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Medical tax breaks' 10% and FSA year-end considerations

My brother and I tended to get sick around Christmas.

Maybe we wore ourselves out with all the excitement. Maybe the sharing of Christmas cards and trinkets with our classmates and neighborhood kids included shared germs. Maybe we were allergic to the decorated pine tree that filled up our living room.

Whatever the cause, colds and coughs were part of the holiday tradition at the Bell homestead. We learned to live with it and have a Merry Christmas anyway.

As an adult, I still take extra measures -- and extra zinc and vitamin C -- to avoid late-year sniffles.

And I still think about medical issues at holiday time partly because of the fifth song in our Christmas Tax Tip Tunes series, All I Want for Christmas is My Two Front Teeth.

I wasn't familiar with the Al Alberts Showcase until I found the video clip above on YouTube. But I love this youngster's rendition of the humorous holiday classic. I also love that her mom dressed her in the very same type of Christmas outfit my mother picked out for me when I was that age.

But enough reminiscing. The other reason medical matters come to mind around the holidays is that there are some tax-related moves you might want to consider.

Spending down your FSA: I've already discussed the possible ways to spend remaining medical flexible spending account (FSA) money so that you don't lose it, so I'll be brief in this recap.

In most cases, employees who put pre-tax money via automatic payroll deposits into an FSA must spend all the account cash by the end of the benefit year. That's Dec. 31 for most plans. If you don't, your boss gets the excess.

Dental work is a popular way to wipe out excess FSA money. My post of a couple weeks ago has more suggestions of items to add to your medical FSA spending list.

Clearing the 10 percent deduction hurdle: If you itemize deductions, you'll also want to look at medical costs.

You now must have medical and dental costs that exceed 10 percent of your adjusted gross income (AGI). That means if your AGI is $50,000 you must have more than $5,000 in medical/dental costs before they're worth anything on Schedule A.

Note the "more than" requirement. If you have $5,500 in medical costs, you can deduct only the $500 that's above your AGI threshold.

That 10 percent mark, which went up beginning with the 2013 tax year from the previous 7.5 percent cutoff, is a tough one to meet for most folks.

You might be able to clear it, though, if you bunch your medical costs. Bunching is making the tax-deductible expenditures (in this case medical costs) in one tax year when they'll be more tax useful.

You only have a few weeks to make allowable medical expenditures. You also might be able to make some that you don't usually think about. These include not only the usual co-pays for prescriptions and doctor's office visits, but other more specialized medical expenditures.

Travel costs to and from medical treatment, to pick up prescriptions and even in some instances medical conferences is deductible. Christmas carol inspired orthodontia counts. So do weight loss programs that are medically necessary.

Sorry. That medical necessity rule is firm. You can't write off your special Weight Watchers meals that you've been eating for months so that you can indulge on December goodies.

But you can find more, and atypical, ways to maximize medical tax deductions in my post-operative post from October.

My holiday wish for you today is that you have a healthy and happy holiday season. But do take a few minutes away from your Christmas shopping and before the end of the year to make sure you don't waste any tax-saving medical moves.

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