Medical concierge fees are partly tax deductible: only the slice of the fee that pays for actual medical services counts, while the portion that buys access, availability, and scheduling perks does not. Even the qualifying slice only helps if you itemize on Schedule A and your total medical expenses for the year exceed 7.5% of your adjusted gross income.
Which Part of the Fee Qualifies
Most concierge practices charge one annual retainer that bundles real medical services with membership benefits. The IRS will not let you deduct that lump sum. You have to separate it.
The deductible piece is whatever portion pays for specific medical services: the comprehensive annual physical, included bloodwork and preventive screenings, cardiac or cancer screening, diagnostic tests, and defined office visits for medical evaluation. These fit the Section 213 definition of medical care, which covers amounts paid for the diagnosis, treatment, or prevention of disease.1Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses Publication 502 confirms that an annual physical and diagnostic tests are deductible even when you have no symptoms.2Internal Revenue Service. Publication 502, Medical and Dental Expenses
The non-deductible piece is everything the retainer buys that isn’t a medical service. Guaranteed same-day appointments, 24/7 phone or email access to the physician, longer visits, expedited referrals, and specialist coordination are access and convenience benefits. Nothing there diagnoses or treats a condition, so nothing there is a medical expense. Paying to be a member of the practice, separate from receiving care, is a personal expense.
A concrete example: on a $3,000 annual fee where the practice designates $800 as the cost of your physical and included labs, only $800 is a potential deduction. The other $2,200 gives you no tax benefit.
You Have to Itemize, and You Have to Clear 7.5% of AGI
Even the qualifying portion only matters if two things are true. First, your total itemized deductions (medical, state and local taxes, mortgage interest, charitable giving, and the rest) must beat your standard deduction. If they don’t, the medical line does nothing for you.3Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026
Second, only medical and dental expenses above 7.5% of your AGI count. That floor is permanent.1Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses At $100,000 of AGI, only the medical costs above $7,500 produce any benefit. A concierge fee by itself rarely gets you there. You have to combine it with every other qualifying medical cost from the year, and clear the floor, before any part of the fee reduces your tax.
Getting a Defensible Allocation
The burden of proof sits with you. A lump-sum payment with no breakdown is easy for the IRS to disallow.
Ask the Practice for an Itemized Statement
The cleanest approach is an annual statement from the practice showing what you paid for: the physical, the included labs, preventive screenings, other guaranteed medical services, and the remainder labeled as the membership or access fee. Most concierge practices will produce one on request, and many already do because patients ask.
Build a Market-Rate Estimate
If the practice won’t provide a breakdown, price the included medical services at fair market value using a non-concierge provider in your area. If a comparable comprehensive physical and lab panel runs $750 locally, that becomes your deductible component. Keep the quotes, prior explanation-of-benefits statements, or published fee schedules that support the number. This carries more audit risk than a practice-issued statement, but it holds up if the numbers are reasonable and you can show your work.
What to Keep
Your file should include the payment receipt for the full amount, the allocation statement or your own market-rate analysis, and a description of the medical services covered. The deduction stands or falls on linking specific dollars to specific medical services. A vague assertion that some of the fee was medical, without tying it to identified services, is the fastest way to lose the deduction on audit.
Paying With an HSA or FSA
Health Savings Accounts and Flexible Spending Arrangements follow the same Section 213 definition, so the same split applies. Only the medical portion of a concierge fee is a qualified expense. Using HSA funds to cover the access portion creates a non-qualified distribution, meaning income tax on the amount plus a 20% additional tax if you’re under 65.4Internal Revenue Service. Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans For an FSA, the non-medical portion is technically a non-qualified expense even if the administrator reimburses the whole fee without checking. Hold on to the allocation statement.
One boundary is worth flagging because it looks like concierge medicine but isn’t. Direct primary care (DPC) practices charge a flat periodic fee that covers all primary care services and do not bill insurance at all. Under the One, Big, Beautiful Bill signed in July 2025, beginning January 1, 2026, an otherwise HSA-eligible individual enrolled in a qualifying DPC arrangement can keep contributing to an HSA and can use HSA funds tax-free to pay the periodic DPC fee.5Internal Revenue Service. Treasury, IRS Provide Guidance on New Tax Benefits for Health Savings Account Participants Under the One, Big, Beautiful Bill If your doctor runs a traditional concierge practice that also bills insurance for services, the splitting analysis above still applies. The DPC rule is not a general concierge exception.
Timing and Refunds
You generally deduct medical expenses in the year you pay them. But Publication 502 says you typically cannot deduct payments for medical care you will receive in a future year. That creates tension for a prepaid concierge fee. The safer approach for the larger items, like the physical and included screenings, is to deduct the medical portion in the year those services are actually delivered. Credit card payments are the one clean exception: you deduct when the charge is made, not when you pay the card off.2Internal Revenue Service. Publication 502, Medical and Dental Expenses
If you leave the practice mid-year and get a prorated refund, and you deducted the medical portion of the fee in a prior year, you generally report the refunded amount as income on the later year’s return, up to the amount that actually reduced your tax.2Internal Revenue Service. Publication 502, Medical and Dental Expenses If the earlier deduction didn’t move your tax (because you fell below the 7.5% floor, say), the refund isn’t reportable as income.