: A legally adopted child is treated as your own child. This child includes a child lawfully placed with you for legal adoption.

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.

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.

But if you pay the agency or other person for medical care that was provided and paid for before adoption negotiations began, you can’t include them as medical expenses.

You may be able to take a credit for other expenses related to an adoption. See the Instructions for Form 8839, Qualified Adoption Expenses, for more information.

Child of divorced or separated parents: 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. Each parent can include the medical expenses they pay for the child if:

1. The child is in the custody of one or both parents for more than half the year;

2. The child receives over half of the child’s support during the year from the parents; and

3. The child’s parents:

   a. Are divorced or legally separated under a decree of divorce or separate maintenance,

   b. Are separated under a written separation agreement, or

   c. Live apart at all times during the last 6 months of the year.

This doesn’t apply if the child’s dependency is being claimed under a multiple support agreement.

4.2.2 Qualifying Relative

A qualifying relative is a person:

1. Who is your:

   a. Son, daughter, stepchild, or foster child, or a descendant of any of them (for example, your grandchild),

   b. Brother, sister, half brother, half sister, or a son or daughter of any of them,

   c. Father, mother, or an ancestor or sibling of either of them (for example, your grandmother, grandfather, aunt, or uncle),

   d. Stepbrother, stepsister, stepfather, stepmother, son-in-law, daughter-in-law, father-in-law, mother-in-law, brother-in-law, or sister-in-law, or

   e. Any other person (other than your spouse) who lived with you all year as a member of your household if your relationship didn’t violate local law,

2. Who wasn’t a qualifying child of any taxpayer for 2024, and

3. For whom you provided over half of their support in 2024.

Support claimed under a multiple support agreement: 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. 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.

Any medical expenses paid by others who joined you in the agreement can’t be included as medical expenses by anyone. However, you can include the entire unreimbursed amount you paid for medical expenses.

Example: You and your three siblings each provide one-fourth of your parent’s total support. Under a multiple support agreement, you treat your parent as your dependent. You paid all of your parent’s medical expenses. Your siblings repaid you for three-fourths of these expenses. In figuring your medical expense deduction, you can include only one-fourth of your parent’s medical expenses. Your siblings can’t include any part of the expenses. However, if you and your siblings share the nonmedical support items and you separately pay all of your parent’s medical expenses, you can include the unreimbursed amount you paid for your parent’s medical expenses in your medical expenses.

4.3. What About Expenses For A 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. This includes expenses for the decedent’s spouse and dependents as well as for the decedent.

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. The expenses must be paid within the 1-year period beginning with the day after the date of death. If you are the survivor or personal representative making this choice, you must attach a statement to the decedent’s Form 1040 or 1040-SR (or the decedent’s amended return, Form 1040-X) saying that the expenses haven’t been and won’t be claimed on the estate tax return.

Qualified medical expenses paid before death by the decedent aren’t deductible if paid with a tax-free distribution from any Archer MSA, Medicare Advantage MSA, or health savings account.

4.3.1 What If The Decedent’s Return Had Been Filed?

Form 1040-X can be filed for the year or years the expenses are treated as paid, unless the period for claiming a refund has passed. Generally, a claim for refund 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.

Example: Hudson properly filed a 2023 income tax return. Hudson died in 2024 with unpaid medical expenses of $1,500 from 2023 and $1,800 in 2024. If the expenses are paid within the 1-year period, Hudson’s survivor or personal representative can file an amended return for 2023 claiming a deduction based on the $1,500 medical expenses. The $1,800 of medical expenses from 2024 can be included on the decedent’s final return for 2024.

4.3.2 Paying 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 Schedule A (Form 1040) in the year paid, whether they are paid before or after the decedent’s death. 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.

5. What Medical Expenses Are Includible?

Following is a list of items that you can include in figuring your medical expense deduction. The items are listed in alphabetical order.

5.1 Includible Medical Expenses (A-Z)

This list doesn’t include all possible medical expenses. To determine if an expense not listed can be included in figuring your medical expense deduction, see What Are Medical Expenses, earlier.

• Abortion: You can include in medical expenses the amount you pay for a legal abortion.

• Acupuncture: You can include in medical expenses the amount you pay for acupuncture.

• Alcoholism: You can include in medical expenses amounts you pay for an inpatient’s treatment at a therapeutic center for alcohol addiction. This includes meals and lodging provided by the center during treatment.

  You can also include in medical expenses amounts you pay for transportation to and from alcohol recovery support organization (for example, Alcoholics Anonymous) meetings in your community if the attendance is pursuant to competent medical advice that membership in the alcohol recovery support organization is necessary for the treatment of a disease involving the excessive use of alcohol.

• Ambulance: You can include in medical expenses amounts you pay for ambulance service.

• Annual Physical Examination: See Physical Examination, later.

• Artificial Limb: You can include in medical expenses the amount you pay for an artificial limb.

• Artificial Teeth: You can include in medical expenses the amount you pay for artificial teeth.

• Bandages: You can include in medical expenses the cost of medical supplies such as bandages.

• Birth Control Pills: You can include in medical expenses the amount you pay for birth control pills prescribed by a doctor.

• Body Scan: You can include in medical expenses the cost of an electronic body scan.

• 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.

• Breast Pumps and Supplies: You can include in medical expenses the cost of breast pumps and supplies that assist lactation. This doesn’t include the costs of excess bottles for food storage.

• 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. See Cosmetic Surgery, later.

• 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. The cost of permanent improvements that increase the value of your property may be partly included as a medical expense. The cost of the improvement is reduced by the increase in the value of your property. The difference is a medical expense. If the value of your property isn’t increased by the improvement, the entire cost is included as a medical expense.

  Certain improvements made to accommodate a home to your disabled condition, or that of your spouse or your dependents who live with you, don’t usually increase the value of the home and the cost can be included in full as medical expenses. These improvements include, but aren’t limited to, the following items.

  • Constructing entrance or exit ramps for your home.
  • Widening doorways at entrances or exits to your home.
  • Widening or otherwise modifying hallways and interior doorways.
  • Installing railings, support bars, or other modifications to bathrooms.
  • Lowering or modifying kitchen cabinets and equipment.
  • Moving or modifying electrical outlets and fixtures.
  • Installing porch lifts and other forms of lifts (but elevators generally add value to the house).
  • Modifying fire alarms, smoke detectors, and other warning systems.
  • Modifying stairways.
  • Adding handrails or grab bars anywhere (whether or not in bathrooms).
  • Modifying hardware on doors.
  • Modifying areas in front of entrance and exit doorways.
  • Grading the ground to provide access to the residence.

  Only reasonable costs to accommodate a home to your disabled condition are considered medical care. Additional costs for personal motives, such as for architectural or aesthetic reasons, aren’t medical expenses.

  Capital expense worksheet: Use Worksheet A to figure the amount of your capital expense to include in your medical expenses.

5.1.1. Worksheet A. Capital Expense Worksheet

Operation and upkeep: 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. This rule applies even if none or only part of the original cost of the capital asset qualified as a medical care expense.

Improvements to property rented by a person with a disability: 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.

Example: You have arthritis and a heart condition. You can’t climb stairs or get into a bathtub. On the doctor’s advice, you install a bathroom with a shower stall on the first floor of your two-story rented house. The landlord didn’t pay any of the cost of buying and installing the special plumbing and didn’t lower the rent. You can include the entire amount you paid as medical expenses.

• 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.

  Special design: You can include in medical expenses the difference between the cost of a regular car and a car specially designed to hold a wheelchair.

  Cost of operation: The includible costs of using a car for medical reasons are explained under Transportation, later.

• Chiropractor: You can include in medical expenses fees you pay to a chiropractor for medical care.

• Christian Science Practitioner: You can include in medical expenses fees you pay to Christian Science practitioners for medical care.

• Condoms: You can include in medical expenses the amount you pay to purchase condoms.

• Contact Lenses: You can include in medical expenses amounts you pay for contact lenses needed for medical reasons. You can also include the cost of equipment and materials required for using contact lenses, such as saline solution and enzyme cleaner. See Eyeglasses and Eye Surgery, later.

• Crutches: You can include in medical expenses the amount you pay to buy or rent crutches.

• Dental Treatment: You can include in medical expenses the amounts you pay for the prevention and alleviation of dental disease. 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. Treatment to alleviate dental disease includes services of a dentist for procedures such as X-rays, fillings, braces, extractions, dentures, and other dental ailments. But see Teeth Whitening under What Expenses Aren’t Includible, later.

• Diagnostic Devices: You can include in medical expenses the cost of devices used in diagnosing and treating illness and disease.

  Example: You have diabetes and use a blood sugar test kit to monitor your blood sugar level. You can include the cost of the blood sugar test kit in your medical expenses.

• 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. See Pub. 503.

  You can choose to apply them either way as long as you don’t use the same expenses to claim both a credit and a medical expense deduction.

• Drug Addiction: You can include in medical expenses amounts you pay for an inpatient’s treatment at a therapeutic center for drug addiction. This includes meals and lodging provided by the center during treatment.

  You can also include in medical expenses amounts you pay for transportation to and from drug treatment meetings in your community if the attendance is pursuant to competent medical advice that the membership is necessary for the treatment of a disease involving the excessive use of drugs.

• Drugs: See Medicines, later.

• Eye Exam: You can include in medical expenses the amount you pay for eye examinations.

• Eyeglasses: You can include in medical expenses amounts you pay for eyeglasses and contact lenses needed for medical reasons. See Contact Lenses, earlier, for more information.

• 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.

• Fertility Enhancement: You can include in medical expenses the cost of the following procedures performed on yourself, your spouse, or your dependent to overcome an inability to have children.

  • Procedures such as in vitro fertilization (including temporary storage of eggs or sperm).
  • Surgery, including an operation to reverse prior surgery that prevented the person operated on from having children.

  But see Surrogacy Expenses under What Expenses Aren’t Includible, later.

• Founder’s Fee: See Lifetime Care—Advance Payments, later.

• 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. 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.

• 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 disability or illness of the individual receiving the treatment.

• 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. These amounts are treated as medical insurance premiums. See Insurance Premiums, later.

• Hearing Aids: You can include in medical expenses the cost of a hearing aid and batteries, repairs, and maintenance needed to operate it.

• Home Care: See Nursing Services, later.

• Home Improvements: See Capital Expenses, earlier.

• 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. This includes amounts paid for meals and lodging. Also see Lodging, later.

• Insurance Premiums: You can include in medical expenses insurance premiums you pay for policies that cover medical care. You can’t include in medical expenses insurance premiums that were paid and for which you are claiming a credit or deduction. 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). See Qualified Long-Term Care Insurance Contracts under Long-Term Care, later.

  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. The cost of the medical part must be separately stated in the insurance contract or given to you in a separate statement.

5.1.2 Employer-Sponsored Health Insurance Plan

Don’t 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. Also, don’t include any other medical and dental expenses paid by the plan unless the amount paid is included on your Form W-2.

Example: You are a federal employee participating in the premium conversion plan of the Federal Employee Health Benefits (FEHB) program. Your share of the FEHB premium is paid by making a pre-tax reduction in your salary. Because you are an employee whose insurance premiums are paid with money that is never included in your gross income, you can’t deduct the premiums paid with that money.

Long-term care services: 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. This amount will be reported as wages on your Form W-2.

Retired public safety officers: If you are a retired public safety officer, don’t 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. This applies only to distributions that would otherwise be included in income.

Health reimbursement arrangement (HRA): If you have medical expenses that are reimbursed by a health reimbursement arrangement, you can’t include those expenses in your medical expenses.

5.1.3 Medicare Parts A, B and D

• Medicare Part A: If you are covered under social security (or if you are a government employee who paid Medicare tax), you are enrolled in Medicare Part A. The payroll tax paid for Medicare Part A isn’t a medical expense.

  If you aren’t covered under social security (or weren’t a government employee who paid Medicare tax), you can voluntarily enroll in Medicare Part A. In this situation, you can include the premiums you paid for Medicare Part A as a medical expense.

• Medicare Part B: Medicare Part B is a supplemental medical insurance. Premiums you pay for Medicare Part B are a medical expense. Check the information you received from the Social Security Administration to find out your premium.

• Medicare Part D: Medicare Part D is a voluntary prescription drug insurance program for persons with Medicare Part A or B. You can include as a medical expense premiums you pay for Medicare Part D.

• Personal Protective Equipment: You can include in medical expenses the amounts you pay for personal protective equipment, such as masks, hand sanitizer and hand sanitizing wipes, for the primary purpose of preventing the spread of Coronavirus Disease 2019 (COVID-19). For more information, see IRS Announcement 2021-7.

• 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:

  1. Payable in equal yearly installments or more often; and
  2. Payable for at least 10 years, or until you reach age 65 (but not for less than 5 years).

• 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. You must also 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. You can include this cost of continuing participation in the health plan as a medical expense.

  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 don’t have the option to receive cash), don’t include the value of the unused sick leave in gross income. You can’t include this cost of continuing participation in that health plan as a medical expense.

5.1.4. Insurance Premiums You Can’t Include

You can’t include premiums you pay for:

• Life insurance policies;
• Policies providing payment for loss of earnings;
• Policies for loss of life, limb, sight, etc.;
• 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 isn’t 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 and these distributions would otherwise have been included in income.

Taxes imposed by any governmental unit, such as Medicare taxes, aren’t insurance premiums.

Coverage for nondependents: Generally, you can’t deduct any additional premium you pay as the result of including on your policy someone who isn’t your spouse or dependent, even if that person is your child under age 27. However, you can deduct the additional premium if that person is:

• Your child whom you don’t 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 $5,050 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 2024 return.

Also, if you had family coverage when you added this individual to your policy and your premiums didn’t increase, you can enter on Schedule A (Form 1040) the full amount of your medical and dental insurance premiums.

• 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.

• Laboratory Fees: You can include in medical expenses the amounts you pay for laboratory fees that are part of medical care.

• Lactation Expenses: See Breast Pumps and Supplies, earlier.

• 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. These surfaces must be in poor repair (peeling or cracking) or within the child’s reach. The cost of repainting the scraped area isn’t a medical expense.

  If, instead of removing the paint, you cover the area with wallboard or paneling, treat these items as capital expenses. See Capital Expenses, earlier. Don’t include the cost of painting the wallboard as a medical expense.

• Learning Disability: See Special Education, later.

• Legal Fees: You can include in medical expenses legal fees you paid that are necessary to authorize treatment for mental illness. However, you can’t 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 aren’t necessary for medical care.

• 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. The part of the payment you include is the amount properly allocable to medical care. 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. You can use a statement from the retirement home to prove the amount properly allocable to medical care. The statement must be based either on the home’s prior experience or on information from a comparable home.

  Dependents with disabilities: 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. The payments must be a condition for the institution’s future acceptance of your child and must not be refundable.

  Payments for future medical care: Generally, you can’t include in medical expenses current payments for medical care (including medical insurance) to be provided substantially beyond the end of the year. This rule doesn’t apply in situations where the future care is purchased in connection with obtaining lifetime care of the type described earlier.

• 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. See Nursing Home, later.

  You may be able to include in medical expenses the cost of lodging not provided in a hospital or similar institution. You can include the cost of such lodging while away from home if all of the following requirements are met.

  1. The lodging is primarily for and essential to medical care.
  2. 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.
  3. The lodging isn’t lavish or extravagant under the circumstances.
  4. There is no significant element of personal pleasure, recreation, or vacation in the travel away from home.

  The amount you include in medical expenses for lodging can’t be more than $50 for each night for each person. You can include lodging for a person traveling with the person receiving the medical care. 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. Meals aren’t included.

  Don’t include the cost of lodging while away from home for medical treatment if that treatment isn’t 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 isn’t primarily for or essential to the medical care received.

• Long-Term Care: You can include in medical expenses amounts paid for qualified long-term care services and certain amounts of premiums paid for qualified long-term care insurance contracts.

5.1.5. 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 that are:

1. Required by a chronically ill individual, and
2. Provided pursuant to a plan of care prescribed by a licensed health care practitioner.

Chronically ill individual: 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.

1. The individual 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. Activities of daily living are eating, toileting, transferring, bathing, dressing, and continence.