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First, I know about the 7.5% AGI floor for medical deductions in 2018 (scheduled to go to 10% of AGI in 2019). We are above the 7.5% AGI floor.

Our doc has recently transferred to a concierge practice. The monthly fee covers everything he will do for us, including house visits at any hour (yes, I am sure of this). Of course, things he doesn't do such as major surgery, would be billed as usual through our insurance (you would be surprised at some of the things that are called surgery, that could be done in his office, and would be covered by his monthly fee).

My question: Is all of our fee deductible or do I have to estimate the value of the services he actually provides and deduct only that amount?

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I looked into this a few years ago when a doctor that I was using decided to convert to a concierge practice. From what I could find, the answer was a bit murky.

Not all medical expenses are deductible (eg. cosmetic) so if your concierge doctor is performing them, it may be flagged. From what I found, the concierge fee is deductible if legitimate services are being performed but may not be deductible if all you are paying for is access.

Tax law changes all of the time so the short answer is consult with a competent accountant.

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    +1 Thanks, but it is still unclear whether one legitimate service, e.g., a physical exam, validates the entire fee for IRS purposes, or only that portion of the fee equal to the reasonable cost of the exam. As you say, it is murky. – ab2 Sep 13 '18 at 13:03
  • Sorry but I can't clarify it for you. If you read various web explanations, they say that all legitimate medical services are deductible regardless of how you pay for them (traditional insurance versus concierge fee). But none of them break it down and detail when all, some or none of the concierge fee is tax deductible. Give the IRS a call. Visit free tax web sites like Turbo Tax and H&R Block. If you find an answer, plz share. – Bob Baerker Sep 13 '18 at 13:25
  • I'll ask the concierge medical office first -- they have been in business for about 15 years. – ab2 Sep 13 '18 at 18:50

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