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Tax: Medical Expense Deductions

Whose Medical Expenses Can I Include?

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In general, deductible medical expenditures are expenses you pay for medical care and dental care for yourself, your spouse, or any other dependent.


Spouse includes:

  • person to whom you are legally married other than same sex couples. The Internal Revenue Code does not recognize same sex marriage. 
  • a common law spouse if your state considers you legally married. A common law spouse is a person with whom you co-habit, and you hold out as being your spouse, with whom you did not have a marriage licensed by a government authority. In some jurisdictions, the arrangement must also have gone on for a minimum period of time.

When The Person Must Be A Spouse: Expenses you pay on behalf of your spouse are only deductible if the person is your spouse at the time the expenses are incurred or when they are paid.

Example: In late 2010 Larry is injured in a farming accident and incurs medical expenses. In early 2011, he meets, falls in love with, and marries Katrina. After their marriage is finalized, Katrina pays Larry's medical expenses. Katrina can use these expenses when calculating her medical expense deduction, even if she files her tax return separately from Larry. (Tax deductions are only available in the year the medical expenses are paid. See Does It Matter When I Received The Care Or Purchased The Drug, Or When I Paid I Paid For It?)

Legal Separation: If you are legally separated under a decree of separate maintenance, you are not considered married for purposes of deducting medical or dental expenses paid for the person. 


A dependent is a  "qualifying child" or a "qualifying relative" (as you will see, a "qualifying relative" does not have to be an actual relative.)

If a person is a child or relative as described in the tax code, there are additional requirements to meet in order to be a qualifying dependent for IRS tax purposes. A dependent for tax purposes must be a U.S. citizen or national or a resident of the United States, Canada, or Mexico, except for an adopted child. For an adopted child, you must be a U.S. citizen or national and the child needs to have been a member of your household during the taxable year.

A "qualifying child" must:

  • Be your son, daughter, stepchild, foster child, brother, sister, stepbrother, stepsister, or a descendant of any of them. For example, your granddaughter or nephew could qualify.
  • At the end of the taxable year, the person also must be:
    • Under age 19.
    • Under age 24 and a full-time student.
    • Or permanently and totally disabled.
  • Have lived with you for more than half of the taxable year and must not have provided over half of his or her own support during the year. The "support" test for a "qualifying child" focuses on the amount of support the child provides for himself or herself (or the amount of support that you and others provide for the child). Example: Krystol and Scott, a married couple, have a daughter named Natasha. At the end of the taxable year, Natasha is 22 and is a full-time student enrolled in art school. She lives with her parents for nine months of the year. She spends the other three months working on an Alaskan fishing boat where she earns 40% of the income she needs to support herself for the year. Natasha is a "qualifying child" since she (a) is under 24 and a full-time student; (b) lives with her parents for more than half the year; and (c) provides less than half of her own support.

Children of Divorced or Separated Parents and Dependents under Mutual Support Agreements: There are special rules for children of divorced or separated parents and for dependents who are supported under a multiple support agreement. To learn more, see IRS Publication 502, Medical and Dental Expenses (Including the Health Coverage Tax Credit). You can get a copy at: offsite link.

A "qualifying relative" includes:

  • A child or a descendant of a child.
  • A brother, sister, stepbrother, or stepsister.
  • The father or mother, or an ancestor of either.
  • A stepfather or stepmother.
  • A son or daughter of a brother or sister of the taxpayer.
  • A brother or sister of the father or mother of the taxpayer.
  • A son-in-law, daughter-in-law, father-in-law, mother-in-law, brother-in-law, or sister-in-law.

If your dependent does not fall within one of the above categories, he or she might still be considered a "qualifying relative" if:

  • The person lives with you during the taxable year as a part of your household and this relationship did not violate local law. Thus, the term "relative" is misleading as the dependent need not be related to you.
  • You provided half of his or her support during the taxable year. The support test for a "qualifying relative" focuses on the amount of support you alone provide him or her.

Same-Sex Domestic Partner: The IRS has indicated that a same-sex domestic partner can qualify as a dependent. See, for example, Private Letter Ruling 200108010 [ offsite link]. This letter ruling, however, is not binding on the IRS except with respect to the taxpayer that requested the ruling.

Research by:
Dexter D.J. Samida, Esq.
Sullivan and Cromwell
New York, NY



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