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Is a Patient Advocate or Navigator a Qualified Medical Expense for Patients?
In the process of writing about Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSA) I began looking at what constituted a “qualified medical expense,” which is the list of the products and services the IRS lets us pay for tax-free. They are those expenses that we can either claim on our taxes, or pay for through the use of an HSA, MSA or FSA. (What would the IRS ever do without acronyms? But I digress…) After looking at the list of expenses, I began to wonder whether a patient / taxpayer who hires and pays for a health or patient advocate can deduct that expense from their taxes or account? Are we, as advocates who improve their healthcare experiences, deductible expenses? So I went straight to the IRS horses to see what would come from their mouths… and what came from their mouths were big, loud question marks. They don’t know. Advocates might be a deduction. Or they might not. Frustratingly, the process to figure out an answer requires people willing to test the system, at their own expense, which culminates in a “ruling.” And even then, when there is a ruling, the answers might change. (Is this a great country, or what?) The best way to explain this is to use a metaphor – a parallel situation that resulted in a ruling. Acupuncture. Years ago, patients began to deduct the cost of acupuncture from their taxes. Once in awhile, one of those patients got audited. For the first dozen or hundred or thousand (who knows?) the deduction was not allowed because there was no “ruling.” After awhile, there were enough people who fought for the deduction (paying their CPAs or lawyers to do so) that the IRS finally came up with said-ruling that said, “OK – acupuncture is now included on the list of qualified medical expenses (AKA deductions.)” So, a couple of notes: The CPAs and lawyers who successfully got acupuncture reviewed did so by showing evidence that acupuncture has a medical benefit. (ha! If your doctor doesn’t believe in the value of acupuncture, you can tell…