Claiming a tax deduction for medical expenses is getting harder. What to do before the end of the year

  • While the Tax Cuts and Jobs Act eliminated most deductions, the one for medical expenses remains available to people who itemize.
  • For 2018, you can deduct qualifying costs that exceed 7.5 percent of your adjusted gross income. Next year, that threshold jumps to 10 percent.
  • In light of that, it might be worth moving some planned 2019 health-care expenditures to this year if you'll be able to claim them on your 2018 return.

Despite tax-law changes that have made it harder to claim the deduction for medical expenses, it's still worth checking to see if you can take it for 2018.

As it stands, you can deduct qualifying medical expenses that exceed 7.5 percent of your adjusted gross income (taxable income minus certain adjustments) as long as you itemize your deductions. That floor is scheduled to rise to 10 percent in 2019, which will be a harder hurdle to clear.

This means that before the calendar flips to 2019, it might be worth strategizing to get the deduction this year.

"If someone is close to getting the deduction or knows they'll itemize, then if there are things you can accelerate into 2018 instead of waiting until 2019, it might make sense to do it," said Julie Welch, a CPA who serves on the American Institute of CPAs' personal financial planning executive committee.

Examination
Hero Images | Getty Images

For instance, you could consider getting medical procedures or equipment and supplies (i.e., new glasses or a new wheelchair) before the end of the year instead of putting them off. If you do it with hopes of deducting your associated costs on your 2018 return, make sure the bill is paid this year, Welch said.

Be sure not to overlook other qualifying expenses, such as co-pays, co-insurance, dental work and travel costs associated with health care, such as getting to and from the doctor's office. You can check the IRS list of qualifying expenses if you're unsure whether something counts toward the deduction.

Also, if you pay for health insurance with after-tax dollars, your premiums might be able to count toward the deduction. Long-term care premiums also are deductible up to amounts that depend on your age (see chart below).

Deduction limits for long-term care premiums

Age before close of taxable year
2018 maximum deduction
Under 40 $420
More than 40 but under 50 $780
More than 50 but under 60 $1,560
More than 60 but under 70 $4,160
Over 70 $5,200
Source: Internal Revenue Service

Be aware that any expenses paid for with funds from a flexible spending account or health savings account cannot count toward the deduction.

"You already get a tax advantage with those accounts," said Nick Foulks, a lead advisor with Great Waters Financial in Minneapolis.

Some expenses that can't count toward your total for tax purposes are gym memberships, cosmetic procedures and any expenses you were reimbursed for.

And be aware that although you don't send in your receipts and records with your tax return, you would need to be able to produce them if the IRS were to ever ask for proof.

Overall, fewer people are expected to claim the deduction this year because it's only available to itemizers — the ranks of whom are anticipated to drop.

Due to the Tax Cuts and Jobs Act, which nearly doubled the standard deduction and eliminated most other write-offs, itemizers will comprise just 12 percent of 2018 returns, according to the Tax Foundation. That's down from 30 percent in 2017.

For example, the standard deduction for married couples is now $24,000, up from $12,700 — which means a couple would now need deductions totaling more than that for itemizing to make financial sense.

More from Personal Finance:
Online notices can show you how much your Social Security benefits will be in 2019
6 last-minute tips that will trim your 2018 tax bill
7 shopping hacks to keep your spending under control

Subscribe to CNBC on YouTube.