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Are health insurance costs tax-deductible?

Written by: Chase Charaba
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Originally published on March 24, 2022. Last updated March 30, 2022.

When it comes to filing taxes, understanding what expenses are eligible for tax write-offs is important. Employers often ask us, “Is health insurance tax-deductible?” While the short answer is yes, there are some differences in how organizations and individuals can write off a health insurance premium and a medical expense.

In this article, we’ll explore how employers can save with tax advantages for various health insurance scenarios, including:

Health insurance tax deductions for employers

When an employer offers a formal health benefit, the expense can generally be written off as a business expense. The Internal Revenue Service allows employers to deduct a few different healthcare benefits.

Common types of tax-deductible benefit plans and contributions are:

In each of these scenarios, employees also receive tax advantages. Your employees’ payments for group health insurance premiums or HSA contributions can be paid for with pre-tax money.

With an HRA, all eligible reimbursements made through the plan aren’t subject to payroll taxes such as FICA or FUTA. Reimbursements received by your employees through an HRA are tax-free and aren’t included in your employees’ gross income as long as the employee has minimum essential coverage (MEC).

Health insurance tax deductions for the self-employed

If you’re self-employed or a partnership/LLC member, you may have additional opportunities for health insurance deductions compared to other employers.

Most self-employed taxpayers can deduct insurance premiums, including dental and qualifying long-term insurance coverage.

You’ll enter this amount on page one of IRS Form 1040, which means the benefit isn’t dependent on itemizing deductions. You can use this even when you elect to take the standard deduction. This value reduces your adjusted gross income (AGI).

To be eligible, you can’t deduct more than your business profit, and your profit can’t be a tax loss. You also can’t be eligible for employer-provided insurance from another job or spouse.

Can you claim health insurance premiums on your taxes as an employee?

As an employee, you can deduct any health insurance premiums that you pay out of pocket, which hasn’t been reimbursed through a stipend or an HRA. COBRA and Medicare premiums can also be tax-deductible.

You can reimburse Medicare Part B, Part C, and Part D on your tax return.

You can also write off Medicare Part A premiums if you aren’t enrolled in the plan under Social Security and if you’ve never paid Medicare tax as a government employee. Most Medicare Part A recipients don’t pay premiums, so there’s often no expense to deduct.

Employees can also deduct long-term care insurance premiums on their tax returns.

You can only deduct Medicare and out-of-pocket medical expenses that exceed 7.5% of your adjusted gross income as itemized deductions on your personal tax returns.

If you receive premium tax credits, you can’t deduct the amounts that your advance premium tax credits paid for. You can only write off the out-of-pocket expenses that you paid.

Should you chose the standard deduction or itemized deduction for personal medical expenses?

Employees will need to consider their income and medical expenses when deciding whether to take the standard deduction or to itemize their deduction.

To determine which deduction to take, you must calculate the deductible amount. Remember, you can only deduct medical expenses greater than 7.5% of your adjusted gross income.

For example, if your AGI is $56,000, you can only deduct medical expenses greater than $4,200 on your tax return. If your out-of-pocket medical expenses and other expenses exceed the standard deduction, then choosing the itemized deduction will allow you to get more money back on your tax return.

It’s a good idea to consult with your tax advisor to determine which filing method is best for you.

Health insurance tax credits for employers

In addition to the standard tax deductions discussed above, some small employers may qualify for a health coverage tax credit.

Introduced as part of the Affordable Care Act (ACA), these tax credits help small businesses that offer qualified health plans through a Small Business Health Options Program (SHOP) Marketplace.

You can take advantage of these tax credits if you meet all four of the following requirements:

  • Have fewer than 25 full-time equivalent employees (FTEs)
  • Pay your employees an average wage of $56,000 or less each year
  • You offer a group health insurance policy and cover at least 50% of the premium costs
  • You purchased the policy through the SHOP Marketplace

Qualifying employers may receive up to 50% of the contribution made toward employee premium costs. You’ll receive the highest tax credit benefit if you have less than 10 employees and pay them an average of $27,000 or less.

Thanks to amended IRS rules, you may still be eligible for a small business health tax credit if you’re located in a county without a SHOP Marketplace.

Health insurance tax credits for employees

In addition to health insurance tax credits for employers, tax credits are also available to eligible employees who purchase individual health insurance. Premium tax credits can significantly lower the cost of health insurance for qualified individuals.

To learn more about premium tax credits, read our in-depth article

Other tax-deductible medical expenses

Health insurance premiums aren’t the only medical expense deductions you can write off on your taxes. Some out-of-pocket expenses are also deductible. So, what kind of medical expenses are tax-deductible?

Deductible out-of-pocket medical expenses include:

  • Dental insurance
  • Prescriptions
  • Therapy
  • Contact lenses and prescription glasses
  • Birth control

You can even deduct travel costs associated with getting medical care. For the complete list of eligible items, see IRS Publication 502 expenses.

What health benefits aren't tax-deductible?

While there are many tax-deductible health benefits and expenses, not everything is considered tax-deductible by the IRS.

Employees can’t deduct any expenses you reimbursed them for. That’s because they’re essentially being paid back for those expenses.

This isn’t a problem with an HRA, as you’re reimbursing your employees using pre-tax money, which means that it isn’t reported as income, and therefore no taxes are paid on it. This is as long as your employees have health insurance. Plus, as discussed earlier, you’ll be able to deduct the reimbursements you provided to your employees.

However, if you decide to reimburse employees using a health benefit stipend, that reimbursement is taxable and can’t be deducted. Health stipends are considered taxable income for your employees, much like a salary. As a result, your employees pay income tax, and you won’t get tax benefits as an employer.

So why would you offer a taxable health benefit like an employee stipend if you don’t get to write the reimbursement off? Health stipends are a great option for organizations with employees who receive premium tax credits, as they’ll still be able to use their credits and the stipend benefit. It also allows for more flexibility, as there are fewer restrictions on eligible expenses.

If you’re interested in offering your employees a health stipend, PeopleKeep can help. Our WorkPerks stipend administration software makes it easy to provide custom perks to your employees.

What other benefits can employers deduct?

Employers can deduct a variety of employee benefits on their business tax returns.

Fringe benefits such as life insurance coverage and dependent care assistance can be deducted for the employer. You can also deduct workers’ compensation premiums and the set-up costs for qualifying retirement plans.

It’s worth noting that unlike health insurance, employees can’t deduct out-of-pocket life insurance premiums. The Internal Revenue Service sees life insurance as a personal expense that isn’t required by law.

Conclusion

Knowing the differences between each of the health benefits in this article and what tax credit options are available can help your organization owe fewer taxes for the year. It can also help you choose the right health benefit for your employees.

Depending on your organization’s health benefit, you can usually write off your health insurance expenses on your taxes. Group health insurance premiums, HRAs, and HSAs, are tax-advantaged for employers. Health stipends, however, are subject to taxes for the employer and the employee.

You should always consult with a tax professional to see how you can get the most out of your tax return. However, these tips should get you started in the right direction.

This blog article was originally published on February 25, 2016. It was last updated on March 24, 2022.

Originally published on March 24, 2022. Last updated March 30, 2022.
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