Are non-prescription drugs deductible if doctor recommends them?

[mchil]

Can I 
deduct Tyelnol recommened by doctor.

[DoninGA]

Since it is not a prescription medication prescribed by a physician or other medical professional it is not deductible as a medical expense on your tax return.

[TomD8]

Section 26 213(d)(3) of the US code defines "prescribed drug" as "a drug or biological which requires a prescription of a physician for its use by an individual."

https://www.law.cornell.edu/uscode/text/26/213

"Recommended" is not the same as "prescribed".   Medications like  tylenol that don't require a doctor's prescription don't qualify for deduction.

[jwwdgk]

If your health care provider... doctor, nurse practitioner, Etc will write a prescription for the non-prescription item and you have it filled as a prescription at your Pharmacy, or a pharmacy, yes then it is deductible. Also, if your doctor will write a letter for you stating that this product/drug is medically necessary, then it is also deductible. Bear in mind the IRS is very strict on the term "medically necessary". A letter must state specifically "medically necessary". No other words will suffice for this purpose.

[Opus 17]

It is worth noting that over the counter medications are eligible to be reimbursed from an FSA or HSA.  You do not need a letter of medical necessity.  The rules for FSA and HSA qualifying expenses are a bit more generous than the rule for the tax deduction. 

[Opus 17]

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@jwwdgk wrote:

If your health care provider... doctor, nurse practitioner, Etc will write a prescription for the non-prescription item and you have it filled as a prescription at your Pharmacy, or a pharmacy, yes then it is deductible. Also, if your doctor will write a letter for you stating that this product/drug is medically necessary, then it is also deductible. Bear in mind the IRS is very strict on the term "medically necessary". A letter must state specifically "medically necessary". No other words will suffice for this purpose.

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I believe this is incorrect.  Publication 502 is specific that a prescription medication is one that requires a prescription.  

However, OTC medications are eligible for reimbursement from an HSA or FSA, because the rules are more generous.  Just not the tax deduction.  

[jwwdgk]

I believe I have to stand corrected on the option of having a prescription written for a non-prescription item. The IRS must have  changed that sometime over the years. The wording didn't use to specify that a 'prescribed drug is a drug that requires a prescription.'

However, I still believe the item would be deductible if your prescriber writes a "letter of medical necessity", stating that a particular item is considered "medically necessary".

[Mike9241]

from IRS instructions for schedule A

Examples of Medical and
Dental Payments You Can't
Include

• Nonprescription medicines, other
than insulin (including nicotine gum and
certain nicotine patches).

i take a medicine that's available without a prescription. however, what my Dr does is write a prescription for it. it is then covered by my RX insurance and is actually cheaper than the OTC price. 

[Opus 17]

This is another weird tax rabbit hole.

The code (law) says that "An amount paid during the taxable year for medicine or a drug shall be taken into account under subsection (a) only if such medicine or drug is a prescribed drug or is insulin."  And "The term “prescribed drug” means a drug or biological which requires a prescription of a physician for its use by an individual."  §213(b).    So a drug that is available OTC is not deductible even if you get a prescription.  (Note that some drugs have both prescription and OTC formulas, and if you get a prescription for the prescription-only formula, that would be deductible.  Also note that getting a prescription for an OTC drug might get it covered under your insurance, and it can be reimbursed from an HSA or FSA.)

I see a lot of web sites that claim that getting a prescription for a non-prescription drug can (or "sometimes") make it deductible, but they never cite a code, regulation, or Tax Court case.  I think they are getting confused between the deduction and FSA/HSA reimbursement.  In 2003, the IRS ruled that OTC medicines were allowable under a pre-tax employee health plan, but in 2011 the ACA changed the rules and said that you could only use an FSA or HSA to pay for OTC medicines if you got a prescription.  In other words, getting a prescription for OTC meds was beneficial because it let you use tax-free FSA and HSA dollars.  However, the CARES Act in 2020 changed things again and allows taxpayers to buy a wide variety of OTC medical items without a prescription and use their HSA and FSA dollars.  

But, this never touched the law regarding the schedule A deduction.  That law still says the medication must be a kind of medication that requires a prescription -- is not available OTC.  

The reason you may need a letter of medical necessity is to allow HSA and FSA reimbursement for items that can be viewed as general lifestyle items -- supplements, for example.  Supplements and other items that are for general health benefits are not deductible OR reimbursable from an HSA/FSA.  If you get a letter of medical necessity for a supplement, for example, that lets you get reimbursement from your HSA or FSA, but still does not allow a schedule A tax deduction.