When it comes to tracking your miles for taxes, we often talk about the mileage deduction and the mileage reimbursement. But there are other tax reasons to keep a mileage log. Let's dive into the medical expense deduction and what role medical mileage plays.
What is the medical expense deduction?
The IRS lets you deduct medical expenses only if the amount is more than 7.5 percent of your adjusted gross income (AGI). In previous years, that figure was 10 percent.
What does the IRS consider a medical expense?
The IRS defines "medical expenses" as the costs of
- Diagnosing diseases
- Mitigating diseases
- Treating diseases
- Preventing diseases
- Treatments affecting any part or function of the body.
You can't include the costs of things that are beneficial to general health. Unqualified expenses include things like vitamins or a vacation. You can include the medical expenses you pay for yourself on the medical expense deduction. You can also have the costs for a spouse or your dependent. The latter only applies if they were a spouse or dependent at the time the services were provided or when you paid for them. There is a giant list of medical expenses that you can deduct. Consequently, legitimate medical expenses can lead to a sizable deduction. For this post, we'll focus on transportation, medical mileage and car costs.
Transportation costs on the medical expense deduction
The IRS allows you to include your transportation costs that are primarily for and essential to medical care. You can add:
- Bus, train, taxi, plane fares or ambulance services
- Transportation expenses of a parent who must go with a child
- Transportation expenses for visits to see a mentally ill dependent. The IRS allows this if the visits are a recommended part of treatment.
- Transportation expenses of a nurse or other person who can give treatments required by the patient who is traveling and unable to travel alone. This can include injections, medications and more.
You can include the cost of special medical equipment for your car. This could include the cost of special hand controls or anything else installed in the car for use by a person of disability. You can also include the difference between the cost of a regular car and a car specially designed to hold a wheelchair. You can also deduct the costs of operating your vehicle for health care, which we'll dive into below.
How much is the medical mileage deduction?
You can deduct 18 cents per mile for medical driving in 2018. Be sure to keep good records though, as the IRS may ask for documentation.
How to calculate medical mileage deduction?
Much like the mileage deduction, you can use two methods to calculate car-related expenses for this deduction. The actual expense method lets you include out-of-pocket expenses like gas and oil. For the medical expense deduction, you can't include depreciation, insurance, maintenance or general repair expenses. You can also use the standard mileage rate of 18 cents per mile (for 2018) to calculate your medical mileage portion. For both methods, you can include parking fees and tolls. Which practice should you use? I'm not a tax professional, but your best bet is to calculate both and use the one that gives you a larger deduction. Let's say Jenny drove 2,800 miles for medical reasons in 2016. She spent $400 for gas, $30 for oil and $100 on parking and tolls. Her car expenses part of the medical expenses deduction using the actual expense method is $630 ($400+$100+$30 = $530). To calculate the medical mileage part, multiply 2,800 by .17 cents for $476. Then, add the $100 in parking and tolls for a total of $576. Your results will vary based on local gas prices, so it's vital to keep track of all your drives. Just like with other deductions, you'll need accurate documentation if you face an audit.
Can you write off mileage to pick up prescriptions?
Yes, you can deduct trips to pick up prescriptions. You can also write off mileage for trips to medical appointments and other health-related activities.
The IRS medical mileage rate over time
The IRS periodically adjusts the medical mileage rate over time based on a variety of factors. Here's how the rate has changed over time: [table id=8 /]
Transportation costs you can't include with this deduction
There are some transportation costs you can't include in the medical expense deduction. Those include:
- Going to and from work, even if your condition requires an unusual means of transportation
- The costs of operating a specially equipped car for other than medical reasons
- Travel for purely personal reasons to another city for medical care or an operation
- Travel meant for the general improvement of one's health.
These seem straightforward but let's unpack the last one. If your doctor tells you to get more exercise and you drive hours to hike, you can't include those on your medical mileage.
How to claim mileage for medical expenses on taxes
You can deduct your medical and dental care costs on the Schedule A (Form 1040) for the year you're filing the tax return for. You can still claim the deduction for previous years if you're eligible and didn't take the write off. To do this, you can file Form 1040X, Amended U.S. Individual Income Tax Return, for the year you want to claim. Do not combine multiple years' worth of medical expense deductions on a single return. If you didn't claim a medical or dental expense that would have been deductible in an earlier year, you can file Form 1040X, Amended U.S. Individual Income Tax Return, for the year in which you overlooked the expense. Don't claim the expense on this year's return. In general, the IRS says "an amended return must be filed within three years from the date the original return was filed or within two years from the time the tax was paid, whichever is later." As always, consult with your tax professional before taking the medical expense deduction. You can also learn more from on the IRS website.
Medical mileage log requirements
Like with business miles, the IRS doesn't just take your word for your medical miles. You need documentation of these trips in the form of a mileage log. Your mileage log should include a record of:
- your mileage
- the dates of your medical trips
- the places you drove for medical purposes
- the medical purpose for your trips.
You don't have to include this log when you take the medical deduction. But, if you ever face an IRS audit, you'll need to back up your deductions with proof. Without proof, the IRS can deny your deduction after the fact and impose penalties.
