Understanding IRS Code 213[d]
By Staff Reporters
There have been thousands of legal cases involving the many nuances of what constitutes “medical care” for purposes of section 213(d) of the Internal Revenue Code. A determination of whether an expense is for “medical care” is based on all the relevant facts and circumstances. To be an expense for medical care, the expense has to be primarily for the prevention or alleviation of a physical or mental defect or illness. The determination often hangs on the word “primarily”.
Allowable Expenditures
| Acupuncture | Alcoholism Treatment |
| Ambulance | Artificial Limb |
| Artificial Teeth | Bandages |
| Birth Control Pills (by prescription) | Breast Reconstruction Surgery (mastectomy) |
| Car Special Hand Controls (for disability) | Certain Capital Expenses (for the disabled) |
| Chiropractors | Christian Science Practitioners |
| COBRA premiums | Contact Lenses |
| Cosmetic Surgery (if due to trauma or disease) | Crutches |
| Dental Treatment | Dermatologist |
| Diagnostic Devices | Disabled Dependent Care Expenses |
| Drug Addiction Treatment (inpatient) | Drugs (prescription) |
| Eyeglasses | Fertility Enhancement |
| Guide Dog | Gynecologist |
| Health Institute (if prescribed by physician) | H.M.O. (certain expenses) |
| Hearing Aids | Home Care |
| Hospital Services | Laboratory Fees |
| Lasik Surgery | Lead-Based Paint Removal |
| Learning Disability Fees (prescription) | Legal Fees (if for mental illness) |
| Life-Care Fees | Lodging (for out-patient treatment) |
| Long-Term Care (medical expenses) | Long-Term Care Insurance (up to allowable limits) |
| Meals (associated with receiving treatments) | Medical Conferences (for ill spouse/dependent) |
| Medicare Premiums | Medicare Deductibles |
| Nursing Care | Mentally Retarded (specialized homes) |
| Obstetrician | Nursing Homes |
| Operations – Surgical | Operating Room Costs |
| Optician | Ophthalmologist |
| Organ Transplant (including donor’s expenses) | Optometrist |
| Orthopedic Shoes | Orthodonture |
| Osteopath | Orthopedist |
| Over-the-Counter Medicines | Out-of-pocket expenses while enrolled in Medicare |
| Pediatrician | Oxygen and Equipment |
| Podiatrist | Personal Care Services (for chronically ill) |
| Prenatal Care | Post-Nasal Treatments |
| Prosthesis | Prescription Medicines |
| Psychiatric Care | PSA Test |
| Psychoanalysis | Psychiatrist |
| Psychologist | Psychoanalyst |
| Radium Treatment | Qualified Long-Term Care Services |
| Special Education for Children (ill or disabled) | Smoking Cessation Programs |
| Spinal Tests | Specialists |
| Sterilization | Splints |
| Telephones and Television for the Hearing | Surgeon |
| Therapy | Impaired |
| Treatment | Transportation Expenses for Health Care |
| Vitamins (if prescribed) | Vaccines |
| Wheelchair | Weight Loss Programs |
| X-Rays | Wig (hair loss from disease) |
Non-Allowable Expenditures
| Advance Payment for Future Medical Expenses | Athletic Club Membership |
| Automobile Insurance Premium | Babysitting (for healthy children) |
| Boarding School Fees | Bottled Water |
| Commuting Expenses for the Disabled | Controlled Substances |
| Cosmetics and Hygiene Products | Dancing Lessons |
| Diaper Service | Domestic Help |
| Electrolysis or Hair Removal | Funeral Expenses |
| Hair Transplant | Health Programs at Resorts, Health Clubs, & Gyms |
| Household Help | Illegal Operations and Treatments |
| Illegally Procured Drugs | Maternity Clothes |
| Medigap premiums | Nutritional Supplements |
| Premiums for Life or Disability Insurance | Premiums for Accident Insurance |
| Premiums for your HSA-qualified health plan | Scientology Counseling |
| Social Activities | Special Feeds/Beverages |
| Swimming Lessons | Teeth Whitening |
| Travel for General Health Improvement | Tuition in a Particular School for Problem Children |
Conclusion
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Filed under: Accounting, Health Insurance, Taxation | Tagged: Healthcare Savings Account, HSA, Internal Revenue Code 213[d]
