Self employed health insurance deduction.. Do medical concierge fees count as insurance in this context?

[JohnH2 · Accepted solution]

No, medical concierge fees (if retainer based fees) are not considered medical insurance.

However, you may have a deduction on your Schedule A, depending on what the medical concierge fees are for (and if you otherwise qualify for a medical expense deduction).

The tax code defines medical care as the treatment, alleviation or mitigation of a medical condition.  If the concierge fee shortens your wait time to see a physician, it is likely not deductible because it is a payment for convenience. However, if these fees are related to the alleviation of a medical condition, they may be deductible on your Schedule A. The following IRS Letter Ruling illustrates this distinction:  https://www.irs.gov/pub/irs-wd/11-0027.pdf

You may check with your Concierge Plan Administrator to see if these fees cover any qualified medical expenses.

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[Carl]

It depends. For starters, it's not insurance any way you look at it. It's basically a retainer.

If you are paying say, $100 a month for care as needed, that's $1200 a year. So say you visit the doctor only once during the year at a cost of $250 against your concergie (retainer) fee. You can only claim the $250 as a medical expense. The other $750 is just "gone".

Now if your doctor carries the remaining retainer over to the next year, then so can you. For example lets say in year two you have a medical procedure that costs $1600. Buy the end of year two you would have paid another $1200 for a total of $2400. So if your doctor allowed you to "carry over" the first year, then so can you.

If you received $250 of medical car in the first year, that leaves $750 to carry over. Added to the $1200 you will have paid in the 2nd year that comes to $1,950. So it's no problem to claim the $1600 medical expense incurred in the 2nd year.

But lets say your agreement with the doctor does not allow you to carry over any excess year to year. You just "lose" what you don't use. In that case, you can only claim what you *actually* *paid* in the tax year, which would be $1200 of the $1600 bill. You can claim the remaining $400 the next year.

[dmertz]

Since it is not insurance, it does not qualify for a self-employed health insurance deduction.