Pre paid medical expense rule?

[Floydklonster]

Hello,

my wife is going through IVF. We purchased a bundled package for the IVF.  This was paid in full with a combination of cash, credit and a personal loan in December 2024.  The IVF started in January 2025 and could continue throughout the year.   As part of the package, we had to pay in full before the IVF was started.  We did receive a receipt for payment of the package.  Can we deduct this as a medical expense on our 2024 tax return?  I read pub 502 that says “You can include only the medical and dental expense you paid this year, but generally not payments for medical or dental care you will receive in a future year.”  But I am not sure how this is interpreted by the irs.  This was not a payment on an account, it was accepted as paid in full.

The total paid is greater than 7.5% of our AGI and we also have mortgage interest and state/local taxes that we would include if itemizing to make it all worth it. 

thanks

floyd

[AmyC]

It depends. I am thinking that you must have been going to the doctor and discussing the issue in 2024 or you would not have made a payment. This would make the payment part of your ongoing medical care rather than a future expense. I could only find one court case related to IVF and it was not related to your case in any manner.

If you had any visits with the doctor, I feel the deduction is valid.

[Opus 17]

Later in publication 502 it says,

Generally, you can't include in medical expenses current payments for medical care (including medical insurance) to be provided substantially beyond the end of the year.

The IRS does not define "substantially beyond" the end of the year.

The idea is that you can't deduct pre-paid medical care too far in advance, and I think (but am not sure) that the IRS is targeting concierge medical arrangements and other situations where you are not ill but pay in advance in case you get ill.

Here, you have a medical need in 2024 (IVF is deductible in general), and your actual treatment started in January 2025 (which is not "substantially" past the end of 2024).  So I would say you are find to deduct in 2024.