Year-end planning for medical expense claims

While Canadians benefit from a publicly funded health care system, there are nonetheless a significant (and increasing) number of medical and para-medical expenses which are not covered by provincial health care plans. As well, an increasing number of Canadians – who may work on contract or who hold several part-time jobs – do not have private insurance coverage for such costs through their employer.

In many instances, therefore, Canadians have to pay for such unavoidable expenditures – including dental care, prescription drugs, ambulance trips and many other para-medical services, like physiotherapy, on an out-of-pocket basis. The good news is that where such costs must be paid for partially or entirely by the taxpayer, the tax system provides a medical expense tax credit to help offset those costs. The bad news is that the computation of such expenses and, in particular, the timing of making a claim for the credit, can be confusing. In addition, the determination of what expenses qualify for the credit and which do not isn’t necessarily intuitive, nor is the determination of when it’s necessary to obtain prior authorization from a medical professional in order to ensure that the contemplated expenditure will qualify for the credit.

The basic rule is that qualifying medical expenses (a lengthy list of which can be found on the Canada Revenue Agency website at https://www.canada.ca/en/revenue-agency/services/tax/individuals/topics/about-your-tax-return/tax-return/completing-a-tax-return/deductions-credits-expenses/lines-33099-33199-eligible-medical-expenses-you-claim-on-your-tax-return.html) over 3% of the taxpayer’s net income, or $2,397, whichever is less, can be claimed for purposes of the medical expense tax credit on the taxpayer’s return for 2020.

Put in more practical terms, the rule for 2020 is that any taxpayer whose net income is less than $79,900 will be entitled to claim medical expenses that are greater than 3% of his or her net income for the year. Those having income over $79,900 will be limited to claiming qualifying expenses which exceed the $2,397 threshold.

The other aspect of the medical expense tax credit which can cause some confusion is that it’s possible to claim medical expenses which were incurred prior to the current tax year, but weren’t claimed on the return for the year that the expenditure was made. The actual rule is that the taxpayer can claim qualifying medical expenses incurred during any 12-month period which ends in the current tax year, meaning that each taxpayer must determine which 12-month period ending in 2020 will produce the greatest amount eligible for the credit. That determination will obviously depend on when medical expenses were incurred so there is, unfortunately, no universal rule of thumb which can be used.

Medical expenses incurred by family members – the taxpayer, his or her spouse, children who were born in 2003 or later, and certain other dependent relatives – can be added together and claimed by one member of the family. In most cases, it’s best, in order to maximize the amount claimable, to make that claim on the tax return of the lower income spouse, where that spouse has tax payable for the year.

As December 31^st approaches, it’s a good idea to add up the medical expenses which have been incurred during 2020, as well as those paid during 2019 and not claimed on the 2019 return. Once those totals are known, it will be easier to determine whether to make a claim for 2020 or to wait and claim 2020 expenses on the return for 2021. And, if the decision is to make a claim for 2020, knowing what medical expenses were paid, and when, will enable the taxpayer to determine the optimal 12-month period for that claim.

It’s worth noting that, for many Canadians, 2020 has been a year in which income was reduced, owing to temporary layoffs or even permanent job loss. Where income is lower (assuming such income is below the $79,900 threshold), the extent to which qualifying medical expenses incurred during the year will be claimable for purposes of the medical expense tax credit increases. Take, for example, an individual who was laid off for three months during 2020 and who has incurred $2,500 in eligible medical expenses. If that individual’s income for 2020 is $30,000, he or she will be able to claim $1,600 of those expenses for purposes of the medical expense tax credit. If the individual returns to full employment in 2021 and earns $40,000, he or she will be able to claim only $1,300 of those eligible medical expenses on the return for 2021.

Finally, it’s a good idea to look into the timing of medical expenses which will have to be paid early in 2021. Where those are significant expenses (for instance, a particularly costly medication which must be taken on an ongoing basis) it may make sense, where possible, to accelerate the payment of those expenses to December 2020, where that means they can be included in 2020 totals and claimed on the 2020 return.