Is a concierge medical fee deductible?

I know of no reason why such a fee would not be deductible on Schedule A as a medical expense.

medical expense.

I'm not sure what the answer is. However, I can give you a reason why in some circumstances it would not be deductible. The IRS could argue it is nothing more than an advance payment, not deductible until the tax year in which medical services are rendered.

It's certainly not an advance payment. It's a flat, minimum payment and is not for services to be rendered, but just for the right to be that physician's patient. For lawyers this kind of arrangement is known as a true retainer. I don't see a problem with it.

___ Stu

I wasn't aware that the right to see a physician meets the definition in Sec. 213 and its regs for medical care. Until the person actually receives something from the medical group that meets the definition of medical care, the payment is no different than me paying a hospital on

It's not a prepayment, because there are no specific services it goes to. It expires after a specified period of time whether it was used or not. It's a payment for access, and you get the access immediately.

Rather than being like paying for something to be used at a later time, it's like paying for medication your doctor proscribes you to use when you need it - if you don't need it, you don't take it, but you still get the deduction for it.

___ Stu

"you get access immediately" really is a theory, from the people I know who have bailed out of such plans.

But, the plans I am familiar with give you more than just access; the fee includes some services, such as an annual physical, some other sort of consultations, etc.

I don't agree with you. Until you receive medical care, the fee you paid for access is nothing more than a prepayment. Even if the fee covers your first physical, until you get that physical, or meet with a doctor or nurse or receive anything else that meets the definition in sec. 213 as medical care, you have made a nondeductible prepayment. I don't see this as an issue as the person who pays the concierge fee will no doubt receive medical care. My point is, you need to understand that if you make that payment at the end of a tax year before you receive any care, you won't be able to deduct it in that year.

I can certainly agree with that. But that's not what's going on in OP's case. In his situation he is paying a flat fee, say at the beginning of the year, for the privilege of seeing that particular doctor during the year. The payment doesn't apply to anything after the end of the year. (If the payment is not made at the beginning of the year, I agree it should be pro-rated).

But it is a fee for the doctor being available during that year, and it expires at the end of the year. If it's prepayment for services, it is only for services rendered during the tax year and not in any subsequent year.

___ Stu

My point is that, if for any reason, you never receive any medical care during the year as defined in sec. 213, then the fee you paid on 1/1 for one year is nothing more than a personal nondeductible expense. Paying someone to be "available" is not medical care. I don't expect anyone to pay this fee for concierge medicine and not incur some medical care which would make the fee deductible... probably (concierge fees has not been adjudicated). Bill Brown said he knew of no reqson why the fee would not be deductible. My reply says there is a reason if you never receive any medical care for your concierge fee.

By your logic, health insurance premiums are not deductible if you don't get sick that year.

I've read the posts in this thread and as I still know of no reason why such a fee would not be deductible on Schedule A as a medical expense.

Payments for future medical care. Generally, you can not include in medical expenses current payments for medical care (including medical insurance) to be provided substantially beyond the end of the year. This rule does not apply in situations where the future care is purchased in connection with obtaining lifetime care of the type de- scribed earlier.

After reading some of these responses, my take is that it is a combination of payment for services and insurance. I am on Medicare. The physician I signed with does take Medicare payments. He gives a thorough physical once a year. He spends more time on routine visits than was the case with other practices.

If all goes well, much of the payment is not used up. As you get sicker, you end up with more doctoring than the minimal amount you get in standard Medicare, In that sense it is like insurance you would prefer not to have to use.

It's also similar to an HMO -- you pay an annual fee, and you get access to all the HMO's services. Pub 502 says that these fees are deductible as if they were medical insurance.

How does this differ from an HMO, which _is_ deductible? There's no requirement that an HMO have more than one doctor.

Seth

HMO payments are deductible payments for health insurance. A concierge fee is not a health insurance policy payment.

If it also includes, say, a 25% discount on medical services (which is meaningless, because the price is arbitrary) is it now more like an HMO with a 75% co-pay?

Seth

No. It's not an insurance premium.

Is your statement about concierge fees based directly on a statute or court case?

I dare you to find one of these medical entities offering concierge services registered with any state department of insurance as an insurer with the policy that they are selling you listed as an offering and the necessary tax forms filed each year reflecting the premiums and tax due where applicable.

Guys...guys... it is not insurance. It is a fee for access that may or not contain other items. My only point has been... It is a nondeductible prepayment of medical expense. Until you actually receive deductible medical care from the business entity, you don't get a deduction. Therefore, I also made the point that if you pay the fee at the end of the year for the following year's access, you wouldn't be able to deduct it until you received medical care in the period covered by the prepayment. I'm done on this thread.