Internal Revenue Service
Revenue Ruling

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 Rev. Rul. 76-79

1976-1 C.B. 70

Section 213

IRS Headnote

Medical expenses; physician-recommended cruise. Of an individual's expenses incurred in making a physician-recommended cruise with a group of physicians who provide clinical medical services, dietary supervision, and seminars relative to the individual's medical condition, only the amounts attributable to reviewing the individual's medical records, performing medical tests, and reporting the results to the individual's personal physician are expenditures for medical care.

Full Text

Rev. Rul. 76-79

Advice has been requested whether, under the circumstances described below, a medical expense deduction is allowable under section 213 of the Internal Revenue Code of 1954 for any part of an individual's expenses for a cruise undertaken upon a physician's recommendation.

An individual, upon a doctor's recommendation, embarked upon a cruise aboard a cruise ship with a group of physicians who provide certain medical services, such as reviewing the patient's medical records, performing certain tests upon the patient as directed by the patient's personal physician or as indicated by the patient's condition, and reporting the results of the patient's medical progress to the patient's personal physician. In addition, they provide instructive seminars relative to the patient's medical condition and supervise the patient's dietary program. The cruise ship is not a hospital or other medical institution, and all the medical services provided aboard ship are available in the individual's home town.

Section 213(a) of the Code allows, subject to certain limitations not relevant here, a deduction for expenses paid during the taxable year, not compensated for by insurance or otherwise, for the "medical care" of the taxpayer and the taxpayer's spouse and dependents. Section 213(e) of the Code defines the term "medical care" to include amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body; for transportation primarily for and essential to medical care; or for insurance covering medical care.

Section 1.213-1(e)(1)(ii) of the Income Tax Regulations provides, in part, that expenditures for medical care allowable under section 213 of the Code will be confined strictly to expenses incurred primarily for the prevention or alleviation of a physical or mental defect or illness. However, an expenditure that is merely beneficial to the general health of an individual is not an expenditure for medical care.

Section 1.213-1(e)(1)(iv) of the regulations provides that expenses paid for transportation primarily for and essential to the rendition of medical care are expenses paid for medical care. However, an amount allowable as a deduction for "transportation primarily for and essential to medical care" shall not include the cost of any meals and lodging while away from home receiving medical treatment. For example, if a doctor prescribes that a taxpayer go to a warm climate in order to alleviate a specific chronic ailment, the cost of meals and lodging while there would not be deductible. Furthermore, if the travel is undertaken merely for the general improvement of the taxpayer's health, neither the cost of transportation nor the cost of meals and lodging would be deductible. If a doctor prescribes an operation or other medical care, and the taxpayer chooses for purely personal considerations to travel to another locality (such as a resort area) for the operation or the other medical care, neither the cost of transportation nor the cost of meals and lodging (except where paid as part of a hospital bill) is deductible.

In the instant case, the cruise was not primarily for and essential to the individual's medical care. Accordingly, the transportation expense of the cruise cost is not a deductible medical expense under section 213 of the Code. Moreover, the food and lodging expense of the cruise cost is not a deductible medical expense because the ship is not a hospital or other medical institution. See section 1.213-1(e)(1)(v) of the regulations. Inasmuch as the instructive seminars relative to the patient's medical condition and the supervision of the patient's dietary program are for the preservation of general health, the part of the cruise cost attributable to those items is not a deductible medical expense. However, amounts paid for reviewing the patient's medical records, performing medical tests, and reporting results to the patient's personal physician are amounts paid for the diagnosis, cure, mitigation, treatment or prevention of disease. Such amounts are deductible, within the limitations of section 213, if the individual can establish what part of the amount paid for the cruise is attributable to those items.