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PT 5 Publication 502 (2009), Medical and Dental
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Worksheet D. Adjusted Basis of Medical Equipment or Property Sold

Instructions: Use this worksheet if you deducted the cost of medical equipment or property in one year and sold the equipment or property in a later year. This worksheet will give you the adjusted basis of the equipment or property you sold.
1. Enter the cost of the equipment or property. 1.
2. Enter your total includible medical expenses for the year you included the cost in your medical expenses 2.
3. Divide line 1 by line 2 3.
4. Enter 7.5% of your AGI for the year the cost was included in your medical expenses 4.
5. Multiply line 3 by line 4. If your allowable itemized deductions for the year you purchased the equipment or property were not more than your AGI for that year, stop here. This is the adjusted basis of the equipment or property. If your allowable itemized deductions for the year you purchased the equipment or property were more than your AGI for that year, complete lines 6 through 11 5.
6. Subtract line 5 from line 1 6.
7. Enter your total allowable itemized deductions for the year the cost was included in your medical expenses 7.
8. Divide line 6 by line 7 8.
9. Enter your AGI for the year the cost was included in your medical expenses 9.
10. Subtract line 9 from line 7 10.
11. Multiply line 8 by line 10. 11.
12. Add line 5 to line 11. If your allowable itemized deductions for the year you purchased the equipment or property were more than your AGI for that year, this is the adjusted basis of the equipment or property 12.

Next, use Worksheet E to figure the total gain or loss on the sale of the medical equipment or property.

Worksheet E. Gain or Loss On the Sale of Medical Equipment or Property

Instructions: Use the following worksheet to figure total gain or loss on the sale of medical equipment or property that you deducted in an earlier year.
1. Enter the amount that the medical equipment or property sold for 1.
2. Enter your selling expenses 2.
3. Subtract line 2 from line 1 3.
4. Enter the adjusted basis of the equipment or property from Worksheet D, line 5, or line 12, if applicable 4.
5. Subtract line 4 from line 3. This is the total gain or loss from the sale of the medical equipment or property. 5.

If you have a loss, it is not deductible. If you have a gain, it is includible in your income. The part of the gain that is a recovery of an amount you previously deducted is taxable as ordinary income. Enter it on Form 1040, line 21. Any part of the gain that is more than the recovery of an amount you previously deducted is taxable as a capital gain. Enter it on Schedule D (Form 1040), Capital Gains and Losses.

For more information about the recovery of an amount that you claimed as an itemized deduction in an earlier year, see Recoveries in Publication 525.

Example.

You have a heart condition and difficulty breathing. Your doctor prescribed oxygen equipment to help you breathe. Last year, you bought the oxygen equipment for $3,000. You itemized deductions and included it in your medical expense deduction.

Last year you also paid $10,750 for deductible medical services and $6,400 for other itemized deductions. Your AGI was $15,000.

Taking into account the 7.5% limit on medical expenses, your allowable itemized deductions totaled $19,025, figured as follows:

Oxygen equipment 3,000
Medical services 10,750
Total medical expenses 13,750
7.5% of AGI (.075 × $15,000) −1,125
Allowable medical expense deduction 12,625
Other itemized deductions 6,400
Allowable itemized deductions 19,025

You figure your adjusted basis as shown on the filled-in Worksheet D.

Worksheet D. Adjusted Basis of Medical Equipment or Property Sold—Illustrated

Instructions: Use this worksheet if you deducted the cost of medical equipment or property in one year and sold the equipment or property in a later year. This worksheet will give you the adjusted basis of the equipment or property you sold.
1. Enter the cost of the equipment or property. 1. 3,000
2. Enter your total includible medical expenses for the year you included the cost in your medical expenses 2. 13,750
3. Divide line 1 by line 2 3. .218
4. Enter 7.5% of your AGI for the year the cost was included in your medical expenses 4. 1,125
5. Multiply line 3 by line 4. If your allowable itemized deductions for the year you purchased the equipment or property were not more than your AGI for that year, stop here. This is the adjusted basis of the equipment or property. If your allowable itemized deductions for the year you purchased the equipment or property were more than your AGI for that year, complete lines 6 through 11 5. 245
6. Subtract line 5 from line 1 6. 2,755
7. Enter your total allowable itemized deductions for the year the cost was included in your medical expenses 7. 19,025
8. Divide line 6 by line 7 8. .145
9. Enter your AGI for the year the cost was included in your medical expenses 9. 15,000
10. Subtract line 9 from line 7 10. 4,025
11. Multiply line 8 by line 10. 11. 584
12. Add line 5 to line 11. If your allowable itemized deductions for the year you purchased the equipment or property were more than your AGI for that year, this is the adjusted basis of the equipment or property. 12. 829
This year you sold the oxygen equipment for $2,025 and you had selling expenses of $25. You must report on this year's tax return part of the $2,000 as ordinary income. To compute the part of the sales price that is taxable, you must determine the gain by subtracting the total adjusted basis from the selling price.

Worksheet E.Gain or Loss On the Sale of Medical Equipment or Property—Illustrated

Instructions: Use the following worksheet to figure gain or loss on the sale of medical equipment or property that you deducted in an earlier year.
1. Enter the amount that the medical equipment or property sold for 1. 2,025
2. Enter your selling expenses 2. 25
3. Subtract line 2 from line 1 3. 2,000
4. Enter the adjusted basis of the equipment or property from Worksheet D, line 5, or line 12, if applicable 4. 829
5. Subtract line 4 from line 3. This is the total gain or loss from the sale of the medical equipment or property. 5. 1,171

Damages for Personal Injuries

If you receive an amount in settlement of a personal injury suit, part of that award may be for medical expenses that you deducted in an earlier year. If it is, you must include that part in your income in the year you receive it to the extent it reduced your taxable income in the earlier year. See What If You Receive Insurance Reimbursement in a Later Year , discussed earlier under How Do You Treat Reimbursements.

Example.

You sued this year for injuries you suffered in an accident last year. You sought $10,000 for your injuries and did not itemize your damages. Last year, you paid $500 for medical expenses for your injuries. You deducted those expenses on last year's tax return. This year you settled your lawsuit for $2,000. Your settlement did not itemize or allocate the damages. The $2,000 is first presumed to be for the medical expenses that you deducted. The $500 is includible in your income this year because you deducted the entire $500 as a medical expense deduction last year.

Future medical expenses. If you receive an amount in settlement of a damage suit for personal injuries, part of that award may be for future medical expenses. If it is, you must reduce any future medical expenses for these injuries until the amount you received has been completely used.

Example.

You were injured in an accident. You sued and sought a judgment of $50,000 for your injuries. You settled the suit for $45,000. The settlement provided that $10,000 of the $45,000 was for future medical expenses for your injuries. You cannot include the first $10,000 that you pay for medical expenses for those injuries.

Workers' compensation. If you received workers' compensation and you deducted medical expenses related to that injury, you must include the workers' compensation in income up to the amount you deducted. If you received workers' compensation, but did not deduct medical expenses related to that injury, do not include the workers' compensation in your income.

Impairment-Related Work Expenses

If you are disabled, you can take a business deduction for expenses that are necessary for you to be able to work. If you take a business deduction for these impairment-related work expenses, they are not subject to the 7.5% limit that applies to medical expenses.

You are disabled if you have:

  • A physical or mental disability (for example, blindness or deafness) that functionally limits your being employed, or

  • A physical or mental impairment (for example, a sight or hearing impairment) that substantially limits one or more of your major life activities, such as performing manual tasks, walking, speaking, breathing, learning, or working.

Impairment-related expenses defined. Impairment-related expenses are those ordinary and necessary business expenses that are:
  • Necessary for you to do your work satisfactorily,

  • For goods and services not required or used, other than incidentally, in your personal activities, and

  • Not specifically covered under other income tax laws.

Where to report. If you are self-employed, deduct the business expenses on the appropriate form (Schedule C, C-EZ, E, or F) used to report your business income and expenses.

If you are an employee, complete Form 2106, Employee Business Expenses, or Form 2106-EZ, Unreimbursed Employee Business Expenses. Enter on Schedule A (Form 1040), line 28, that part of the amount on Form 2106, line 10, or Form 2106-EZ, line 6, that is related to your impairment. Enter the amount that is unrelated to your impairment on Schedule A (Form 1040), line 21. Your impairment-related work expenses are not subject to the 2%-of-adjusted-gross-income limit that applies to other employee business expenses.

Example.

You are blind. You must use a reader to do your work. You use the reader both during your regular working hours at your place of work and outside your regular working hours away from your place of work. The reader's services are only for your work. You can deduct your expenses for the reader as business expenses.

Health Insurance Costs for Self-Employed Persons

If you were self-employed and had a net profit for the year, you may be able to deduct, as an adjustment to income, amounts paid for medical and qualified long-term care insurance on behalf of yourself, your spouse, and your dependents. For this purpose, you were self-employed if you were a general partner (or a limited partner receiving guaranteed payments) or you received wages from an S corporation in which you were more than a 2% shareholder. The insurance plan must be established under your trade or business and the deduction cannot be more than your earned income from that trade or business.

You cannot deduct payments for medical insurance for any month in which you were eligible to participate in a health plan subsidized by your employer or your spouse's employer. You cannot deduct payments for a qualified long-term care insurance contract for any month in which you were eligible to participate in a long-term care insurance plan subsidized by your employer or your spouse's employer.

If you qualify to take the deduction, use the Self-Employed Health Insurance Deduction Worksheet in the Form 1040 instructions to figure the amount you can deduct. But if any of the following applies, do not use the worksheet.

  • You had more than one source of income subject to self-employment tax.

  • You file Form 2555, Foreign Earned Income, or Form 2555-EZ, Foreign Earned Income Exclusion.

  • You are using amounts paid for qualified long-term care insurance to figure the deduction.

If you cannot use the worksheet in the Form 1040 instructions, use the worksheet in Publication 535, Business Expenses, to figure your deduction.

Note.

When figuring the amount you can deduct for insurance premiums, do not include any advance payments shown in box 1 of Form 1099-H. Also, if you are claiming the health coverage tax credit, subtract the amount shown on Form 8885, line 4 from the total insurance premiums you paid.

Also, do not include amounts paid for health insurance coverage with retirement plan distributions that were tax-free because you are a retired public safety officer.

Where to report. You take this deduction on Form 1040, line 29. If you itemize your deductions and do not claim 100% of your self-employed health insurance on line 29, include any remaining premiums with all other medical care expenses on Schedule A (Form 1040), subject to the 7.5% limit.

COBRA Premium Assistance

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) provides that if you were covered under a group health plan and you would lose coverage because of a qualifying event, you should be allowed an opportunity to elect COBRA continuation health coverage under the plan. If there was no available election, your employer or the plan was subject to an excise tax. You can be required to pay the full premium for the COBRA continuation coverage.

If you are an assistance eligible individual, you pay 35% of the premium otherwise payable for this coverage and are treated as having paid the full premium. You are an assistance eligible individual if:

  • You are a qualified beneficiary as a result of an involuntarily termination that occurred during the period beginning on September 1, 2008, and ending on December 31, 2009,

  • You are eligible for COBRA continuation coverage at any time during that period, and

  • You elect the coverage.

A qualified beneficiary is generally any individual who is covered under a group health plan on the day before the involuntary termination. This includes the covered employee, the employee’s spouse, and the employee’s dependent.

The premium assistance (the 65% reduction of the premium) applies to the first period of coverage beginning after February 16, 2009. The reduction applies until the earliest of:

  1. The first date the assistance eligible individual becomes eligible for other group health plan coverage or Medicare coverage,

  2. The date that is 9 months after the first day of the first month for which the reduced premium applies to the individual, or

  3. The date the individual ceases to be eligible for COBRA continuation coverage.

The premium assistance is not included in your gross income. However, if your modified adjusted gross income (AGI) is more than $125,000 ($250,000 if married filing jointly) but not more than $145,000 ($290,000 if married filing jointly), your income tax for the year is increased by a percentage of the premium assistance. Use Worksheet F to figure the amount you must include as tax on your return. If your modified AGI is more than $145,000 ($290,000 if married filing jointly), your income tax for the tax year is increased by the total premium assistance. Include the increase in your income tax on Form 1040, line 60 or Form 1040NR, line 57. On the dotted line next to that line, enter the amount of the tax and identify it as “COBRA.

Worksheet F.Recapture of COBRA Premium Assistance for Higher Income Taxpayers

Instructions: Use the following worksheet to figure the taxable portion of your COBRA premium if your modified AGI (line 3 below) is more than $125,000 ($250,000 if married filing jointly) but less than $145,000 ($290,000 if married filing jointly).
1. Enter your AGI (Form 1040, line 38 or Form 1040NR, line 35) 1.
2. Enter the total of any amounts from Form 2555, lines 45 and 50; Form 2555-EZ, line 18; and Form 4563, line 15, and any exclusion of income from American Samoa and Puerto Rico 2.
3. Modified AGI. Add lines 1 and 2 3.
4. Enter $125,000 ($250,000 if married filing jointly) 4.
5. Subtract line 4 from line 3 5.
6. Enter $20,000 ($40,000 if married filing jointly) 6.
7. Divide line 5 by line 6. Enter the result as a decimal (rounded to at least 3 places) 7. .
8. Enter the amount of the COBRA premium assistance* you received in 2009 8.
9. Multiply line 8 by line 7. Enter result here and include it on Form 1040, line 60 or Form 1040NR, line 57. On the dotted line next to that line, enter the amount shown on line 9 and identify it as “COBRA. 9.
*Contact your former employer or health insurance plan to obtain the total premium assistance, if unknown.

You may elect to permanently waive the right to the premium assistance. You will not receive the premium assistance and you will not have to include the assistance in your income tax if your modified AGI is more than $125,000 ($250,000 if married filing jointly). To make this election, give a signed and dated notification (include a reference to “permanent waiver”) to the person to whom premiums are payable.

You will not qualify for the health coverage tax credit (discussed next) for any month for which you receive premium assistance.

For more information see Notice 2009-27, available at www.irs.gov/irb/2009-16_irb/ar09.

Health Coverage Tax Credit

If you paid the premiums for qualified health insurance coverage, you may be able to claim the health coverage tax credit (HCTC). If you are eligible, you can get monthly HCTC (advance payments), a yearly HCTC, or a combination of these methods (see How To Take the Credit , later). For 2009, the HCTC is 65% of the premiums paid for coverage in January through April, and 80% of the premiums paid for coverage in May through December. For 2010, the HCTC is 80% of the premiums paid for coverage in each month.

More information. For a complete discussion of the HCTC, visit our website www.irs.gov and enter “hctc” in the search box. Also, see Form 8885.

Who Can Take This Credit?

You can take this credit for any month in which all of the following were true on the first day of the month.

  1. You were an eligible:

    1. Trade adjustment assistance (TAA) recipient,

    2. Alternative TAA recipient, Reemployment TAA recipient, or

    3. Pension Benefit Guaranty Corporation (PBGC) pension recipient.

  2. You paid the premium for qualified health insurance coverage for yourself or a qualifying family member. See Qualified Health Insurance , later.

  3. You were not imprisoned under federal, state, or local authority.

  4. You did not have other specified coverage. See Other Specified Coverage , later.

If you were an eligible recipient described in (1), your state’s workforce agency (unemployment office) or the PBGC will notify the HCTC Program that you may be eligible for the credit. When notified, the HCTC Program will mail you an HCTC Program Kit. If you have not received the Program Kit, you probably are not an eligible recipient and do not qualify for the credit.

It can take the state or PBGC time to notify the HCTC Program about the event. You should make the full premium payments to your health plan until you are enrolled in the HCTC Program. You may be able to claim the yearly HCTC for these premiums when you file your tax return.

No credit if exemption claimed by another taxpayer. You cannot take this credit if you can be claimed as an exemption on someone else's tax return.

Qualifying Family Member

You can include the premiums you pay for qualified health insurance for qualifying family members in figuring your credit. A qualifying family member is:

  • Your spouse (but see Both spouses eligible below), or

  • Anyone whom you can claim as a dependent on your tax return. (For children whose parents are divorced, see Children of divorced or separated parents , later.)

However, anyone who has other specified coverage (defined later), is not a qualifying family member.

Both spouses eligible. Your spouse is not treated as a qualifying family member if:
  • You are married at the end of the year,

  • You and your spouse are both eligible recipients during the year, and

  • You file separate tax returns.

Married and living apart. For purposes of this credit, you are not considered married on the last day of the year if all of the following apply.
  • You file a separate return.

  • Your home is the home for more than half the year of a dependent under age 13 or a dependent who is physically or mentally not able to care for himself or herself.

  • You pay more than half the cost of keeping up your home for the year.

  • Your spouse does not live in your home for the last 6 months of the year.

Legally separated. You are not considered married if you are legally separated from your spouse under a decree of divorce or separate maintenance.

Children of divorced or separated parents. Under the rules for medical expenses, a child of divorced or separated parents can be treated as a dependent of both parents if certain requirements are met. See Qualifying Child under Whose Medical Expenses Can You Include, earlier. However, for purposes of the HCTC, only the custodial parent can treat the child as a qualifying family member, even if the other parent can claim the child as a dependent. The custodial parent is the parent having custody for the greater portion of the tax year.

Qualified Health Insurance

The following health insurance qualifies for the credit.

  • COBRA continuation coverage. (This is coverage that employers with 20 or more employees must offer to employees or former employees and their beneficiaries who have lost coverage because of certain events.) See the caution on page 26.

  • Coverage under a group health plan that is available through the employment of your spouse. (But see Other Specified Coverage , later.)

  • Coverage under an individual health insurance policy if you were covered during the entire 30-day period that ends on the date you separated from the employment which qualified you for the allowance or benefit as an eligible individual (defined earlier). For this purpose, coverage under an individual health insurance policy includes medical insurance offered to individuals and their families, but does not include coverage under a federal, state, or other group health insurance policy.

COBRA continuation coverage allows individuals who had lost their jobs to receive a reduction in health insurance premiums. You do not qualify for the HCTC for any month that you received a reduction in premium.

State-qualified health insurance. Certain state qualified health insurance can qualify for a credit. To find out which plans are qualified for your state, you can:
  • Visit the website, www.irs.gov, type “hctc” in the search box, and then, click on HCTC: List of State-Qualified Health Plans, or

  • You can call 1-866-628-4282 (tollfree) (or TDD/TTY 1-866-626-4282).

Nonqualified Health Insurance

The following health insurance does not qualify for the credit.

  1. Medicare supplemental (Medigap) insurance, Tricare supplemental insurance, or similar supplemental insurance to an employer-sponsored group health plan.

  2. Any insurance if substantially all of the coverage is:

    1. Coverage for on-site medical clinics,

    2. Hospital indemnity or other fixed indemnity insurance,

    3. Accident or disability income insurance (or a combination of the two),

    4. Liability insurance,

    5. A supplement to liability insurance,

    6. Workers' compensation or similar insurance,

    7. Automobile medical payment insurance,

    8. Credit-only insurance,

    9. Limited scope dental or vision benefits,

    10. Benefits for long-term care, nursing home care, home health care, community-based care (or any combination), or

    11. Coverage for only a specified disease or illness.

  3. Coverage under a flexible spending or similar arrangement.

Insurance that covers other individuals. If you have qualified health insurance that covers anyone besides yourself and your qualifying family member(s), (defined earlier), you may not be able to take into account all of your payments. You cannot treat an amount as paid for insurance for yourself and qualifying family members unless all of the following requirements are met.
  • The charge for insurance for yourself and qualifying family members is either separately stated in the contract or furnished to you by the insurance company in a separate statement.

  • The amount you paid for insurance for yourself and qualifying family members is not more than the charge that is stated in the contract or furnished by the insurance company.

  • The amount stated in the contract or furnished by the insurance company is not unreasonably large in relation to the total charges under the contract.

Eligible Coverage Month

Eligibility for the credit is determined on a monthly basis. An eligible coverage month is any month in which, as of the first day of the month, you:

  1. Are an eligible recipient,

  2. Are covered by qualified health insurance (defined earlier) that you pay for,

  3. Do not have other specified coverage (defined later), and

  4. Are not imprisoned under federal, state, or local authority.

If you file a joint return, only one spouse has to satisfy the requirements.

An individual who receives COBRA premium assistance (discussed earlier) for a month is disqualified from receiving the HCTC for that month.

Other Specified Coverage

Even if you are otherwise eligible, you are not eligible for the credit for a month if, as of the first day of the month, you have other specified coverage. Other specified coverage is coverage under the following.

  1. Any insurance which constitutes medical care (unless substantially all of that insurance is for benefits listed earlier under (1) or (2) under Nonqualified Health Insurance ) if at least 50% of the cost of the coverage is paid by an employer (or former employer) of you or your spouse.

  2. Any of the following government health programs:

    1. Medicare Part A or Part B,

    2. Medicaid, or the State Children's Health Insurance Program (SCHIP),

    3. The Federal Employees Health Benefit Plan (FEHBP), or

    4. Tricare, the medical and dental care program for members and certain former members of the uniformed services and their dependents.

Benefits from the Veterans Administration. Entitlement to or receipt of benefits from the Veterans Administration is not other specified coverage.

How To Take the Credit

If you claim this credit, you cannot take the same expenses that you use to figure your HCTC into account in determining your:

  • Medical and dental expenses on Schedule A (F