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Medical Expense Deductions

Some expenses, like the costs of at-home nursing care for a disabled dependent, would ordinarily be deductible as medical expenses. If they enable the taxpayer to be gainfully employed, they can also qualify as employment-related dependent care.

However, you can't use the same expenses for both the medical deduction and the dependent care credit. You'll have to decide which tax benefit will help you more.

Generally speaking, if you have a choice, it's better to maximize your child or dependent care credit up to the applicable dollar limitations ($3,000 for one qualifying person, or $6,000 for two or more). If your expenses exceed this limitation, any excess that qualifies as a medical deduction should be treated as such.

Remember that only medical expenses that exceed 10 percent of your adjusted gross income are deductible. (This threshold is 7.5 percent through 2016if the taxpayer or spouse is over age 65.)

Example

During 2014, John and Mary Davis paid $15,000 of work-related expenses for the care of their physically handicapped daughter. The work-related expenses were for services performed in the Davis' home and qualified as medical expenses. The Davis' adjusted gross income for 2014 was $100,000.

If they take the maximum of $3,000 of these expenses into account for purposes of the dependent care credit, they can claim a 20% credit of $600, and treat the balance, or $12,000, as medical expenses. Because the Davises had no other medical expenses, they can deduct $2,000 ($12,000 minus 10% of $100,000, or $10,000) as a medical expense. Since they are in the 25% bracket, the $2,000 deduction saves them $500 in taxes. Total tax savings: $600 + $500 = $1,100.

However, if they claim the full $15,000 as a medical expense, subtracting the 10% of AGI amount ($10,000) leaves a deduction of $5,000. In the 25% bracket, this deduction would save $1,250 in taxes.

The Davises are better off forgoing the child and dependent care credit, and instead claiming the full medical expense deduction for their daughter's expenses.

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