Diabetes & Taxes

90376_1582Death, taxes… diabetes. We’re all certain that until there is a cure, we’ve definitely got diabetes and have to pay our taxes (at least in the United States). Don’t we already bleed enough?

When you have a very expensive chronic illness (hint: diabetes is a very expensive chronic illness), it pays to be prepared when it comes to doing your taxes and squeezing every dime out of your medical deduction. You need to begin the hunt for your expenses – and the receipts for those expenses.

Topic 502 of the IRS is all about Medical and Dental Expenses. We all need to know about this topic. Here’s the deal if you itemize your expenses on your 1040:

For years beginning after December 31, 2012, you may deduct only the amount of your total medical expenses that exceed 10% of your adjusted gross income or 7.5% if you or your spouse is 65 or older. The 7.5% limitation is a temporary exemption starting January 1, 2013 to December 31, 2016 for individuals age 65 and older and their spouses.

It Pays To Itemize

It pays to itemize. Seriously. Plain and simple: we spend a lot of our diabetes care, but we don’t think about all of the items. (And a lot of the time, we don’t keep the receipts…)

I’m telling you this: start now. Even if you didn’t keep the receipts from last year, start collecting. If you’re high tech, scan them in somewhere. Take a picture of your receipts and put them in a file on your computer. Heck, get a folder and put it next to your keys and put any receipts that can be included as medical/dental expenses into it. Find a system that works for you. But start now.

Ground Rules

I AM NOT A TAX PROFESSIONAL. Oh, please. I have a BA degree and a MSc. degree, neither of which is in accounting. You know (hopefully) by now how much I do not like math. I use a bolus calculator for a reason. I have wonderful friends who are CPAs. Do not look to me for tax advice. Do not look to me as the shining pillar of how to do taxes. I am many things, but I am not a tax professional nor am I perfect. (I am The Perfect D, but…)

I’m not giving you the entire list of what are considered acceptable deductible medical expenses. If you want the whole list, you can get it from the IRS website.

Here are the ground rules for what you can deduct:

  • You can only include the medical expenses you paid during the year and you can only use the expenses once on the return.
  • If you got reimbursed for any medical expenses, you must reduce the expense by the amount you were reimbursed.

For instance: You paid a doctor $120 for an appointment in May of 2014, sent the receipt into your insurance, and they sent you a check for $100 in December of 2014. You can then only claim $20 for this 2014 expense on your taxes, because you paid only $20 to see the doctor. 

What You Can Deduct If You Have Diabetes

Deductible diabetes medical expenses may include (but are not limited) to:

Your payments to your healthcare team: physicians, CDEs, nutritionists, dietitians, psychiatrists, psychologists, endocrinologists, nephrologists, podiatrists, cardiologists, physical therapists, chiropractors, and “non-traditional medical practitioners”, including acupuncture for smoking cessation, and massage therapists when used for a medical condition.

Your prescriptions/insulin. Anything that you have a prescription for, you can list as a medical expense. And… even if you don’t have a prescription for insulin, it’s still a medical expense that is covered. That includes your pump and all supplies. Your insulin pens and syringes and cartridges. If it helps you get the drug into your body, it’s a medical expense that can be deducted.

Your meter and blood glucose testing supplies. (These are diagnostic devices and therefore, covered. Same goes for your CGM and sensors. Ketone test strips (urine or blood).

291573_5192Your medical supplies. Yeah, you’re thinking, of course. But medical supplies include: alcohol swabs, IV Prep 3000, Band-Aids, etc.

Your eyeglasses or contact lenses. If you have contact lenses, you can deduct the cost of the enzyme cleaners and daily cleaning solutions. Don’t forget to include your eye exam, even if it was a refraction/non-dilated exam. That’s included.

Dental treatments at the dentist’s office, including cleanings and fillings. (You cannot expense floss, toothbrushes, or toothpaste.)

Your guide dog expenses, including grooming and food and vet fees. 

Your lab fees. Your ambulance fees or ER fees or hospital stay. All of it is covered. They’ll send you receipts. You’ll weep at seeing how much they charge.

Your lodging for medical care (up to $50 per person per night) (meals not included), if:

  1. The lodging is primarily for and essential to medical care.
  2. The medical care is provided by a doctor in a licensed hospital or in a medical care facility related to, or the equivalent of, a licensed hospital.
  3. The lodging is not lavish or extravagant under the circumstances.
  4. There is no significant element of personal pleasure, recreation, or vacation in the travel away from home.

Your cost of special dietary considerations (i.e. celiac disease – and you must click on that link and read this post from one of my favorite bloggers) or costs for participation in a weight-loss program after an obesity diagnosis) when prescribed by a doctor. Don’t try to deduct health club dues. Nope.

Your admission/registration costs AND travel expenses for a chronically ill person or spouse or a parent of a chronically ill kid to attend a medical conference to learn about new medical treatments. (You can’t deduct meals or lodging while attending the conference.) Hello? Friends for Life? AADE or ADA? Ahem. Deductible medical expenses. Holla. 

Your Electronic Health Records cost to keep all your data in one place. Also known as a “medical information plan” or a “personal electronic health record.”

1442111_98999959Your transportation costs to and from medical appointments/hospitals/medical centers. Don’t forget tolls, parking, gas, oil… Straight from the IRS:

Payments for transportation primarily for and essential to medical care that qualify as medical expenses, such as payments of the actual fare for a taxi, bus, train, ambulance, or for medical transportation by personal car, the amount of your actual out-of-pocket expenses such as for gas and oil, or the amount of the standard mileage rate for medical expenses, plus the cost of tolls and parking fees.

Some of your health insurance premiums. I’m not going to get into this one, as it’s a minefield of what you can and cannot deduct. You need to look at the IRS website on this particular subset.

What You Can’t Deduct

One of the things that I wish could be covered is hypoglycemia recovery supplies (i.e. glucose tabs, juice, etc.). I’m doing everything that I can to keep that cost to a minimum, but really… we all probably spend far too much on that, and it’s not reimbursable. (Not unless you have a prescription written by your doctor for “juice”…)

You can’t deduct the cost of the cell phone plans and minutes calling your insurance company to argue over what is covered and what isn’t.

You can’t medically deduct the cost of your Internet service plan for the time you spend getting peer to peer support online from the DOC.

You can’t deduct the over-the-counter salves and moisturizers to keep our pretty diabetic feet from cracking or drying out.

Hopefully I’ve triggered something in your brain that says: “I can deduct that?! Booya!” Start preparing now for the 2014 tax season. (I’m quite aware that U.S. taxes are not due until April 15th, but don’t wait until the 15th to think about all the items that you can add together for your medical expense deductions… you’ll get overwhelmed and you’ll inevitably miss something.)

Happy deduction hunting! 

 

 

 

Accu-Chek To: Program – Saving $ on Test Strips & Getting More

logoIt’s little things like this that I love to share.

Accu-Chek has a new program that gives a fantastic discount on blood glucose monitoring strips and a little something extra to feed the soul.

It’s called Accu-Chek To: and I’ve signed up this week because I believe that they’re doing something right. (A great price. A great idea. A great program.)

It’s a monthly subscription program and they describe it like this:

Every month you’ll receive a box filled with the ACCU-CHEK® essentials you need, plus amazing items for you to discover – all delivered right to your door.

You’re given two options: Accu-Chek Essentials or Accu-Check Essentials + Discovery. It’s a five dollar difference between the two and here’s the reason why: with the Discovery add on, they surprise you each month with samples that help to nourish your body and soul (and aren’t necessarily diabetes-centric).

When you to to the website, you are given the option to view a quick video (but here it is, because you know…)

and then as you scroll down, you’re presented with two choices to start:

Do you have an Accu-Check blood glucose meter?

(If you don’t, you have the option to choose a meter. While I do have a Nano, they’ve now come out with a designer version and it’s.so.cool… Ahem.) You can choose a Nano or Aviva Plus…

Then you choose your monthly subscription option… and here’s the cool part.

50 strips = $20.00

100 strips = $40.00

(If you want the goody surprise box, it’s $25.00 and $45.00.)

You are getting the strips for almost 50% off what you would pay at a store. 

I went to a big name store (rhymes with Ball-Mart) a few days ago just to see what the shelf price of strips were. Even the cheap-o strips don’t meet that price when you use the Accu-Chek To: program. And you get a meter for free. And you don’t have to go to the store. And the strips are accurate. (After all the work that’s been done with StripSafely, I know which strips I feel I can trust. My personal opinion.)

I’ll get strips sent to me every month and a box of goodies. This month’s samples could include lip balm, body butter, tasty treats… and I’m all about that. If you like what you get for samples, you can purchase more at the site. (And you can also purchase more diabetes testing supplies. I’m going to check that out, too…)

The boxes are sent out on the third Wednesday of every month. Tick-tock. Get yours for this month. 

So, if you are looking to supplement your existing strips every month (which I am doing, as my insurance won’t pay for the number of strips I blow through each month) or you are trying to figure out a way to keep costs down and take care of yourself, this is the program we’ve all been waiting for.

The Fine Print

Here’s the deal: you cannot use this program and get the cost reimbursed through Medicaid or Medicare. It’s for individuals who either do not have health insurance or you have health insurance but will not seek to get reimbursed from your insurance using this program.  It’s only available for U.S. residents right now. 

For individuals like me on a high deductible insurance program and strips are part of that high deductible, while I can’t get the strips I receive through the monthly subscription program as part of my deductible, every bit helps.

I am not an employee of Roche. I am not compensated for this post. My opinions are my own. I just think this is an amazing program that does two things: saves me money on things that are expensive for my diabetes and gives me a little lift with the samples they send. 

 

Procrastinators Unite… Tomorrow!

1267744_87396573You still have time, you procrastinator you.

The docket that FDA has open on blood glucose test strips has been extended to May 7th. You can use the “Ain’t Got No Time For That” method that I came up with for all of us to comment and kick the number over the 400 comment goalpost. (Or more than 400? Be still, my beating heart.)

Even if you have commented, no one is telling us that you can’t comment more than once, so please bring your thoughts about generic/third party test strips.

Third party test strips are not made by the monitor manufacturer, so who’s responsible if there’s a need for adverse event reporting? Who do we call to report it?  Until there’s a clear cut ruling on this, it’s a Wild West sort of world.

Want to learn more about third party test strips and inspiration for your comment? Head on over to Stripsafely.com and read up. (There’s also a great article on this very topic and details about the companies offering generic strips at Diabetes Mine. A definite must read.)

I know that you’re not a procrastinator, but I’m sure that you know someone who might be. Can you do the 26 million people with diabetes a favor today and reach out to someone in your community (with diabetes or not) and ask them to do you a solid?

Diabetes doesn’t procrastinate. We shouldn’t either…

 

Where All The Cool Kids Will Be On Monday…

Less than a year ago, Bennet Dunlap decided that the status quo just wasn’t good enough for us.

We needed to band together as a community to talk about blood glucose meter accuracy and what it means to the 26 million people with diabetes (and growing). Better accuracy begets better control and better outcomes for those of us who rely on our blood glucose meters to give an accurate number. Better accuracy, quite frankly, wasn’t happening.

So, Bennet created the Strip Safely campaign and gave us all a voice under the Strip Safely umbrella. I’m the Robin to his Batman, mostly saying: “Holy glucose meters!” and ensuring our costumes are freshly pressed by Alfred. It’s an honor to work with him and every other person who believes in the importance of blood glucose meter accuracy.

Last summer, Strip Safely attracted the notice of those at the FDA and a relationship began to develop, one that has grown into something important for the diabetes community… and on Monday, you can see for yourself.

This is where all the cool kids will be on Monday… on a Live Chat with Bennet and Dr. Courtney Lias.

(P.S. You are a cool kid, if you were wondering.)

Here’s the details:

FDA

Talk with FDA expert Courtney Lias and Patient Advocate Bennet Dunlap about Glucose Monitors and Test Strips

Monday, March 31, 1:30–2:30 pm (EDT)

  • Do you want to learn more about the role of the FDA in the regulation of medical devices, such as glucose monitors and test strips, used in the management of diabetes?
  • Do you want to learn what the FDA is doing to increase the accuracy of blood glucose monitors and test strips?

When you participate in this friendly online chat, you will:

  • Enjoy an informal, open discussion with a fellow patient advocate, Center for Devices and Radiological Health subject-matter-expert and others in the diabetes community.
  • Learn more about the role of the CDRH, specifically the Office of In Vitro Diagnostics and its work to ensure the safety and effectiveness of medical devices used in the management of diabetes.
  • Get your questions answered about the newest FDA draft guidances, which are proposing new recommendations intended to improve the accuracy and safe use of blood glucose monitoring test systems, giving healthcare providers and people with diabetes better tools to manage blood glucose levels.
  • Whether you want to just listen to the interview, ask relevant questions about the medical device regulatory process or just speak your mind on the newest draft guidance document…. you should join in the conversation.

Register for this event and be sure to mark your calendars and join us on March 31st, 2014.

Please let your friends in the diabetes community know about this event. While not all the cool kids will be able to make it, I hope that you’ll join us all on the chat and learn how you can help the community and FDA. We are a community and we can’t do diabetes alone.

"Do it. Do. It. DO IT!!!"

I am quoting my daughter when she wants me to complete something for her: opening a jar, getting art supplies off the top shelf, or putting tofu and ketchup on a plate for lunch. (The Kid has some eclectic food combinations.)

But today, I’m saying this to you. Two minutes of your day can help all of those with diabetes. How?

This:

Keep Test Strips Available              View in browser
[TURN IMAGES ON: StripSafely - Accurate Diabetes Testing Matters. Please Turn Images On.]
Got two minutes to help shape the future of accurate diabetes testing? 

 

FDA is looking for comments about new draft glucose meter rules in two open dockets. Open dockets are a unique opportunity where the FDA is focused on listening to the public – we need them to hear us. 

The current rules for glucose meters are from 2003. It may be another decade before FDA asks for public comment on meter rules.
We have until April 7th.

 

DC is a town where the number of messages matters. Many comments, even if they are repetitive, will help the diabetes community be heard.

Other interests will lobby for their views. We must speak up for our views. Our health. Our lives. 

 

How can you help?
We’ve made it easy with sample comments, a step-by-step guide to commenting to a FDA docket, and additional guidance information. 

1. Review the sample comments here:http://www.stripsafely.com/sample-page/guidance/

2. Use the step-by-step guide to post comments to the dockets:http://www.stripsafely.com/sample-page/comment2fda/

3. Share this email with everyone you know.
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Now is the time for the community to speak up. The more comments left on the dockets, the more support we give the FDA to make the changes needed for accurate diabetes testing. 

These dockets are only open until April 7
Don’t let another decade go by with inaccurate diabetes testing. 

Thanks and StripSafely,
Bennet & Christel

 

P.S. Want to learn more about the guidance? Check this out: 

http://www.stripsafely.com/sample-page/guidance/about-guidance/

 

 

So, please. Do it. Do. It. DO IT!

And thank you.