Department of the Treasury

Internal Revenue Service

Publication 502

Cat. No. 15002Q

Medical and 

Dental 

Expenses

For use in preparing

2023 Returns

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Future Developments

For the latest information about developments related to 

Pub. 502, such as legislation enacted after it was 

published, go to IRS.gov/Pub502.

What's New

Standard mileage rate. The standard mileage rate allowed for operating expenses for a car when you use it for 

medical reasons is 22 cents a mile. See Transportation 

under What Medical Expenses Are Includible, later.

Reminders

Photographs of missing children. The IRS is a proud 

partner with the National Center for Missing & Exploited 

Children® (NCMEC). Photographs of missing children selected by the Center may appear in this publication on pages that would otherwise be blank. You can help bring 

these children home by looking at the photographs and 

calling 800-THE-LOST (800-843-5678) if you recognize a 

child.

Introduction

This publication explains the itemized deduction for medical and dental expenses that you claim on Schedule A 

(Form 1040). It discusses what expenses, and whose expenses, you can and can't include in figuring the deduction. It explains how to treat reimbursements and how to 

figure the deduction. It also tells you how to report the deduction on your tax return and what to do if you sell medical property or receive damages for a personal injury.

Medical expenses include dental expenses, and in this 

publication the term “medical expenses” is often used to 

refer to medical and dental expenses.

You can deduct on Schedule A (Form 1040) only the 

part of your medical and dental expenses that is more 

than 7.5% of your adjusted gross income (AGI).

This publication also explains how to treat impairment-related work expenses and health insurance premiums if you are self-employed.

Pub. 502 covers many common medical expenses but 

not every possible medical expense. If you can't find the 

expense you are looking for, refer to the definition of medical expenses under What Are Medical Expenses, later.

See How To Get Tax Help near the end of this publication for information about getting publications and forms.

Comments and suggestions. We welcome your comments about this publication and suggestions for future 

editions.

You can send us comments through IRS.gov/

FormComments. Or, you can write to the Internal Revenue 

Dec 21, 2023
Service, Tax Forms and Publications, 1111 Constitution 

Ave. NW, IR-6526, Washington, DC 20224.

Although we can’t respond individually to each comment received, we do appreciate your feedback and will 

consider your comments and suggestions as we revise 

our tax forms, instructions, and publications. Don’t send 

tax questions, tax returns, or payments to the above address.

Getting answers to your tax questions. If you have 

a tax question not answered by this publication or the How 

To Get Tax Help section at the end of this publication, go 

to the IRS Interactive Tax Assistant page at IRS.gov/

Help/ITA where you can find topics by using the search 

feature or viewing the categories listed.

Getting tax forms, instructions, and publications. 

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Don’t resubmit requests you’ve already sent us. You can 

get forms and publications faster online.

Useful Items

You may want to see:

Publication

Health Savings Accounts and Other 

Tax-Favored Health Plans

Forms (and Instructions)

U.S. Individual Income Tax Return

U.S. Tax Return for Seniors

cdu(o) Itemized Deductions

Premium Tax Credit (PTC)

What Are Medical Expenses?

Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and for the purpose of affecting any part or function of the body. These 

expenses include payments for legal medical services 

rendered by physicians, surgeons, dentists, and other 

medical practitioners. They include the costs of equipment, supplies, and diagnostic devices needed for these 

purposes.

Medical care expenses must be primarily 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.

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. 

 969

 1040

 1040-SR

 Schedule A (Form 1040)

 8962

Medical expenses also include amounts paid for qualified 

long-term care services and limited amounts paid for any 

qualified long-term care insurance contract.

What Expenses Can You 

Include This Year?

You can include only the medical and dental expenses 

you paid this year, but generally not payments for medical 

or dental care you will receive in a future year. (But see 

Decedent under Whose Medical Expenses Can You Include, later, for an exception.) This is not the rule for determining whether an expense can be reimbursed by a flexible spending arrangement (FSA). 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.

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.

Separate returns. 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.

Community property states. 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, Community Property. 

2 Publication 502 (2023)
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 AGI.

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. See Support 

claimed under a multiple support agreement, later, under 

Qualifying Relative.

Spouse

You can include medical expenses you paid for your 

spouse. 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.

Example 1. Your spouse received medical treatment 

before you were married. You paid for the treatment 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.

Dependent

You can include medical expenses you paid for your dependent. 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. A person generally qualifies as your dependent 

for purposes of the medical expense deduction if both of 

the following requirements are met.

1. The person was a qualifying child (defined later) or a 

qualifying relative (defined later).

2. The person was a U.S. citizen or national or a resident 

of the United States, Canada, or Mexico. If your qualifying child was adopted, see Exception for adopted 

child, later.

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 $4,700 or more 

in 2023;

2. The person filed a joint return for 2023; or

3. You, or your spouse if filing jointly, could be claimed 

as a dependent on someone else's 2023 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 2023, that child doesn't have to 

be a U.S. citizen or national, or a resident of the United 

States, Canada, or Mexico.

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 2023 and younger than 

you (or your spouse if filing jointly),

b. Under age 24 at the end of 2023, 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 2023;

4. Didn't provide over half of their own support for 2023; 

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.

Publication 502 (2023) 3
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 (discussed 

later).

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 (see Qualifying Child, 

earlier) of any taxpayer for 2023, and

3. For whom you provided over half of the support in 

2023. But see Child of divorced or separated parents, 

earlier, Support claimed under a multiple support 

agreement next, and Kidnapped child under Qualifying Relative in Pub. 501, Dependents, Standard Deduction, and Filing Information.

Support claimed under a multiple support agreement. If you are considered to have provided more than 

TIP

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.

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.

What if the decedent's return had been filed and the 

medical expenses weren't included? 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 2022 income tax return. Hudson died in 2023 with unpaid medical expenses 

of $1,500 from 2022 and $1,800 in 2023. If the expenses 

are paid within the 1-year period, Hudson’s survivor or 

CAUTION

!

4 Publication 502 (2023)
personal representative can file an amended return for 

2022 claiming a deduction based on the $1,500 medical 

expenses. The $1,800 of medical expenses from 2023 

can be included on the decedent's final return for 2023.

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 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.

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.

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 

Publication 502 (2023) 5
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.

Capital Expense 

Worksheet

Worksheet A.

Keep for Your Records

Instructions: Use this worksheet to figure the amount, if any, of your 

medical expenses due to a home improvement.

1. Enter the amount you paid for the home 

improvement .......................... 1.

2. Enter the value of your home 

immediately after the 

improvement ............... 2.

3. Enter the value of your home 

immediately before the 

improvement ............... 3.

4. Subtract line 3 from line 2. This is the 

increase in the value of your home due to the 

improvement .......................... 4.

• If line 4 is more than or equal to line 1, you 

have no medical expenses due to the home 

improvement; stop here.

• If line 4 is less than line 1, go to line 5.

5. Subtract line 4 from line 1. These are your 

medical expenses due to the home 

improvement .......................... 5.

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.

6 Publication 502 (2023)
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.

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, Child and Dependent Care Expenses.

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 

Publication 502 (2023) 7
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.

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.

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.

8 Publication 502 (2023)
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.

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 made directly to the insurance provider 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 $4,700 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 2023 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.

Publication 502 (2023) 9
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.

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:

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.

2. The individual requires substantial supervision to be 

protected from threats to health and safety due to severe cognitive impairment.

Maintenance and personal care services. Maintenance or personal care services is care which has as its 

primary purpose the providing of a chronically ill individual 

with needed assistance with the individual’s disabilities 

10 Publication 502 (2023)
(including protection from threats to health and safety due 

to severe cognitive impairment).

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. The contract must:

1. Be guaranteed renewable;

2. Not provide for a cash surrender value or other money 

that can be paid, assigned, pledged, or borrowed;

3. 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

4. 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.

The amount of qualified long-term care premiums you 

can include is limited. You can include the following as 

medical expenses on Schedule A (Form 1040).

1. Qualified long-term care premiums up to the following 

amounts.

a. Age 40 or under—$480.

b. Age 41 to 50—$890.

c. Age 51 to 60—$1,790.

d. Age 61 to 70—$4,770.

e. Age 71 or over—$5,960.

2. Unreimbursed expenses for qualified long-term care 

services.

Note. The limit on premiums is for each person.

Also, if you are an eligible retired public safety officer, 

you can't 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.

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.

You can't include in medical expenses the cost of meals 

that aren't part of inpatient care. Also see Weight-Loss 

Program and Nutritional Supplements, later.

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. The costs of the 

medical conference must be primarily for and necessary 

to the medical care of you, your spouse, or your dependent. The majority of the time spent at the conference must 

be spent attending sessions on medical information.

The cost of meals and lodging while attending the 

conference isn't deductible as a medical expense.

Medicines

You can include in medical expenses amounts you pay for 

prescribed medicines and drugs. A prescribed drug is one 

that requires a prescription by a doctor for its use by an individual. You can also include amounts you pay for insulin. 

Except for insulin, you can't include in medical expenses 

amounts you pay for a drug that isn't prescribed.

Imported medicines and drugs. If you imported medicines or drugs from other countries, see Medicines and 

Drugs From Other Countries under What Expenses Aren't 

Includible, later.

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. This 

includes the cost of meals and lodging in the home if a 

principal reason for being there is to get medical care.

Don't include the cost of meals and lodging if the reason for being in the home is personal. You can, however, 

include in medical expenses the part of the cost that is for 

medical or nursing care.

Nursing Services

You can include in medical expenses wages and other 

amounts you pay for nursing services. The services need 

not be performed by a nurse as long as the services are of 

a kind generally performed by a nurse. 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. These services can be 

provided in your home or another care facility.

Generally, only the amount spent for nursing services is 

a medical expense. 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. For example, because of your medical 

condition, you pay a visiting nurse $300 per week for medical and household services. Ten percent of the nurse’s 

time is spent doing household services such as washing 

dishes and laundry. You can include only $270 per week 

CAUTION

!

Publication 502 (2023) 11
as medical expenses. The $30 (10% × $300) allocated to 

household services can't be included. However, certain 

maintenance or personal care services provided for qualified long-term care can be included in medical expenses. 

See Maintenance and personal care services under 

Long-Term Care, earlier. 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. See Pub. 503.

You can also include in medical expenses part of the 

amount you pay for that attendant's meals. Divide the food 

expense among the household members to find the cost 

of the attendant's food. Then divide that cost in the same 

manner as in the preceding paragraph. If you had to pay 

additional amounts for household upkeep because of the 

attendant, you can include the extra amounts with your 

medical expenses. This includes extra rent or utilities you 

pay because you moved to a larger apartment to provide 

space for the attendant.

Employment taxes. 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. 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. For information on employment tax responsibilities of household employers, see 

Pub. 926.

Operations

You can include in medical expenses amounts you pay for 

legal operations that aren't for cosmetic surgery. See Cosmetic Surgery under What Expenses Aren't Includible, 

later.

Optometrist

See Eyeglasses, earlier.

Organ Donors

See Transplants, later.

Osteopath

You can include in medical expenses amounts you pay to 

an osteopath for medical care.

Oxygen

You can include in medical expenses amounts you pay for 

oxygen and oxygen equipment to relieve breathing problems caused by a medical condition.

Physical Examination

You can include in medical expenses the amount you pay 

for an annual physical examination and diagnostic tests by 

a physician. You don't have to be ill at the time of the examination.

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.

Premium Tax Credit

You can't include in medical expenses the amount of 

health insurance premiums paid by or through the premium tax credit. You also can't include in medical expenses any amount of advance payments of the premium tax 

credit made that you did not have to pay back. However, 

any amount of advance payments of the premium tax 

credit that you did have to pay back can be included in 

medical expenses.

Example 1. You are under age 65 and unmarried. The 

cost of your health insurance premiums in 2023 is $8,700. 

Advance payments of the premium tax credit of $4,200 

are made to the insurance company and you pay premiums of $4,500. On your 2023 tax return, you are allowed a 

premium tax credit of $3,600 and must repay $600 excess 

advance credit payments (which is less than the repayment limitation). You are treated as paying $5,100 ($8,700 

less the allowed premium tax credit of $3,600) for health 

insurance premiums in 2023. You will enter $5,100 on 

Schedule A, line 1.

Example 2. The facts are the same as in Example 1, 

except you are allowed a premium tax credit of $4,900 on 

your tax return and receive a net premium tax credit of 

$700. You are treated as paying $3,800 ($8,700 less the 

allowed premium tax credit of $4,900) for health insurance 

premiums in 2023. You will enter $3,800 on Schedule A, 

line 1.

Prosthesis

See Artificial Limb and Breast Reconstruction Surgery, 

earlier.

Psychiatric Care

You can include in medical expenses amounts you pay for 

psychiatric care. This includes the cost of supporting a 

mentally ill dependent at a specially equipped medical 

center where the dependent receives medical care. See 

Psychoanalysis next and Transportation, later.

Psychoanalysis

You can include in medical expenses payments for psychoanalysis. However, you can't include payments for psychoanalysis that is part of required training to be a psychoanalyst.

12 Publication 502 (2023)
Psychologist

You can include in medical expenses amounts you pay to 

a psychologist for medical care.

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.

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. Overcoming the learning disabilities must be the 

primary reason for attending the school, and any ordinary 

education received must be incidental to the special education provided. 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.

You can't include in medical expenses the cost of sending a child with behavioral problems to a school where the 

course of study and the disciplinary methods have a beneficial effect on the child's attitude if the availability of medical care in the school isn't a principal reason for sending 

the student there.

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). Also see Vasectomy, later.

Stop-Smoking Programs

You can include in medical expenses amounts you pay for 

a program to stop smoking. However, you can't include in 

medical expenses amounts you pay for drugs that don't 

require a prescription, such as nicotine gum or patches, 

that are designed to help stop smoking.

Surgery

See Operations, earlier.

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. This includes teletypewriter (TTY) and 

telecommunications device for the deaf (TDD) equipment. 

You can also include the cost of repairing the equipment.

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. This may be 

the cost of an adapter that attaches to a regular set. It may 

also be the part of the cost of a specially equipped television that exceeds the cost of the same model regular television set.

Therapy

You can include in medical expenses amounts you pay for 

therapy received as medical treatment.

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. This includes 

the cost of medical care for the donor, in connection with 

the donation of an organ to you, your spouse, or dependent. This also includes transportation expenses.

Transportation

You can include in medical expenses amounts paid for 

transportation primarily for, and essential to, medical care.

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.

Car expenses. You can include out-of-pocket expenses, 

such as the cost of gas and oil, when you use a car for 

medical reasons. You can't include depreciation, insurance, general repair, or maintenance expenses.

If you don't want to use your actual expenses for 2023, 

you can use the standard medical mileage rate of 22 cents 

a mile.

You can also include parking fees and tolls. You can 

add these fees and tolls to your medical expenses 

whether you use actual expenses or the standard mileage 

rate.

Example. In 2023, you drove 2,800 miles for medical 

reasons. You spent $400 for gas, $30 for oil, and $100 for 

tolls and parking. You want to figure the amount to include 

in medical expenses both ways to see which gives the 

greater deduction.

Publication 502 (2023) 13
You figure the actual expenses first. You add the $400 

for gas, the $30 for oil, and the $100 for tolls and parking 

for a total of $530.

You then figure the standard mileage amount. You multiply 2,800 miles by 22 cents a mile for a total of $616. 

Then you add the $100 tolls and parking and mileage for a 

total of $716 (616 + 100).

You include the $716 of car expenses with the other 

medical expenses for the year because the $716 is more 

than the $530 figured using actual expenses.

Transportation expenses you can't include. You can't 

include in medical expenses the cost of transportation in 

the following situations.

• Going to and from work, even if your condition requires an unusual means of transportation.

• Travel for purely personal reasons to another city for 

an operation or other medical care.

• Travel that is merely for the general improvement of 

one's health.

• The costs of operating a specially equipped car for 

other than medical reasons.

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. You may be able 

to include up to $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. See Lodging, earlier.

You can't 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. However, see Medical 

Conferences, earlier.

Tuition

Under special circumstances, you can include charges for 

tuition in medical expenses. See Special Education, earlier.

A lump-sum fee which includes education, board, and 

medical care—without distinguishing which part of the fee 

results from medical care—is not considered an amount 

payable for medical care. However, 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.

Vasectomy

You can include in medical expenses the amount you pay 

for a vasectomy.

Vision Correction Surgery

See Eye Surgery, earlier.

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). This includes fees you pay for membership in a weight reduction group as well as fees for attendance at periodic meetings. You can't 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.

You can't 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. You can include the cost of special food in 

medical expenses only if:

1. The food doesn't satisfy normal nutritional needs,

2. The food alleviates or treats an illness, and

3. The need for the food is substantiated by a physician.

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. See also Weight-Loss 

Program under What Expenses Aren't Includible, later.

Wheelchair

You can include in medical expenses the amounts you pay 

for a wheelchair used for the relief of a sickness or disability. The cost of operating and maintaining the wheelchair 

is also a medical expense.

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 their hair from disease.

X-ray

You can include in medical expenses amounts you pay for 

X-rays for medical reasons.

What Expenses Aren't 

Includible?

Following is a list of some items that you can't include in 

figuring your medical expense deduction. The items are 

listed in alphabetical order.

14 Publication 502 (2023)
Baby Sitting, Childcare, and Nursing 

Services for a Normal, Healthy Baby

You can't 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. Also, any expense allowed as a childcare credit 

can't be treated as an expense paid for medical care.

Controlled Substances

You can't include in medical expenses amounts you pay 

for controlled substances (such as marijuana, laetrile, 

etc.) that aren't legal under federal law, even if such substances are legalized by state law.

Cosmetic Surgery

Generally, you can't include in medical expenses the 

amount you pay for cosmetic surgery. This includes any 

procedure that is directed at improving the patient's appearance and doesn't meaningfully promote the proper 

function of the body or prevent or treat illness or disease. 

You generally can't include in medical expenses the 

amount you pay for procedures such as face lifts, hair 

transplants, hair removal (electrolysis), and liposuction.

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.

Example. An individual undergoes surgery that removes a breast as part of treatment for cancer. The individual pays a surgeon to reconstruct the breast. The surgery to reconstruct the breast corrects a deformity directly 

related to the disease. The cost of the surgery is includible 

in the individual’s medical expenses.

Dancing Lessons

You can't include in medical expenses the cost of dancing 

lessons, swimming lessons, etc., even if they are recommended by a doctor, if they are only for the improvement 

of general health.

Diaper Service

You can't 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.

Electrolysis or Hair Removal

See Cosmetic Surgery, earlier.

Flexible Spending Arrangement

You can't include in medical expenses amounts for which 

you are fully reimbursed by your flexible spending 

arrangement if you contribute a part of your income on a 

pre-tax basis to pay for the qualified benefit.

Funeral Expenses

You can't include in medical expenses amounts you pay 

for funerals.

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, as 

explained under Lifetime Care—Advance Payments, or 

qualified long-term care insurance contracts, as explained 

under Long-Term Care, earlier.

Hair Transplant

See Cosmetic Surgery, earlier.

Health Club Dues

You can't 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.

You can't include in medical expenses the cost of membership in any club organized for business, pleasure, recreation, or other social purpose.

Health Savings Accounts

You can’t include in medical expenses amounts you contribute to a health savings account. You can’t include expenses you pay for with a tax-free distribution from your 

health savings account. You also can’t use other funds 

equal to the amount of the distribution and include the expenses. For more information, see Pub. 969.

Household Help

You can't include in medical expenses the cost of household help, even if such help is recommended by a doctor. 

This is a personal expense that isn't deductible. However, 

you may be able to include certain expenses paid to a person providing nursing-type services. For more information, 

see Nursing Services, earlier, under What Medical Expenses Are Includible. Also, certain maintenance or personal 

care services provided for qualified long-term care can be 

included in medical expenses. For more information, see 

Long-Term Care, earlier, under What Medical Expenses 

Are Includible.

Illegal Operations and Treatments

You can't include in medical expenses amounts you pay 

for illegal operations, treatments, or controlled substances 

Publication 502 (2023) 15
whether rendered or prescribed by licensed or unlicensed 

practitioners.

Insurance Premiums

See Insurance Premiums under What Medical Expenses 

Are Includible, earlier.

Maternity Clothes

You can't include in medical expenses amounts you pay 

for maternity clothes.

Medical Savings Account (MSA)

You can't include in medical expenses amounts you contribute to an Archer MSA. You can't include expenses you 

pay for with a tax-free distribution from your Archer MSA. 

You also can't use other funds equal to the amount of the 

distribution and include the expenses. For more information on Archer MSAs, see Pub. 969.

Medicines and Drugs From Other 

Countries

In general, you can't include in your medical expenses the 

cost of a prescribed drug brought in (or ordered and shipped) from another country. You can only include the cost 

of a drug that was imported legally. For example, you can 

include the cost of a prescribed drug the Food and Drug 

Administration announces can be legally imported by individuals.

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.

Nonprescription Drugs and Medicines

Except for insulin, you can't include in medical expenses 

amounts you pay for a drug that isn't prescribed. A prescribed drug is one that requires a prescription by a doctor for 

its use by an individual.

Example. Your doctor recommends that you take aspirin. Because aspirin is a drug that doesn't require a 

physician's prescription for its use by an individual, you 

can't include its cost in your medical expenses.

Nutritional Supplements

You can't include in medical expenses the cost of nutritional supplements, vitamins, herbal supplements, “natural 

medicines,” etc., unless they are recommended by a medical practitioner as treatment for a specific medical condition diagnosed by a physician. These items are taken to 

maintain your ordinary good health and aren't for medical 

care.

Personal Use Items

You can't 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 disability or illness. For example, the cost of a 

toothbrush and toothpaste is a nondeductible personal expense.

In order to accommodate an individual with a physical 

disability, you may have to purchase an item ordinarily 

used as a personal, living, or family item in a special form. 

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. See Braille Books and Magazines under What Medical Expenses Are Includible, earlier.

Premium Tax Credit

You can't include in medical expenses the amount of 

health insurance premiums paid by or through the premium tax credit. You also can't include in medical expenses any amount of advance payments of the premium tax 

credit made that you did not have to pay back. However, 

any amount of advance payments of the premium tax 

credit that you did have to pay back can be included in 

medical expenses.

Surrogacy Expenses

You can't include in medical expenses the amounts you 

pay for the identification, retention, compensation, and 

medical care of a gestational surrogate because they are 

paid for an unrelated party who is not you, your spouse, or 

your dependent.

Swimming Lessons

See Dancing Lessons, earlier.

Teeth Whitening

You can't include in medical expenses amounts paid to 

whiten teeth. See Cosmetic Surgery, earlier.

Veterinary Fees

You generally can't include veterinary fees in your medical 

expenses, but see Guide Dog or Other Service Animal under What Medical Expenses Are Includible, earlier.

Weight-Loss Program

You can't 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. You can't 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). If the weight-loss treatment isn't 

for a specific disease diagnosed by a physician, you can't 

16 Publication 502 (2023)
include either the fees you pay for membership in a 

weight-reduction group or fees for attendance at periodic 

meetings. Also, you can't include membership dues in a 

gym, health club, or spa.

You can't 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.

See Weight-Loss Program under What Medical Expenses Are Includible, earlier.

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.

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. 

This includes payments from Medicare.

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 doesn't reimburse.

Example. You have insurance policies that cover your 

hospital and doctors' bills but not your nursing bills. The 

insurance you receive for the hospital and doctors' bills is 

more than their charges. 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 don't cover some of your medical expenses.

Health reimbursement arrangement (HRA). An HRA 

is an employer-funded plan that reimburses employees for 

medical care expenses and allows unused amounts to be 

carried forward. An HRA is funded solely by the employer 

and the reimbursements for medical expenses, up to a 

maximum dollar amount for a coverage period, aren't included in your income.

Other reimbursements. Generally, you don't reduce 

medical expenses by payments you receive for:

• Permanent loss or loss of use of a member or function 

of the body (loss of limb, sight, hearing, etc.) or disfigurement to the extent the payment is based on the nature of the injury without regard to the amount of time 

lost from work, or

• Loss of earnings.

You must, however, reduce your medical expenses by 

any part of these payments that is designated for medical 

costs. See How Do You Figure and Report the Deduction 

on Your Tax Return, later.

For how to treat damages received for personal injury 

or sickness, see Damages for Personal Injuries, later.

What if Your Insurance Reimbursement Is 

More Than Your Medical Expenses?

If you are reimbursed more than your medical expenses, 

you may have to include the excess in income. You may 

want to use Figure 1 to help you decide if any of your reimbursement is taxable.

Figure 1.

*See Premiums paid by you and your employer.

Was any part of

your premiums

paid by your

employer?

Were your

employer’s

contributions to

your premiums

included in your

income?

Did you pay any

part of the

premiums?

NONE of the

excess

reimbursement is

taxable.

ALL of the excess

reimbursement is

taxable.

PART of the

excess

reimbursement is

taxable.*

No







Yes

Yes

No

No

Yes







Is Your Excess Medical

Reimbursement Taxable?

Premiums paid by you. If you pay either the entire premium for your medical insurance or all the costs of a plan 

similar to medical insurance and your insurance payments 

or other reimbursements are more than your total medical 

expenses for the year, you have excess reimbursement. 

Generally, you don't include the excess reimbursement in 

your gross income. However, gross income does include 

total payments in excess of $420 a day ($153,300 for 

2023) for qualified long-term care services.

Publication 502 (2023) 17
Premiums paid by you and your employer. If both you 

and your employer contribute to your medical insurance 

plan and your employer's contributions aren't included in 

your gross income, you must include in your gross income 

the part of your excess reimbursement that is from your 

employer's contribution.

If you aren't covered by more than one policy, you can 

figure the amount of the excess reimbursement you must 

include in gross income using Worksheet B. If you are covered under more than one policy, see More than one policy, later.

Excess Reimbursement 

Includible in Income 

When You Have Only 

One Policy

Worksheet B.

Keep for Your Records

Instructions: Use this worksheet to figure the amount of excess 

reimbursement you must include in income when both you and your 

employer contributed to your medical insurance and your employer's 

contributions aren't included in your gross income.

1. Enter the amount contributed to your 

medical insurance for the year by your 

employer ........................ 1.

2. Enter the total annual cost of the 

policy ............................ 2.

3. Divide line 1 by line 2 ............... 3.

4. Enter the amount of excess 

reimbursement .................... 4.

5. Multiply line 3 by line 4. This is the 

amount of the excess reimbursement you must include as other income 

on Form 1040 or 1040-SR ........... 5.

Premiums paid by your employer. If your employer or 

your former employer pays the total cost of your medical 

insurance plan and your employer's contributions aren't included in your income, you must report all of your excess 

reimbursement as other income.

More than one policy. If you are covered under more 

than one policy, the cost of at least one of which is paid by 

both you and your employer, you must first divide the medical expenses among the policies to figure the excess reimbursement from each policy. Then divide the policy 

costs to figure the part of any excess reimbursement that 

is from your employer's contribution. Any excess reimbursement that is due to your employer's contributions is 

includible in your income.

You can figure the part of the excess reimbursement 

that is from your employer's contribution by using Worksheet C. Use Worksheet C only if both you and your employer paid part of the cost of at least one policy. If you 

had more than one policy, but you didn't share in the cost 

of at least one policy, don't use Worksheet C.

Excess Reimbursement 

Includible in Income 

When You Have More 

Than One Policy

Worksheet C.

Keep for Your Records

Instructions: Use this worksheet to figure the amount of excess 

reimbursement you must include as income on your tax return when 

(a) you are reimbursed under two or more health insurance policies, 

(b) at least one of which is paid for by both you and your employer, 

and (c) your employer's contributions aren't included in your gross 

income. If you and your employer didn't share in the cost of at least 

one policy, don't use this worksheet.

1. Enter the reimbursement from your 

employer's policy .................... 1.

2. Enter the reimbursement from your own 

policy .............................. 2.

3. Add lines 1 and 2 .................... 3.

4. Divide line 1 by line 3 ................ 4.

5. Enter the total medical expenses you paid 

during the year. If this amount is at least as 

much as the amount on line 3, stop here 

because there is no excess 

reimbursement ..................... 5.

6. Multiply line 4 by line 5 ............... 6.

7. Subtract line 6 from line 1 ............. 7.

8. Enter employer's contribution to the annual 

cost of the employer's policy ........... 8.

9. Enter total annual cost of the employer's 

policy .............................. 9.

10. Divide line 8 by line 9. This is the 

percentage of your total excess 

reimbursement you must report as other 

income ............................ 10.

11. Multiply line 7 by line 10. This is the 

amount of your total excess 

reimbursement you must report as other 

income on Form 1040 or 1040-SR ...... 11.

What if You Receive Insurance 

Reimbursement in a Later Year?

If you are reimbursed in a later year for medical expenses 

you deducted in an earlier year, you must generally report 

the reimbursement as income up to the amount you previously deducted as medical expenses.

However, don't report as income the amount of reimbursement you received up to the amount of your medical 

deductions that didn't reduce your tax for the earlier year.

For more information about the recovery of an amount 

that you claimed as an itemized deduction in an earlier 

year, see Recoveries in Pub. 525, Taxable and Nontaxable 

Income.

18 Publication 502 (2023)
What if You Are Reimbursed for Medical 

Expenses You Didn't Deduct?

If you didn't deduct a medical expense in the year you 

paid it because your medical expenses weren't more than 

7.5% of your AGI or because you didn't itemize deductions, don't include the reimbursement, up to the amount 

of the expense, in income. However, if the reimbursement 

is more than the expense, see What if Your Insurance Reimbursement Is More Than Your Medical Expenses, earlier. 

How Do You Figure and Report 

the Deduction on Your Tax 

Return?

Once you have determined which medical expenses you 

can include, figure and report the deduction on your tax 

return.

What Tax Form Do You Use?

You report your medical expense deduction on Schedule A (Form 1040). See the Instructions for Schedule A 

(Form 1040) for more detailed information on figuring your 

medical and dental expense deduction.

Recordkeeping. You should keep records of your 

medical and dental expenses to support your deduction. Don't send these records with your paper 

return.

Sale of Medical Equipment or 

Property

If you deduct the cost of medical equipment or property in 

one year and sell it in a later year, you may have a taxable 

gain. The taxable gain is the amount of the selling price 

that is more than the adjusted basis of the equipment or 

property.

The adjusted basis is the portion of the cost of the 

equipment or property that you couldn't deduct because of 

the 7.5% or 10% AGI limit used to figure your medical deduction. Refer to your Schedule A for the year the cost 

was included to determine which limit applied to you. Use 

Worksheet D to figure the adjusted basis of the equipment 

or property.

RECORDS

Adjusted Basis of 

Medical Equipment or 

Property Sold

Worksheet D.

Keep for Your Records

Instructions: Use this worksheet if you deducted the cost of medical 

equipment or property in one year and sold the equipment or 

property in a later year. This worksheet will give you the adjusted 

basis of the equipment or property you sold.

1. Enter the cost of the equipment or 

property ....................... 1.

2. Enter your total includible medical 

expenses for the year you included 

the cost in your medical 

expenses ...................... 2.

3. Divide line 1 by line 2 ............ 3.

4. Enter 7.5% or 10% of your AGI 

(whichever applies) for the year the 

cost was included in your medical 

expenses ..................... 4.

5. Multiply line 3 by line 4. If your 

allowable itemized deductions for the 

year you purchased the equipment 

or property weren't more than your 

AGI for that year, stop here. This is 

the adjusted basis of the equipment 

or property. If your allowable itemized 

deductions for the year you 

purchased the equipment or property 

were more than your AGI for that 

year, complete lines 6 through 

11 ............................ 5.

6. Subtract line 5 from line 1 ........ 6.

7. Enter your total allowable itemized 

deductions for the year the cost was 

included in your medical 

expenses ...................... 7.

8. Divide line 6 by line 7 ............ 8.

9. Enter your AGI for the year the cost 

was included in your medical 

expenses ...................... 9.

10. Subtract line 9 from line 7 ........ 10.

11. Multiply line 8 by line 10 ......... 11.

12. Add line 5 to line 11. If your allowable 

itemized deductions for the year you 

purchased the equipment or property 

were more than your AGI for that 

year, this is the adjusted basis of the 

equipment or property ........... 12.

Next, use Worksheet E to figure the total gain or loss on 

the sale of the medical equipment or property.

Publication 502 (2023) 19
Gain or Loss on the 

Sale of Medical 

Equipment or Property

Worksheet E.

Keep for Your Records

Instructions: Use the following worksheet to figure total gain or 

loss on the sale of medical equipment or property that you 

deducted in an earlier year.

1. Enter the amount that the medical 

equipment or property sold for ...... 1.

2. Enter your selling expenses ......... 2.

3. Subtract line 2 from line 1 ........... 3.

4. Enter the adjusted basis of the 

equipment or property from Worksheet 

D, line 5, or line 12, if applicable ...... 4.

5. Subtract line 4 from line 3. This is the 

total gain or loss from the sale of the 

medical equipment or property ...... 5.

If you have a loss, it isn't deductible. If you have a gain, 

it’s includible in your income. The part of the gain that is a 

recovery of an amount you previously deducted is taxable 

as ordinary income. Enter it on Form 1040 or 1040-SR. 

Any part of the gain that is more than the recovery of an 

amount you previously deducted is taxable as a capital 

gain. Enter it on Form 8949, Sales and Other Dispositions 

of Capital Assets, and Schedule D (Form 1040), Capital 

Gains and Losses.

For more information about the recovery of an amount 

that you claimed as an itemized deduction in an earlier 

year, see Recoveries in Pub. 525.

Damages for Personal Injuries

If you receive an amount in settlement of a personal injury 

suit, part of that award may be for medical expenses that 

you deducted in an earlier year. If it is, you must include 

that part in your income in the year you receive it to the extent it reduced your taxable income in the earlier year. See 

What if You Receive Insurance Reimbursement in a Later 

Year, discussed earlier under How Do You Treat Reimbursements.

Example. You sued this year for injuries you suffered 

in an accident last year. You sought $10,000 for your injuries and didn't itemize your damages. Last year, you paid 

$500 for medical expenses for your injuries. You deducted 

those expenses on last year's tax return. This year you 

settled your lawsuit for $2,000. Your settlement didn't itemize or allocate the damages. The $2,000 is first presumed 

to be for the medical expenses that you deducted. The 

$500 is includible in your income this year because you 

deducted the entire $500 as a medical expense deduction 

last year.

Future medical expenses. If you receive an amount in 

settlement of a damage suit for personal injuries, part of 

that award may be for future medical expenses. If it is, you 

must reduce any future medical expenses for these injuries until the amount you received has been completely 

used.

Example. You were injured in an accident. You sued 

and sought a judgment of $50,000 for your injuries. You 

settled the suit for $45,000. The settlement provided that 

$10,000 of the $45,000 was for future medical expenses 

for your injuries. You can't include the first $10,000 that 

you pay for medical expenses for those injuries.

Workers' compensation. If you received workers' compensation and you deducted medical expenses related to 

that injury, you must include the workers' compensation in 

income up to the amount you deducted. If you received 

workers' compensation, but didn't deduct medical expenses related to that injury, don't include the workers' compensation in your income.

Impairment-Related Work 

Expenses

If you are a person with disabilities, you can take a business deduction for expenses that are necessary for you to 

be able to work. If you take a business deduction for these 

impairment-related work expenses, they aren't subject to 

the 7.5% limit that applies to medical expenses.

You have a disability if you have:

• A physical or mental disability (for example, blindness 

or deafness) that functionally limits your being employed; or

• A physical or mental impairment (for example, a sight 

or hearing impairment) that substantially limits one or 

more of your major life activities, such as performing 

manual tasks, walking, speaking, breathing, learning, 

or working.

Impairment-related expenses defined. Impairment-related expenses are those ordinary and necessary business expenses that are:

• Necessary for you to do your work satisfactorily;

• For goods and services not required or used, other 

than incidentally, in your personal activities; and

• Not specifically covered under other income tax laws.

Where to report. If you are self-employed, deduct the 

business expenses on the appropriate form (Schedule C, 

E, or F) used to report your business income and expenses.

If you are an employee, complete Form 2106, Employee Business Expenses. Enter on Schedule A (Form 

1040) that part of the amount on Form 2106 that is related 

to your impairment.

Example. You are blind. You must use a reader to do 

your work. You use the reader both during your regular 

20 Publication 502 (2023)
working hours at your place of work and outside your regular working hours away from your place of work. The 

reader's services are only for your work. You can deduct 

your expenses for the reader as business expenses.

Health Insurance Costs for 

Self-Employed Persons

If you were self-employed and had a net profit for the year, 

you may be able to deduct, as an adjustment to income, 

amounts paid for medical and qualified long-term care insurance on behalf of yourself, your spouse, your dependents, and your children who were under age 27 at the end 

of 2023. For this purpose, you were self-employed if you 

were a general partner (or a limited partner receiving guaranteed payments) or you received wages from an S corporation in which you were more than a 2% shareholder. 

The insurance plan must be established under your trade 

or business and the deduction can't be more than your 

earned income from that trade or business.

You can't deduct payments for medical insurance for 

any month in which you were eligible to participate in a 

health plan subsidized by your employer, your spouse's 

employer, or an employer of your dependent, or your child 

under age 27, at the end of 2023. You can't deduct payments for a qualified long-term care insurance contract for 

any month in which you were eligible to participate in a 

long-term care insurance plan subsidized by your employer or your spouse's employer.

If you qualify to take the deduction, use the Self-Employed Health Insurance Deduction Worksheet in the Instructions for Form 1040 to figure the amount you can deduct. But if any of the following applies, don't use that 

worksheet.

• You had more than one source of income subject to 

self-employment tax.

• You file Form 2555, Foreign Earned Income.

• You are using amounts paid for qualified long-term 

care insurance to figure the deduction.

If you can't use the worksheet in the Instructions for Form 

1040, use Form 7206, Self-Employed Health Deduction, 

to figure your deduction.

Use Pub. 974, Premium Tax Credit, instead of the worksheet in the 2023 Instructions for Form 1040 if the insurance plan established, or considered to be established, 

under your business was obtained through the Health Insurance Marketplace and you are claiming the premium 

tax credit.

When figuring the amount you can deduct for insurance 

premiums, don't include amounts paid for health insurance coverage with retirement plan distributions that were 

tax free because you are a retired public safety officer.

Where to report. You take this deduction on Form 1040 

or 1040-SR. If you itemize your deductions and don't claim 

100% of your self-employed health insurance costs on 

Form 1040 or 1040-SR, include any remaining premiums 

with all other medical expenses on Schedule A (Form 

1040) subject to the 7.5% limit.

Child under age 27. If the insurance policy covers your 

nondependent child who was under age 27 at the end of 

2023, you can claim the premiums for that coverage on 

Form 1040 or 1040-SR. If you can't claim 100% of your 

self-employed health insurance costs on Form 1040 or 

1040-SR, any excess amounts attributable to that child 

aren't eligible to be claimed on Schedule A (Form 1040).

Generally, family health insurance premiums don't increase if coverage for an additional child is added. If this is 

the situation, no allocation would be necessary. If the premiums did increase (such as where coverage was expanded from single to family to add the nondependent child), 

you can allocate the amount on Form 1040 or 1040-SR to 

the nondependent child and any excess amounts not attributable to that child would be eligible to be claimed on 

Schedule A.

Example 1. You were self-employed in 2023 and had 

self-only coverage for health insurance. Your premium for 

that coverage was $5,000 for the year. You change to family coverage only to add your 26-year-old nondependent 

child to the plan. Your health insurance premium increases 

to $10,000 for the year. After completing the Self-Employed Health Insurance Deduction Worksheet in the Instructions for Form 1040, you can only deduct $4,000 on 

Form 1040 or 1040-SR. The $4,000 is allocable to the 

nondependent child. You can only claim the $5,000 allocable to your coverage on Schedule A. The $1,000 excess 

premiums allocable to the nondependent child can’t be 

claimed by you.

Example 2. The facts are the same as in Example 1, 

except that you had family coverage when you added your 

26-year-old nondependent child to the policy. There was 

no increase in the $10,000 premium. In this case, you 

could claim $4,000 on Form 1040 or 1040-SR and $6,000 

on Schedule A.

More information. For more information, see Pub. 535.

How To Get Tax Help

If you have questions about a tax issue; need help preparing your tax return; or want to download free publications, 

forms, or instructions, go to IRS.gov to find resources that 

can help you right away.

Preparing and filing your tax return. After receiving all 

your wage and earnings statements (Forms W-2, W-2G, 

1099-R, 1099-MISC, 1099-NEC, etc.); unemployment 

compensation statements (by mail or in a digital format) or 

other government payment statements (Form 1099-G); 

and interest, dividend, and retirement statements from 

banks and investment firms (Forms 1099), you have several options to choose from to prepare and file your tax return. You can prepare the tax return yourself, see if you 

Publication 502 (2023) 21
qualify for free tax preparation, or hire a tax professional to 

prepare your return.

Free options for tax preparation. Your options for preparing and filing your return online or in your local community, if you qualify, include the following.

• Free File. This program lets you prepare and file your 

federal individual income tax return for free using software or Free File Fillable Forms. However, state tax 

preparation may not be available through Free File. Go 

to IRS.gov/FreeFile to see if you qualify for free online 

federal tax preparation, e-filing, and direct deposit or 

payment options.

• VITA. The Volunteer Income Tax Assistance (VITA) 

program offers free tax help to people with 

low-to-moderate incomes, persons with disabilities, 

and limited-English-speaking taxpayers who need 

help preparing their own tax returns. Go to IRS.gov/

VITA, download the free IRS2Go app, or call 

800-906-9887 for information on free tax return preparation.

• TCE. The Tax Counseling for the Elderly (TCE) program offers free tax help for all taxpayers, particularly 

those who are 60 years of age and older. TCE volunteers specialize in answering questions about pensions and retirement-related issues unique to seniors. 

Go to IRS.gov/TCE or download the free IRS2Go app 

for information on free tax return preparation.

• MilTax. Members of the U.S. Armed Forces and qualified veterans may use MilTax, a free tax service offered by the Department of Defense through Military 

OneSource. For more information, go to 

MilitaryOneSource (MilitaryOneSource.mil/MilTax).

Also, the IRS offers Free Fillable Forms, which can 

be completed online and then e-filed regardless of income.

Using online tools to help prepare your return. Go to 

IRS.gov/Tools for the following.

• The Earned Income Tax Credit Assistant (IRS.gov/

EITCAssistant) determines if you’re eligible for the 

earned income credit (EIC).

• The Online EIN Application (IRS.gov/EIN) helps you 

get an employer identification number (EIN) at no 

cost.

• The Tax Withholding Estimator (IRS.gov/W4App) 

makes it easier for you to estimate the federal income 

tax you want your employer to withhold from your paycheck. This is tax withholding. See how your withholding affects your refund, take-home pay, or tax due.

• The First-Time Homebuyer Credit Account Look-up 

(IRS.gov/HomeBuyer) tool provides information on 

your repayments and account balance.

• The Sales Tax Deduction Calculator (IRS.gov/

SalesTax) figures the amount you can claim if you 

itemize deductions on Schedule A (Form 1040).

Getting answers to your tax questions. On 

IRS.gov, you can get up-to-date information on 

current events and changes in tax law.

• IRS.gov/Help: A variety of tools to help you get answers to some of the most common tax questions.

• IRS.gov/ITA: The Interactive Tax Assistant, a tool that 

will ask you questions and, based on your input, provide answers on a number of tax topics.

• IRS.gov/Forms: Find forms, instructions, and publications. You will find details on the most recent tax 

changes and interactive links to help you find answers 

to your questions.

• You may also be able to access tax information in your 

e-filing software.

Need someone to prepare your tax return? There are 

various types of tax return preparers, including enrolled 

agents, certified public accountants (CPAs), accountants, 

and many others who don’t have professional credentials. 

If you choose to have someone prepare your tax return, 

choose that preparer wisely. A paid tax preparer is:

• Primarily responsible for the overall substantive accuracy of your return,

• Required to sign the return, and

• Required to include their preparer tax identification 

number (PTIN).

Although the tax preparer always signs the return, 

you're ultimately responsible for providing all the 

information required for the preparer to accurately 

prepare your return and for the accuracy of every item reported on the return. Anyone paid to prepare tax returns 

for others should have a thorough understanding of tax 

matters. For more information on how to choose a tax preparer, go to Tips for Choosing a Tax Preparer on IRS.gov.

Employers can register to use Business Services Online. The Social Security Administration (SSA) offers online service at SSA.gov/employer for fast, free, and secure 

W-2 filing options to CPAs, accountants, enrolled agents, 

and individuals who process Form W-2, Wage and Tax 

Statement, and Form W-2c, Corrected Wage and Tax 

Statement.

IRS social media. Go to IRS.gov/SocialMedia to see the 

various social media tools the IRS uses to share the latest 

information on tax changes, scam alerts, initiatives, products, and services. At the IRS, privacy and security are our 

highest priority. We use these tools to share public information with you. Don’t post your social security number 

(SSN) or other confidential information on social media 

sites. Always protect your identity when using any social 

networking site.

The following IRS YouTube channels provide short, informative videos on various tax-related topics in English, 

Spanish, and ASL.

• Youtube.com/irsvideos.

CAUTION

!

22 Publication 502 (2023)
• Youtube.com/irsvideosmultilingua.

• Youtube.com/irsvideosASL.

Watching IRS videos. The IRS Video portal 

(IRSVideos.gov) contains video and audio presentations 

for individuals, small businesses, and tax professionals.

Online tax information in other languages. You can 

find information on IRS.gov/MyLanguage if English isn’t 

your native language.

Free Over-the-Phone Interpreter (OPI) Service. The 

IRS is committed to serving taxpayers with limited-English 

proficiency (LEP) by offering OPI services. The OPI Service is a federally funded program and is available at Taxpayer Assistance Centers (TACs), most IRS offices, and 

every VITA/TCE tax return site. The OPI Service is accessible in more than 350 languages.

Accessibility Helpline available for taxpayers with 

disabilities. Taxpayers who need information about accessibility services can call 833-690-0598. The Accessibility Helpline can answer questions related to current and 

future accessibility products and services available in alternative media formats (for example, braille, large print, 

audio, etc.). The Accessibility Helpline does not have access to your IRS account. For help with tax law, refunds, or 

account-related issues, go to IRS.gov/LetUsHelp.

Note. Form 9000, Alternative Media Preference, or 

Form 9000(SP) allows you to elect to receive certain types 

of written correspondence in the following formats.

• Standard Print.

• Large Print.

• Braille.

• Audio (MP3).

• Plain Text File (TXT).

• Braille Ready File (BRF).

Disasters. Go to IRS.gov/DisasterRelief to review the 

available disaster tax relief.

Getting tax forms and publications. Go to IRS.gov/

Forms to view, download, or print all of the forms, instructions, and publications you may need. Or, you can go to 

IRS.gov/OrderForms to place an order.

Getting tax publications and instructions in eBook 

format. Download and view popular tax publications and 

instructions (including the Instructions for Form 1040) on 

mobile devices as eBooks at IRS.gov/eBooks.

Note. IRS eBooks have been tested using Apple's 

iBooks for iPad. Our eBooks haven’t been tested on other 

dedicated eBook readers, and eBook functionality may 

not operate as intended.

Access your online account (individual taxpayers 

only). Go to IRS.gov/Account to securely access information about your federal tax account.

• View the amount you owe and a breakdown by tax 

year.

• See payment plan details or apply for a new payment 

plan.

• Make a payment or view 5 years of payment history 

and any pending or scheduled payments.

• Access your tax records, including key data from your 

most recent tax return, and transcripts.

• View digital copies of select notices from the IRS.

• Approve or reject authorization requests from tax professionals.

• View your address on file or manage your communication preferences.

Get a transcript of your return. With an online account, you can access a variety of information to help you 

during the filing season. You can get a transcript, review 

your most recently filed tax return, and get your adjusted 

gross income. Create or access your online account at 

IRS.gov/Account.

Tax Pro Account. This tool lets your tax professional 

submit an authorization request to access your individual 

taxpayer IRS online account. For more information, go to 

IRS.gov/TaxProAccount.

Using direct deposit. The safest and easiest way to receive a tax refund is to e-file and choose direct deposit, 

which securely and electronically transfers your refund directly into your financial account. Direct deposit also 

avoids the possibility that your check could be lost, stolen, 

destroyed, or returned undeliverable to the IRS. Eight in 

10 taxpayers use direct deposit to receive their refunds. If 

you don’t have a bank account, go to IRS.gov/

DirectDeposit for more information on where to find a bank 

or credit union that can open an account online.

Reporting and resolving your tax-related identity 

theft issues. 

• Tax-related identity theft happens when someone 

steals your personal information to commit tax fraud. 

Your taxes can be affected if your SSN is used to file a 

fraudulent return or to claim a refund or credit.

• The IRS doesn’t initiate contact with taxpayers by 

email, text messages (including shortened links), telephone calls, or social media channels to request or 

verify personal or financial information. This includes 

requests for personal identification numbers (PINs), 

passwords, or similar information for credit cards, 

banks, or other financial accounts.

• Go to IRS.gov/IdentityTheft, the IRS Identity Theft 

Central webpage, for information on identity theft and 

data security protection for taxpayers, tax professionals, and businesses. If your SSN has been lost or 

stolen or you suspect you’re a victim of tax-related 

Publication 502 (2023) 23
identity theft, you can learn what steps you should 

take.

• Get an Identity Protection PIN (IP PIN). IP PINs are 

six-digit numbers assigned to taxpayers to help prevent the misuse of their SSNs on fraudulent federal income tax returns. When you have an IP PIN, it prevents someone else from filing a tax return with your 

SSN. To learn more, go to IRS.gov/IPPIN.

Ways to check on the status of your refund. 

• Go to IRS.gov/Refunds.

• Download the official IRS2Go app to your mobile device to check your refund status.

• Call the automated refund hotline at 800-829-1954.

The IRS can’t issue refunds before mid-February 

for returns that claimed the EIC or the additional 

child tax credit (ACTC). This applies to the entire 

refund, not just the portion associated with these credits.

Making a tax payment. Payments of U.S. tax must be 

remitted to the IRS in U.S. dollars. Digital assets are not 

accepted. Go to IRS.gov/Payments for information on how 

to make a payment using any of the following options.

• IRS Direct Pay: Pay your individual tax bill or estimated 

tax payment directly from your checking or savings account at no cost to you.

• Debit Card, Credit Card, or Digital Wallet: Choose an 

approved payment processor to pay online or by 

phone.

• Electronic Funds Withdrawal: Schedule a payment 

when filing your federal taxes using tax return preparation software or through a tax professional.

• Electronic Federal Tax Payment System: Best option 

for businesses. Enrollment is required.

• Check or Money Order: Mail your payment to the address listed on the notice or instructions.

• Cash: You may be able to pay your taxes with cash at 

a participating retail store.

• Same-Day Wire: You may be able to do same-day 

wire from your financial institution. Contact your financial institution for availability, cost, and time frames.

Note. The IRS uses the latest encryption technology to 

ensure that the electronic payments you make online, by 

phone, or from a mobile device using the IRS2Go app are 

safe and secure. Paying electronically is quick, easy, and 

faster than mailing in a check or money order.

What if I can’t pay now? Go to IRS.gov/Payments for 

more information about your options.

• Apply for an online payment agreement (IRS.gov/

OPA) to meet your tax obligation in monthly installments if you can’t pay your taxes in full today. Once 

you complete the online process, you will receive immediate notification of whether your agreement has 

been approved.

CAUTION

!

• Use the Offer in Compromise Pre-Qualifier to see if 

you can settle your tax debt for less than the full 

amount you owe. For more information on the Offer in 

Compromise program, go to IRS.gov/OIC.

Filing an amended return. Go to IRS.gov/Form1040X 

for information and updates.

Checking the status of your amended return. Go to 

IRS.gov/WMAR to track the status of Form 1040-X amended returns.

It can take up to 3 weeks from the date you filed 

your amended return for it to show up in our system, and processing it can take up to 16 weeks.

Understanding an IRS notice or letter you’ve received. Go to IRS.gov/Notices to find additional information about responding to an IRS notice or letter.

Responding to an IRS notice or letter. You can now 

upload responses to all notices and letters using the 

Document Upload Tool. For notices that require additional 

action, taxpayers will be redirected appropriately on 

IRS.gov to take further action. To learn more about the 

tool, go to IRS.gov/Upload.

Note. You can use Schedule LEP (Form 1040), Request for Change in Language Preference, to state a preference to receive notices, letters, or other written communications from the IRS in an alternative language. You may 

not immediately receive written communications in the requested language. The IRS’s commitment to LEP taxpayers is part of a multi-year timeline that began providing 

translations in 2023. You will continue to receive communications, including notices and letters, in English until they 

are translated to your preferred language

Contacting your local TAC. Keep in mind, many questions can be answered on IRS.gov without visiting a TAC. 

Go to IRS.gov/LetUsHelp for the topics people ask about 

most. If you still need help, TACs provide tax help when a 

tax issue can’t be handled online or by phone. All TACs 

now provide service by appointment, so you’ll know in advance that you can get the service you need without long 

wait times. Before you visit, go to IRS.gov/TACLocator to 

find the nearest TAC and to check hours, available services, and appointment options. Or, on the IRS2Go app, 

under the Stay Connected tab, choose the Contact Us option and click on “Local Offices.”

The Taxpayer Advocate Service (TAS) 

Is Here To Help You

What Is TAS?

TAS is an independent organization within the IRS that 

helps taxpayers and protects taxpayer rights. Their job is 

to ensure that every taxpayer is treated fairly and that you 

know and understand your rights under the Taxpayer Bill 

of Rights.

CAUTION

!

24 Publication 502 (2023)
How Can You Learn About Your Taxpayer 

Rights?

The Taxpayer Bill of Rights describes 10 basic rights that 

all taxpayers have when dealing with the IRS. Go to 

TaxpayerAdvocate.IRS.gov to help you understand what 

these rights mean to you and how they apply. These are 

your rights. Know them. Use them.

What Can TAS Do for You?

TAS can help you resolve problems that you can’t resolve 

with the IRS. And their service is free. If you qualify for 

their assistance, you will be assigned to one advocate 

who will work with you throughout the process and will do 

everything possible to resolve your issue. TAS can help 

you if:

• Your problem is causing financial difficulty for you, 

your family, or your business;

• You face (or your business is facing) an immediate 

threat of adverse action; or

• You’ve tried repeatedly to contact the IRS but no one 

has responded, or the IRS hasn’t responded by the 

date promised.

How Can You Reach TAS?

TAS has offices in every state, the District of Columbia, 

and Puerto Rico. To find your advocate’s number:

• Go to TaxpayerAdvocate.IRS.gov/Contact-Us;

• Download Pub. 1546, The Taxpayer Advocate Service 

Is Your Voice at the IRS, available at IRS.gov/pub/irspdf/p1546.pdf;

• Call the IRS toll free at 800-TAX-FORM 

(800-829-3676) to order a copy of Pub. 1546;

• Check your local directory; or

• Call TAS toll free at 877-777-4778.

How Else Does TAS Help Taxpayers?

TAS works to resolve large-scale problems that affect 

many taxpayers. If you know of one of these broad issues, 

report it to TAS at IRS.gov/SAMS. Be sure to not include 

any personal taxpayer information.

Low Income Taxpayer Clinics (LITCs)

LITCs are independent from the IRS and TAS. LITCs represent individuals whose income is below a certain level 

and who need to resolve tax problems with the IRS. LITCs 

can represent taxpayers in audits, appeals, and tax collection disputes before the IRS and in court. In addition, 

LITCs can provide information about taxpayer rights and 

responsibilities in different languages for individuals who 

speak English as a second language. Services are offered 

for free or a small fee. For more information or to find an 

LITC near you, go to the LITC page at 

TaxpayerAdvocate.IRS.gov/LITC or see IRS Pub. 4134, 

Low Income Taxpayer Clinic List, at IRS.gov/pub/irs-pdf/

p4134.pdf.

To help us develop a more useful index, please let us know if you have ideas for index entries.

Index See “Comments and Suggestions” in the “Introduction” for the ways you can reach us.

A

Abortion 5

Acupuncture 5

Adopted child's medical 

expenses 3

AGI limitation 1, 2

Alcoholism 5

Ambulances 5

Archer MSAs:

Medical expenses paid for decedent 

from 4

Artificial limbs 5

Artificial teeth 5

Aspirin 16

Assistance (See Tax help)

Assisted living homes 11

Athletic club dues 15

Automobiles (See Cars)

B

Baby sitting 15

Bandages 5

Basis:

Medical equipment or property 

(Worksheet D) 19

Birth control pills 5

Body scan 5

Braille books and magazines 5

Breast pumps and supplies 5

Breast reconstruction surgery 5

C

Calculation of deduction 19

Capital expenses 5

Improvements to rented property 6

Operation and upkeep 6

Worksheet A 6

Cars 6

Out-of-pocket expenses 13

Standard medical mileage rates 13

Child care 15

Children's medical expenses:

Adopted child 3

Dependents 3

Chiropractor 7

Christian Scientist practitioner 7

Chronically ill persons 10

Community property states 2

Contact lenses 7

Controlled substances 15

Cosmetic surgery 15

Crutches 7

D

Dancing lessons 15

Decedent's medical expenses 4, 5

Deductible amount 3

Deductible expenses 3-14

Definition of medical expenses:

Doctor 2

Physician 2

Dental treatment 7

Artificial teeth 5

Teeth whitening 16

Dentures 5

Dependent's medical expenses:

Adopted child 3

Multiple support agreement 4

Qualifying child 3

Qualifying relative 3

Dependents:

Disabled dependent care 7, 10

Publication 502 (2023) 25
Diagnostic devices 7

Diaper services 15

Disabilities, persons with:

Dependent care expenses 7, 10

Improvements to rented property 6

Special education 13

Divorced taxpayers:

Medical expenses of child 4

Drug addiction 7

Drugs (See Medicines)

Dues:

Health club 15

E

Education, special 13

Electrolysis 15

Employer-sponsored health 

insurance plans 8

Employment taxes 12

Excluded expenses:

Insurance premiums 9

Eye exam 7

Eye surgery 7

Eyeglasses 7

F

Fertility enhancement:

Eggs, temporary storage of 7

Fertility 7

In vitro fertilization 7

Figuring the deduction 19

Final return for decedent:

Medical expenses paid 4

Flexible spending arrangement 15

Food (See Weight-loss programs)

Form 1040 or 1040-SR:

Self-employed persons, health 

insurance costs 21

Form 1040-X:

Amended return 2

Deceased taxpayer 4

Form 1040, Schedule A:

Impairment-related work 

expenses 20

Medical and dental expenses 1, 19

Self-employed persons, health 

insurance costs 21

Form 1040, Schedule C:

Impairment-related work 

expenses 20

Form 1040, Schedule E:

Impairment-related work 

expenses 20

Form 1040, Schedule F:

Impairment-related work 

expenses 20

Form 2106:

Impairment-related work 

expenses 20

Form 2555:

Self-employed persons, health 

insurance costs 21

Founder's fee (See Lifetime care, 

advance payments)

Funeral expenses 15

Future medical care 10, 15

G

Glasses 7

Guide dog or other animal 7

H

Hair:

Removal 15

Transplants 15

Wigs 14

Health club dues 15

Health institutes 8

Health insurance:

Employer-sponsored plan 8

Pension Benefit Guaranty 

Corporation (PBGC) recipient 21

Premiums:

Deductible 8

Nondeductible 9

Paid by employer 18

Paid by employer and you 18

Paid by you 17

Prepaid 9

Unused sick leave used to pay 9

Reimbursements 

(See Reimbursements)

Self-employed persons 21

Health maintenance organizations 

(HMOs) 8

Health reimbursement 

arrangements (HRAs) 17

Health savings accounts (HSAs):

Payments from 15

Hearing aids 8

Hearing-impaired persons:

Guide dog or other animal for 7

HMOs (Health maintenance 

organizations) 8

Home care (See Nursing services)

Home improvements (See Capital 

expenses:)

Hospital services 8

Hotels 10

Household help 15

HRAs (Health reimbursement 

arrangements) 17

I

Illegal operations and 

treatments 15

Illegal substances 15

Impairment-related work 

expenses 20

Reporting of 20

Insulin 16

Insurance (See Health insurance)

Intellectually and developmentally 

disabled persons:

Mentally disabled 9

Special homes for 9

L

Laboratory fees 9

Lactation expenses (See Breast 

pumps and supplies)

Laser eye surgery 7

Lead-based paint removal 9

Learning disabilities 13

Legal fees 10

Lessons, dancing and 

swimming 15

Lifetime care:

Advance payments for 10

Lodging 10, 14

(See also Trips)

Long-term care 10

Chronically ill individuals 10

Maintenance and personal care 

services 10

Qualified insurance contracts 11

Qualified services 10

M

Maintenance and personal care 

services 10

Maternity clothes 16

Meals 11, 14

(See also Weight-loss programs)

Medical conferences 11

Medical equipment or property:

Adjusted basis (Worksheet D) 19

Medical expense records 19

Medical savings accounts 

(MSAs) 16

Medicare:

Medicare Part A, deductible 

expense 8

Medicare Part B, deductible 

expense 8

Medicare Part D, deductible 

expense 9

Medicines 11

Imported 11, 16

Nonprescription drugs and 

medicines 16

Missing children, photographs of in 

IRS publications 1

Multiple support agreement 4

N

Nondeductible expenses 14-16

Nonprescription drugs and 

medicines 16

Nursing homes 11

Nursing services 11, 15

Chronically ill individuals 10

Nutritional supplements:

Natural medicines 16

26 Publication 502 (2023)
O

Operations 12

Cosmetic surgery 15

Illegal operations and 

treatments 15

Optometrist 12

Organ donors 13

Osteopath 12

Oxygen 12

P

Parking fees and tolls 13

Personal injury damages 20

Personal protective equipment 9

Personal use items 16

Physical examination 12

Physical therapy 13

Plastic surgery 15

Pregnancy test kit 12

Premium Tax Credit 12

Premiums (See Health insurance)

Prepaid insurance premiums 9

Prosthesis 5

Psychiatric care 12

Psychoanalysis 12

Psychologists 13

Publications (See Tax help)

R

Radial keratotomy 7

Recordkeeping 19

Rehabilitation facilities 11

Reimbursements 17-19

Excess includible in income:

More than one policy (Worksheet 

C) 18

One policy (Worksheet B) 18

Excess may be taxable (Figure 

1) 17

Health Reimbursement 

Arrangement (HRA) 17

Insurance 17

Medical expenses not deducted 18

More than one policy 18

Received in later year 19

Rental property:

Improvements to 6

Reporting:

Impairment-related work 

expenses 20

Medical and dental expenses 19

Medical deduction (See Form 1040, 

Schedule A)

Self-employed persons, health 

insurance costs 21

S

Sale of medical equipment or 

property 19

Adjusted basis (Worksheet D) 19

Schedules (See Form 1040 or 1040-

SR)

Seeing-eye dogs 7

Self-employed persons:

Health insurance costs 21

Senior housing 11

Separate returns:

Community property states 2

Medical and dental expenses 2

Separated taxpayers:

Medical expenses of child 4

Service animals 7

Sick leave:

Used to pay health insurance 

premiums 9

Special education 13

Spouse's medical expenses 3

Deceased spouse 5

Sterilization 13

Stop-smoking programs 13

Surgery (See Operations)

Surrogacy expenses 16

Swimming lessons 15

T

Tables and figures:

Medical equipment or property:

Adjusted basis (Worksheet D) 19

Reimbursements, excess includible 

in income:

More than one policy (Worksheet 

C) 18

One policy (Worksheet B) 18

Reimbursements, excess may be 

taxable (Figure 1) 17

Tax help 21

Teeth:

Artificial 5

Dental treatment 7

Whitening 16

Telephone 13

Television 13

Therapy 13

Transplants 13

Travel and transportation 

expenses 13

Car expenses 13

Includible expenses 13, 14

Parking fees and tolls 13

Trips 14

Tuition 14

V

Vasectomy 14

Veterinary fees 16

Vision correction surgery 7

Visually impaired persons:

Guide dog or other animal for 7

Vitamins or minerals 16

W

Weight-loss programs 14, 16

What's new:

Standard medical mileage rate 1

Wheelchairs 14

Wigs 14

Work expenses:

Disabled dependent care 7

Impairment-related 20

Workers' compensation 20

Worksheets:

Capital expenses (Worksheet A) 6

Medical equipment or property:

Adjusted basis (Worksheet D) 19

Reimbursements, excess includible 

in income:

More than one policy (Worksheet 

C) 18

One policy (Worksheet B) 18

Publication 502 (2023) 27