ISSUE
Are amounts paid by an individual for expenses (including transportation costs, registration fee, meals and lodging) of attending a medical conference relating to the chronic disease of the individual's dependent deductible as medical expenses under section 213 of the Internal Revenue Code?
FACTS
Taxpayer A resides in City X and is the parent of B, who is A's dependent. B suffers from a chronic disease and is being treated by physician C.
At C's recommendation and for the purpose of obtaining medical information that may be useful in making decisions concerning B's treatment or in providing care to B, A travels to City Y to attend a conference sponsored by an association that supports research and education concerning the disease. The conference is attended by medical practitioners and individuals with the disease and their families. A spends the majority of A's time at the conference attending sessions that disseminate medical information concerning B's disease. Other sessions at the conference involve presentations or discussions on legal issues, family finances, and other matters commonly arising in families in which a member has the disease. While in City Y, A's social and recreational activities outside of the conference are secondary to A's attendance at the conference.
A pays the following expenses in connection with the conference: transportation to City Y, local transportation to the conference site, a registration fee, meals while attending the conference, and lodging at a hotel while attending the conference.
LAW AND ANALYSIS
Section 213(a) allows a deduction for uncompensated expenses for medical care of an individual, the individual's spouse, or a dependent, to the extent the expenses exceed 7.5 percent of adjusted gross income. Section 213(d)(1) provides that medical care means amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body.
Section 1.213-1(e)(1)(ii) of the Income Tax Regulations provides, in part, that the deduction for medical care expenses will be confined strictly to expenses incurred primarily for the prevention or alleviation of a physical or mental defect or illness. Whether an expenditure is “primarily for” medical care is a question of fact. An expense that is merely beneficial to the general health of an individual is not an expense for medical care.
Section 213(d)(1)(B) provides that “medical care” also includes transportation that is “primarily for and essential to” medical care referred to in section 213(d)(1)(A). A taxpayer who, for purely personal reasons, travels to another locality to obtain an operation or other medical care prescribed by a doctor may not deduct the costs of transportation under section 213. Section 1.213- 1(e)(1)(iv).
Section 213(d)(2) provides that the cost of lodging (up to $50 per night) while away from home that is primarily for and essential to medical care (as defined in section 213(d)(1)(A)) is an amount paid for medical care if (A) the medical care is provided by a physician in a licensed hospital or a related or equivalent facility, and (B) there is no significant element of personal pleasure, recreation, or vacation in the travel away from home.
Meal expenses are not deductible as expenses for medical care unless they are provided at a hospital or similar institution at which the taxpayer, the taxpayer's spouse, or dependent is receiving medical care. Section 1.213-1(e)(1)(iv) and (v).
Section 262 provides that, except as otherwise expressly provided by the Code, no deduction is allowed for personal, living, or family expenses.
In Rev. Rul. 58-533, 1958-2 C.B. 108, the parents of a child who lives away from home at a psychiatric center incur transportation costs to visit the child at regular intervals on the advice of the child's doctors and as an essential part of the child's therapy. The ruling holds that the transportation costs are primarily for and essential to medical care and are deductible under section 213.
By contrast, Rev. Rul. 76-79, 1976-1 C.B. 70, holds that a deduction under section 213 is not allowed for transportation costs incurred by an individual to take a cruise (upon the recommendation of a physician) on which a group of doctors provide both instructional seminars relating to the individual's medical condition and certain medical services. The seminars are for the preservation of the individual's general health only and the medical services are available in the individual's hometown. The ruling holds that the transportation costs are not primarily for and essential to medical care.
In the present case, A travels to the conference in City Y on the recommendation of C, the physician treating A's child B, to obtain medical information that may be useful in making decisions concerning B's treatment or in providing care to B. A spends the majority of A's time at the conference attending sessions that disseminate medical information concerning B's disease. While in City Y, A's social and recreational activities outside of the conference are secondary to A's attendance at the conference. Under these facts, the registration fee paid by A to attend the conference is primarily for medical care, and A's travel is primarily for and essential to medical care. Accordingly, A may deduct the registration fee and transportation expenses under section 213 (subject to the limitations of that section). A may not deduct the cost of meals and lodging while attending the conference because neither A, A's spouse, nor a dependent is receiving medical care from a physician at a licensed hospital or similar institution. See sections 213(d)(2) and 1.213- 1(e)(1)(iv). The result would be the same if A, and not A's dependent, was the individual with the disease.
HOLDING
Amounts paid by an individual for expenses of admission and transportation to a medical conference relating to the chronic disease of the individual's dependent are deductible as medical expenses under section 213 (subject to the limitations of that section), if the costs are primarily for and essential to the medical care of the dependent. The cost of meals and lodging while attending the conference are not deductible as medical expenses under section 213.
EFFECT ON OTHER DOCUMENTS
Rev. Rul. 76-79 is distinguished.
DRAFTING INFORMATION
The principal author of this revenue ruling is Donna M. Crisalli of
the Office of Assistant Chief Counsel (Income Tax and Accounting). For
further information regarding this revenue ruling, contact Ms. Crisalli
on (202) 622-4920 (not a toll-free call).
Section 213
IRS Headnote
Medical expenses; physician-recommended cruise. Of an individual's expenses incurred in making a physician-recommended cruise with a group of physicians who provide clinical medical services, dietary supervision, and seminars relative to the individual's medical condition, only the amounts attributable to reviewing the individual's medical records, performing medical tests, and reporting the results to the individual's personal physician are expenditures for medical care.
Full Text
Rev. Rul. 76-79
Advice has been requested whether, under the circumstances described below, a medical expense deduction is allowable under section 213 of the Internal Revenue Code of 1954 for any part of an individual's expenses for a cruise undertaken upon a physician's recommendation.
An individual, upon a doctor's recommendation, embarked upon a cruise aboard a cruise ship with a group of physicians who provide certain medical services, such as reviewing the patient's medical records, performing certain tests upon the patient as directed by the patient's personal physician or as indicated by the patient's condition, and reporting the results of the patient's medical progress to the patient's personal physician. In addition, they provide instructive seminars relative to the patient's medical condition and supervise the patient's dietary program. The cruise ship is not a hospital or other medical institution, and all the medical services provided aboard ship are available in the individual's home town.
Section 213(a) of the Code allows, subject to certain limitations not relevant here, a deduction for expenses paid during the taxable year, not compensated for by insurance or otherwise, for the "medical care" of the taxpayer and the taxpayer's spouse and dependents. Section 213(e) of the Code defines the term "medical care" to include amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body; for transportation primarily for and essential to medical care; or for insurance covering medical care.
Section 1.213-1(e)(1)(ii) of the Income Tax Regulations provides, in part, that expenditures for medical care allowable under section 213 of the Code will be confined strictly to expenses incurred primarily for the prevention or alleviation of a physical or mental defect or illness. However, an expenditure that is merely beneficial to the general health of an individual is not an expenditure for medical care.
Section 1.213-1(e)(1)(iv) of the regulations provides that expenses paid for transportation primarily for and essential to the rendition of medical care are expenses paid for medical care. However, an amount allowable as a deduction for "transportation primarily for and essential to medical care" shall not include the cost of any meals and lodging while away from home receiving medical treatment. For example, if a doctor prescribes that a taxpayer go to a warm climate in order to alleviate a specific chronic ailment, the cost of meals and lodging while there would not be deductible. Furthermore, if the travel is undertaken merely for the general improvement of the taxpayer's health, neither the cost of transportation nor the cost of meals and lodging would be deductible. If a doctor prescribes an operation or other medical care, and the taxpayer chooses for purely personal considerations to travel to another locality (such as a resort area) for the operation or the other medical care, neither the cost of transportation nor the cost of meals and lodging (except where paid as part of a hospital bill) is deductible.
In the instant case, the cruise was not primarily for and essential to the individual's medical care. Accordingly, the transportation expense of the cruise cost is not a deductible medical expense under section 213 of the Code. Moreover, the food and lodging expense of the cruise cost is not a deductible medical expense because the ship is not a hospital or other medical institution. See section 1.213-1(e)(1)(v) of the regulations. Inasmuch as the instructive seminars relative to the patient's medical condition and the supervision of the patient's dietary program are for the preservation of general health, the part of the cruise cost attributable to those items is not a deductible medical expense. However, amounts paid for reviewing the patient's medical records, performing medical tests, and reporting results to the patient's personal physician are amounts paid for the diagnosis, cure, mitigation, treatment or prevention of disease. Such amounts are deductible, within the limitations of section 213, if the individual can establish what part of the amount paid for the cruise is attributable to those items.IRS Circular 230 Disclosure: United States Treasury Regulations provide that a
taxpayer may rely only on formal written advice meeting specific requirements to
avoid federal tax penalties. Any tax advice in the text of this message, or in any
attachment, does not meet those requirements and, accordingly, is not intended or
written to be used, and cannot be used, by any recipient to avoid any penalties that
may be imposed upon such recipient by the Internal Revenue Service.