We had a hot tub installed for my two knee replacements, we also had to pour a cement pad to set it on. Can we deduct any of these costs for the improvements?

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Yes, you can even deduct the cost of having the hot tub installed if it was prescribed, as you stated, and it is for the treatment of a disease/health issue. Remember, it is important that you will be the only one using the hot tub if you would like to deduct 100% of its cost. If anyone else uses it, you can only deduct a portion based on the percent of use by the other person/people. See IRS publication here to learn more and exactly how much of a deduction you will receive. An excerpt regarding the hot tub is attached as a screen shot.