Tax Tip – Transportation for Medical Care

Taxpayers may include in medical expenses amounts they pay for transportation primarily for, and essential to, medical care, including:

(1) bus, taxi, train, or plane fares, or ambulance service;

(2) transportation expenses of a parent who must go with a child who needs medical care;

(3) transportation expenses of a nurse or other person who can give injections, medications, or other treatment required by a patient who is traveling to get medical care and is unable to travel alone; and

(4) transportation expenses for regular visits to see a mentally ill dependent, if these visits are recommended as a part of treatment (Reg. Sec. 1.213-1(e)(1)(iv); Montgomery v. Comm’r, 51 T.C. 410 (1968), aff’d, 428 F.2d 243 (6th Cir. 1970)).

Taxpayers who use their car for medical reasons can include out-of-pocket expenses, such as the cost of gas and oil, in figuring deductible medical expenses. However, they cannot include depreciation, insurance, general repair, or maintenance expenses. Instead of using actual expenses, taxpayers can use a standard mileage rate (16 cents a mile for 2021, 17 cents a mile for 2020, 20 cents a mile for 2019, and 18 cents a mile for 2018) (Rev. Proc. 2019-46; Notice 2021-2; Notice 2020-5; Notice 2019-2, Notice 2018-3). Parking fees and tolls can be added to medical expenses whether the taxpayer uses actual expenses or the standard mileage rate.


Allie drove 2,800 miles for medical reasons during 2021. She spent $350 for gas, $30 for oil, and $100 for tolls and parking. She wants to calculate the amount she can include in medical expenses both ways to see which gives her the greater deduction. She calculates the actual expenses first. She adds the $350 for gas, the $30 for oil, and the $100 for tolls and parking for a total of $480. She then calculates the standard mileage amount. She multiplies the 2,800 miles by 16 cents a mile for a total of $448. She then adds the $100 tolls and parking for a total of $548. Allie includes the $548 of car expenses with her other medical expenses for the year because the $548 is more than the $480 she calculated using actual expenses.

The cost of transportation for the following situations cannot be included in medical expenses:

(1) going to and from work, even if the taxpayer’s condition requires an unusual means of transportation;

(2) travel for purely personal reasons to another city for an operation or other medical care;

(3) travel that is merely for the general improvement of one’s health; and

(4) the costs of operating a specially equipped car for other than medical reasons (Comm’r v. Bilder, 369 U.S. 499 (1962); Reg. Sec. 1.213-1(e)(1)(iv)).

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(Updated 02/24/2021 06:11)

Published by Don Fitch, CPA

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