Deduction of Nutritional Supplements/Aspirin on Physician's Recommendation?

Over the counter drugs are not deductible even with a doctor's prescription. If your doctor gives you a prescription that must be filled by a pharmacist, that medication would be deductible. However, in the case of employer sponsored health care plans, both prescription and non-prescription drugs may be reimbursed.

Seems to me that the following section of Pub 502 says they are deductible under certain conditions:

Quote from Pub 502

"You cannot include in medical expenses the cost of nutritional supplements, vitamins, herbal supplements, ?natural medicines,? etc. unless they are recommended by a medical practitioner as treatment for a specific medical condition diagnosed by a physician. Otherwise, these items are taken to maintain your ordinary good health, and are not for medical care."

Does that not say that you can include as medical expenses the cost of nutritional supplements if they are recommended as treatment for a specific medical condition diagnosed by a physician?

Many, many hears ago, I got a prescription for Ecotrin from a physician that was filled by a pharmacist. At that time, I did not know that Ecotrin was an enteric coated aspirin that was available OTC as branded and generic products. The big surprise was how little the prescription cost. All the pharmacist did was to get and OTC product and put the pharmacy's label over the original label.

There still are many drugs available in both OTC and prescription strength. For me the prices of the generic house brands are low enough so that the record keeping is not worth the trivial tax saving. Nevertheless, it may be possible to get your physician to prescribe the higher dose and break the tablets into smaller pieces. I have made no study to determine what my costs would be if I took such action.

I presume that under such circumstances, those drugs would be detectible.

Bill

That's ironic. You can spend Part 125 ("cafeteria") funds on over-the- counter nutritional supplements if you have a doctor's orders. Analgesics such as aspirin and ibuprofen can also be reimbursed from those funds -- and no doctor's orders are required. Same for cold remedies, etc.

The real question, which you appear to ignore, is what is the "specific medical condition" these OTC supplements are intended to "treat"? urely, not the heart attack.

Herb Smith wrote: ...

OP indicated treating physician recommended them for aiding in controlling cholesterol levels...that not specific-enough?

Sorry, I should have made that clear. The cardiologist says that my cholosterol is too high and if I don't get it under control, it could lead to another heart attack or stroke. He says that the supplements will reduce the cholosterol. I guess the question is "too high cholosterol" considered to be a "specific medical condition" or not?

njoracle wrote in news:hergqi$use$ snipped-for-privacy@news.eternal-september.org:

I don't know what too high a cholesterol level is in your case, nor do I know anything else about you. However,I do know that using both Plavix and aspirin to quiet down your platelets is just about the upper limit of what you can do there. Since I do work on platelet reactivity in stroke and other cardiovascular diseases, take that for what it's worth. I'm not a physician, but I do know that Plavix + aspirin is a standard regimen for high risk patients. Nevertheless, I would be on the lookout for possible bleeding problems.

In that respect, fish oil in high doses would further suppress platelet reactivity, so do keep your doctor informed.

The definition of a medical expense is at the top of page 3 of Pub 502. High cholesterol levels are not by itself a medical condition. However, if one has had a heart attack and one's licensed physician decides that you are at risk for another heart attack unless you reduce your bad cholesterol and/or increase your good cholesterol and prescribes any of the statins or bile-acid resin drugs, those Rx drugs would be tax deductible. In the same vein, if that physician decides that the prescription drug is not necessary to accomplish the goal and prescribes that you take a certain regimen of nutritional supplements that have shown to accomplish the same outcome, the cost of those supplements would also be tax deductible as they are being prescribed to treat a diagnosed medical condition.

I see nothing in Pub 502 that says you must first have a heart attack to permit the deduction of supplies recommended by a physician to lower cholesterol.

I would disagree with that statement, but maybe the IRS uses different criteria for "disease" than do physicians, researchers and insurance companies?

I'm not a tax professional but I am a cardiologist (retired).

As you point out, Pub 502 allows medical expenses for "diagnosis, cure, mitigation, treatment, or prevention of disease"

The OP stated he has an elevated cholesterol diagnosed by a physician. This is listed as a disease in the ICD9-CM (The International Classification of Diseases, 9th Revision, Clinical Modification). It is a subset of 272 and is included in 272.0 (Pure hypercholesterolemia) and 272.2 (mixed hyperlipidemia).

ICD9-CM is used to classify diseases for the purpose of various studies, as well as for Medicare and other insurance purposes, and is generally accepted world wide, although soon will be replaced by ICD10-CM.

Does the IRS use a different source to determine what is or is not a disease?

--ron

Note that what is deductible on Form 1040 Schedule A as a medical expense is not the same as what may be covered via an employer's FSA, Archer MSA, or an HSA.

With fish oil and Cholestoff, Total Cholesterol went from 173 to 130, Triglycerids went from 220 to 114, LDL from 85 to 58 and HDL about 50 no change (maybe I need some Niacin) over the last 4 years when I first started taking the supplements recommended by my cardiologist. I had already been taking statins, plavix and aspirin.

It would be nice if Medicare Part D would cover these supplements but that's not likely to happen any time soon.

My recollection is that the real question is whether you're doing it for general health or to relieve a specific medical condition. If the former it's not deductible, if the latter, it is.

Seems to me that treating high cholesterol is not for general health but for a specific medical condition.

Medicare Part D was set up specifically to cover "**Prescription** Drugs". It was never intended to cover "anything recommended to treat a medical disease that's not covered someplace else".

As such, it was an expansion to regular Medicare coverage. I suppose someone could do the actuarial work to determine what it would cost to insure for non-prescription drug coverage, dietary supplements, etc. I suspect the cost for such coverage would be excessive.

--ron

So I would assume that one could deduct the cost of Calcium supplements for someone who has Osteopenia/Osteoporsis.

Since there is no cure, just management, of dry mouth/eyes from Sjogren's Syndrome, would the wetting agents (sprays, drops and mouthwashes) recommended by the physicians treating me be accepted as legitimate medical deductions? They are all OTC.

Certainly NOT.

One can have an FSA pay for it, but one cannot deduct it on Schedule A.

OTC drugs are not deductible, period.

Ah yes, and so it the medicine I take to keep the blood thin, in fact just made a supply run over to the package store for Scotch whiskey.

ChEAr$, Harlan Lunsford, EA n LA