## Facts

- A taxpayer had a medical condition requiring treatment at a physician’s office twice weekly.
- The taxpayer had three young children.
- To attend the medical appointments, the taxpayer hired a babysitter to care for the children while the taxpayer was away receiving treatment.
- The babysitter was employed only for the time periods when the taxpayer was absent to obtain the medical care.
- The taxpayer claimed the babysitting payments as a medical expense deduction under I.R.C. § 213.

## Issues

1. Whether babysitting expenses incurred solely because a taxpayer must be absent from home to receive necessary medical treatment are “amounts paid for medical care” deductible under I.R.C. § 213.

## Decision

- The IRS concluded the babysitting expenses are deductible as medical expenses under I.R.C. § 213 to the extent they are incurred primarily for and essential to the taxpayer’s medical care.
- The IRS limited deductibility to amounts incurred only for the periods during which the taxpayer is receiving medical care (including hospitalization), not for general child-care time.

## Legal Principles

- Under I.R.C. § 213, deductible “medical care” includes expenses primarily for and essential to the diagnosis, cure, mitigation, treatment, or prevention of disease.
- Personal or family expenses are generally nondeductible; dependent-care costs qualify under § 213 only when directly caused by and necessary to obtaining medical treatment.
- Ancillary costs may be treated as medical expenses when they are proximately related to receiving medical care and are confined to the time the care is received.

## Conclusion

Babysitting expenses incurred solely to enable a taxpayer to attend necessary medical treatment qualify as deductible medical expenses under I.R.C. § 213, but only for the hours of treatment or hospitalization and only when the costs are primarily for and essential to the taxpayer’s medical care.


Rev. Rul. 78-266, 1978-2 C.B. 123 (1978)