Medical concierge fees are only partially tax deductible. The slice of the fee that pays for actual medical services — your annual physical, included lab work, preventive screenings — can qualify as a medical expense. The rest of the retainer, which buys you same-day appointments, 24/7 access to the doctor, and other convenience perks, is a personal expense with no tax benefit. And even the deductible slice only helps if you itemize and your total medical costs clear a high floor.
Which Part of the Fee the IRS Will Accept
Section 213 of the Internal Revenue Code defines deductible medical care as amounts paid for the diagnosis, treatment, or prevention of disease, or for affecting a structure or function of the body.1Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses IRS Publication 502 confirms that annual physicals and diagnostic tests count even when you have no symptoms.2Internal Revenue Service. Publication 502, Medical and Dental Expenses
A concierge retainer typically bundles two very different things. On one side sit identifiable medical services: the comprehensive physical, bloodwork panels, cardiac or cancer screenings, and a set number of medical office visits. On the other side sit access and convenience features: guaranteed same-day scheduling, around-the-clock phone and email contact with your physician, longer appointment windows, and help coordinating specialist care. Only the first category meets the Section 213 definition. Paying for membership in the practice, separate from receiving care, is not deductible.
A concrete example. You pay a $3,000 annual fee, and the practice assigns $800 of that to your physical and included labs. Your potential medical deduction is $800. The remaining $2,200 is personal, no matter how much you value the access it buys.
The Itemizing and 7.5% AGI Hurdles
Getting the allocation right only matters if the deduction will actually show up on your return. Two gates stand in the way.
First, you have to itemize on Schedule A rather than take the standard deduction. For 2026 the standard deduction is $16,100 single and $32,200 for married couples filing jointly.3Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026 If your medical expenses, state and local taxes, mortgage interest, and charitable gifts together don’t exceed those numbers, Schedule A gives you nothing.
Second, only medical costs above 7.5% of your adjusted gross income count toward the deduction, and that floor is now permanent.1Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses On a $100,000 AGI, the first $7,500 of medical spending is invisible. An $800 medical component of a concierge fee rarely gets you across that line on its own; you need to add it to every other qualifying medical cost you had during the year.
How to Document the Allocation
The deduction depends on tying a specific dollar figure to specific medical services. A lump-sum payment with no breakdown invites the IRS to disallow all of it, and the burden of proof is yours.
Ask the Practice for an Itemized Statement
The strongest documentation is an annual statement from the concierge practice itself that breaks the fee into components: so much for the physical, so much for included lab work and screenings, the rest labeled as the membership or access fee. Many practices already issue these because patients ask every year. If yours doesn’t, request one.
Build Your Own Market-Rate Estimate
If the practice won’t itemize, price the included medical services at fair market value in your area. Get quotes from a non-concierge provider for the same physical and lab panel. If a comparable workup runs $750 locally, that’s your deductible component. Save the quotes, prior-year explanations of benefits, or screenshots of published fee schedules to show how you arrived at the number. This approach carries more audit risk than a practice-issued statement, but it holds up if the figures are reasonable.
What Your File Should Contain
Keep the payment receipt showing the total fee, the allocation statement or your own market-rate analysis, and a description of the medical services covered. A vague claim that “part of the fee was for medical care,” with no dollar figure attached to a specific service, is the fastest way to lose the deduction on review.
Paying Concierge Fees From an HSA or FSA
Health Savings Accounts and Flexible Spending Arrangements use the same Section 213 definition that governs the itemized deduction. That means only the medical portion of a concierge fee is a qualified expense. If you pull HSA funds to cover the access-only piece, the IRS treats it as a non-qualified distribution: ordinary 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 Keep the allocation statement with your HSA records so you can show the withdrawal matched a qualifying service.
One narrow exception now exists for direct primary care (DPC) arrangements, which charge a flat periodic fee and don’t bill insurance at all. Beginning January 1, 2026, under the One, Big, Beautiful Bill signed in July 2025, an otherwise HSA-eligible individual enrolled in a qualifying DPC arrangement can keep contributing to an HSA and can pay the periodic DPC fee from HSA funds without splitting it.5Internal Revenue Service. Treasury, IRS Provide Guidance on New Tax Benefits for Health Savings Account Participants Under the One, Big, Beautiful Bill This applies only to DPC as defined by the new law. A traditional concierge practice that also bills insurance for services is not DPC, and the splitting rules still apply to its retainer.
When the Deduction Lands and What Happens If You Get a Refund
Medical expenses are generally deducted in the year you pay them. Pay your 2027 fee in December 2026 and it belongs on your 2026 return. If you charge the fee to a credit card, you deduct it in the year of the charge, not the year you pay the card balance.2Internal Revenue Service. Publication 502, Medical and Dental Expenses
There’s a complication for prepayments. Publication 502 says you generally can’t deduct payments for care you’ll receive in a future year.2Internal Revenue Service. Publication 502, Medical and Dental Expenses For the larger medical items inside a concierge fee, the safer approach is to claim the medical portion in the year the service is actually delivered.
If you leave the practice mid-year and get a prorated refund of a fee you already deducted, you report the refunded medical portion as income on the later year’s return, but only up to the amount that actually cut your tax bill in the earlier year.2Internal Revenue Service. Publication 502, Medical and Dental Expenses If the original deduction never produced a benefit — for instance, because your medical total didn’t clear the 7.5% floor — the refund isn’t income.