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      Frequently Asked Questions About Celiac Disease   09/30/2015

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease? - list blood tests, endo with biopsy, genetic test and enterolab (not diagnostic) Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes

Deducting Food From Taxes
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Has anyone here made deductions on your taxes for the extra cost of gluten free food? Considering what it has been costing us to keep our family on a gluten free diet we looked into income tax deduction possibilities to help deter the cost. Apparently, the Internal Revenue Service does allow income tax deductions for people with dietary restrictions. We asked an accountant if we qualified and he said that we do but to insure ourselves in the event of an audit we need a letter from our doctor stating that we have celiac disease and must adhere to a gluten free diet for life. We got all of that, but, I didn't know if we would be flagging ourselves for an audit if we made the deductions. Anyone here have experience with this?

Thanks so much.

Kimberly

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Guest jhmom

Kimberly,

I received this from another support group, I hope this helps you and answers your questions... I plan on printing this out and taking to my tax lady and deducting the cost this year.

TAX DEDUCTION FOR GLUTEN-FREE FOODS AS MEDICAL EXPENSE

1. You may deduct the cost of Gluten-Free (gluten-free) products that are in EXCESS of the cost of the gluten containing product that you are replacing.

2. The full cost of special items needed for a gluten-free diet may be deducted. An example is the cost of XANTHAN GUM (methyl cellulose) used in gluten-free home-baked items, which is completely different than anything used in an ordinary recipe.

3. If you make a special trip to a specialty store to purchase gluten-free foods, the actual cost of your transportation to and from the store is deductible. If you are using your vehicle for the trip, you may deduct $.10 per mile each way.

4. The full cost of postage or other delivery expenses on gluten-free purchases made by mail order are deductible.

If you are audited, you will need a letter from your doctor indicating that you have Celiac Disease and must adhere to a Gluten-free diet for life. You will also need substantiation in the form of receipts, cast register tapes or canceled checks for your gluten-free purchases and a schedule showing how you computed your deductions for the gluten-free foods.

The total amount of your deduction for gluten-free foods should be added to your other medical expenses that are reported on line 1 of Schedule A of your form 1040. Do not include your doctors letter, your receipts or your schedule showing how you computed your deduction for gluten-free foods. Save these documents which should be submitted only in the event you are audited by IRS or your state's taxing authority.

If you are audited and the auditor tells you that these items are not deductible, refer the auditor to:

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Maybe someone can clarify this for me, but I think that if the gluten-free food goes into the medical deductions, you can only deduct gluten-free food if your medical deductions are high enough. (I forget the exact percentage of your income, but it's something like 10%?)

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Tarnalberry, You are correct. To deduct medical expenses, they must be a certain percentage of your total income. I am not sure exactly how much but an accountant would know.

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Guest PastorDave

There is a way to purchase gluten free food with before tax dollars, but your workplace must offer a "cafeteria plan." This is where some of your paychecks are taken with before tax dollars and then when you make purchases that are tax-deductable (such as filling prescription medications, buying eyeglasses, paying co-pays for health insurance, and yes, buying gluten free foods) you are then reimbursed the amount from the account that has been deducted from your pay. This lowers your taxable income and therefore cases a tax deduction even if you don't spend enough to consider itemizing your tax deductions. You do need that letter from your doctor, and it is wise to keep all of your reciepts as well (so just give your workplace copies when it comes time to be reimbursed.) - Pastor Dave's financial genious wife. :P

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In the U.S., medical expenses that exceed 7% of your income are deductible. If you count meds, insurance, doctor's fees and lab fees along with your gluten-free food expenses, it is feasible that you could exceed 7%. In 2003, I paid over $8000 in medical NOT counting gluten-free food or all the OTC products I have to use for Sjogren's (eyedrops, special toothpaste, mouthwash, humidifier filters, etc.)

Thanks for the documentation...I probably won't be able to use it since I voluntarily went gluten-free and thus have no official diagnosis, but it is VERY good info to have. We pay far too much for these specialty foods, and not all of us can easily afford them.

You are a very helpful bunch, and I appreciate it.

:D

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PastorDave is referring to the healthcare flexible spending account. You allot a certain amount of pre-tax dollars to be taken out of your paycheck, for every paycheck during the year. Then, you submit receipts to be reimbursed from your own pre-tax dollars for the difference between the cost of gluten and gluten-free foods. For example, if I buy a gluten-free cake mix at $6 and a normal cake mix is $.99, then I get reimbursed $5.01.

The important thing with this type of account is that they are "use it or lost it" accounts. So, by the end of year, if you haven't spent all of the money that you alloted, then you lose the money.

I routinely use my flex spending account to use pre-tax dollars to help defray the cost of my gluten-free foods.

The benefits personnel in your company's HR department should be able to help you with this.

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Good explanation, Kim. I would only add that not all Flexible Spending Accounts (FSA's) permit the reimbursement of these costs. It is actually up to the employer to decide which medical expenses (including gluten free foods) are reimburseable. I have communicated with some Celiac patients who are not able to get reimbursement.

In my own case, I called my HR department and was told "I doubt it". Me being the persistent type, I then called the FSA administrator for our cafeteria plan and fortunately had a very helpful customer service rep who dug and dug and dug and finally came back with the good news that my plan would cover this. The lesson learned here is do not take no for an answer - keep digging to be sure. Benefit plans can be very complex and too many people in the benefits department do not want to take the time to dig, it's alot easier to just say "no that's not covered".

The FSA route is a much better route to take because you do not have to reach the 7% IRS threshold. Also, keep in mind that only those expenses OVER the 7% threshold are deductible. (If my understanding of those simple tax laws is correct!) So if you're income is 40,000 per year, only the amount of medical expenses (including gluten-free food cost difference) over 2,800 are deductible. Then, you must still have other deductions to reach the level of itemization that even warrants filing the Schedule A in the first place!

With the FSA, there is no threshold, ALL of your price difference is in effect deductible. It just works differently, because instead of subtracting the amount you are spending from your taxable income on your tax return, you just do it upfront when you enroll in your FSA at the beginning of the year. It is at that time that you specify how much you want to put into your FSA for the year and that amount of income is not taxable. It is treated like income that goes into your 401k. Kim is also right in her caveat of "use it or lose it". However, what I do is, if by the end of the year I am still carrying a balance in my FSA, I just buy a bunch of gluten-free food to use it up!

The last item worth mentioning (like this post isn't long enough!), is that not all employers offer a FSA. In fact, I would be willing to bet most don't! In this case, your only option is the deductiblity route on Schedule A.

Best wishes,

Dewey

Marion, IA

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I was wondering if the diagnosis from Enterolab would satisfy the government as a diagnosis of the disease? Has anyone tried this? I would hate to pay an accountant and then be told it wouldn't count. Just because my own doctor doesn't accept the test results does not make them invalid. And I assume that they are a deductable medical expense as well.

God bless,

Mariann

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Hi Dewey. You are correct that FSAs will vary from employer to employer, but the gluten free food is a prescription and should be included (certainly in all that I've worked with)... So, your recommendation to be persistent is very well taken.

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Actually, the medical expenses threshhold is 7.5 percent, not 7 percent.

Personally, I would hire a tax expert before trying this. This specific deduction has NEVER been approved by the IRS and the IRS HAS specifically ruled against letting overweight people deduct diet food. The reality is that we don't need special expensive gluten-free food to be gluten-free any more than overweight people need special diet food to lose weight. If you do try, be sure to cover all your bases.

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Well, we took our info to our accountant and he told us to not even bother with the gluten-free deductions. He said it's a bit of a red flag for an audit and you have to have impecable record keeping for the year in the instance there were an audit...just a little tidbit of info.

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Guest jhmom
The total amount of your deduction for gluten-free foods should be added to your other medical expenses that are reported on line 1 of Schedule A of your form 1040. Do not include your doctors letter, your receipts or your schedule showing how you computed your deduction for gluten-free foods. Save these documents which should be submitted only in the event you are audited by IRS or your state's taxing authority.

Just curious, did your tax guy add it to the medical expenses or did you have any to deduct?

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Even when adding gluten-free expenses to other medical expenses I don't come close. I don't have that many gluten-free expenses because I rarely buy the stuff, but even if I did I'd have to buy thousands of dollars worth.

richard

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That's my boat too. I don't skimp on getting gluten-free breads, but still don't spend nearly enough to get to 7.5% of my budget in medical expenses. (Maybe it's having good insurance, maybe I'm just too healthy? :-) Or too cheap? ;-) )

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I'm not as healthy as I need to be but my insurance, while sometimes a pain in the rear, covers a lot. When I got sick and was hospitalized for 11 days with what was finally discovered to be celiac, my total bills came to nearly $40,000. I paid about $300 out of pocket. I have to wonder whether a person without insurance would have just died.

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Guest aramgard

Try being a person on a retirement income and medicare with an HMO. My Celiac was discovered 50 years after my first symptoms. Now I have a really lowered immune system and need antibiotics and allergy medications a lot. The new medications are out of the question. Last year for one episode of sinus imfections complicated with ear infections it took nearly $700 just for the medications. Now I have another sinus infection complicated with ear infections. My doctor is trying to work with me on generic medications. So I guess I am now a second class citizen, only allowed the old medications because the new ones are not covered by my HMO. Our country's medical system really needs revamping. I can just imagine how someone just on medicare must feel with no medication reimbursement. Yipes do we need a revamp of our entire health care system. Shirley

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Hi Mariann,

I have the same question. My diagnosis came from Enterolab and too boot, my gene test revealed that I do not have the exact genes for celiac. However, I still must adhere to a gluten-free/CF lifestyle.

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Tammy,

This is fascinating! You had the (very expensive) genetic testing done and you do NOT have the gene? Yet the Enterolab test said you have Celiac?

I have often questioned the validity of the Enterolab test. If my understanding of your post is correct, then the only conclusion I can draw is the Enterolab test is totally unreliable! All current medical research in Celiac says that if you do not have the gene, you CANNOT have Celiac Disease! Period!

As to the validity of the Enterolab diagnosis for tax purposes, even discounting the above, I would not want to have to try to make THAT case to an auditor! I'm no tax specialist, but I would bet that the diagnosis has to come from a gastroenterologist in order to be deductible.

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Guest jhmom

From my understanding you do not have to specify what your deductions are for, you add it to your health deductions and of course keep all receipts proving the extra cost (that's what I did).

Do not include your doctors letter, your receipts or your schedule showing how you computed your deduction for gluten-free foods. Save these documents which should be submitted only in the event you are audited by IRS or your state's taxing authority.

I used Enterolab and was diagnosed with gluten sensitivity and trust them COMPLETELY!! I think a lot of people including myself use the term "Celiac" because you don't get that dumb founded look from people when explaining what is wrong with you. But BOTH are treated the same way, a strict adherence to a gluten-free diet for life. I am not sure Tammy but did Dr. Fine say you have the actual disease or just gluten sensitivty???

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You can be gluten intolerant/sensitive without being Celiac. It is possible to have an intolerance to gluten and not have either of the main genes they know causes it. There is still a lot of research to be done and there may be more genetic factors involved than they have found. If you are developing antibodies against gluten, then you can't eat it. Period.

As for the tax deduction. I didn't come close to the 7.5% threshhold, so it wouldn't matter anyhow. I have good insurance, and although they won't always authorize an expensive test if there is a cheaper one they can do, they have paid close to $100,000 over the past three years for all of my families medical expenses. My husband takes medication for an illness (that he will have for the rest of his life) that costs $1000 a month. If he goes off the medication he has to have a blood test done monthly (right now it is every 2-4 months depending on the doctor and the medication) that has to be sent to UC Davis (in CA) and is also very expensive. Even with that and all the tests the rest of us have done we just don't have enough expenses. That includes all medical copays for doctors and ER visits, dental bills, medication copays, eye exams, glasses & contacts, and the Enterolab tests (if I want to take the chance) and I only made one online order of gluten-free foods, and didn't keep track of other gluten-free foods I bought at the store or what the cost difference was, but it wasn't much. I imagine a whole years worth wouldn't even come close next year either, even for the whole family.

I live in California, and this year we were hit with a users tax. Anything we buy from out of state via mail, phone or internet, and weren't charged sales tax for (and is legally taxable, so this excludes food, thank God!) we have to pay our local sales tax on those items, and the amount is deducted from our state tax return or added to what we owe! Is that just insane. But because we are "using" the product in California we have to pay "users" tax. Is it like this in other states or are we just lucky? :huh: It took me a while to find all my receipts for those things I bought. But since most of them were from the internet I had all my e-mail receipts saved. It cost me $46.00, I could have bought a lot of gluten-free food for $46.00...

God bless,

Mariann

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Oh and on the Federal Tax form it says under medical expenses "lab tests ordered by your doctor". The Enterolab tests were NOT ordered by my doctor and I am still not sure if they would be legal to deduct, so I am not even going to try next year with my kids tests that I just ordered last month. (I am really paranoid about breaking ANY laws. I don't even go over the speed limit when I drive. It makes my husband nuts, since he generally drives at least 10 miles over the limit.)

Mariann

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Is the FSA an option if I am self-employed? I am guessing if this is an arrangement with an employer that it is not. Although I do have a very nice employer now. ;)

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Sorry, Suzn, I'm almost positive it is not. I had my local IRS office send me all the information relative to cafeteria plans (FSA is a cafeteria plan) and the medical deductions rules about 6 months ago. After reading through all this, I seem to remember it specifically said that cafeteria plans are only available to employees. I guess you could always incorporate and hire yourself! I suspect the paperwork involved in administering an FSA would outweigh the tax benefits.

Mariann, great point about the sensitivity/intolerance. I guess Tammy never specified she was diagnosed with Celiac.

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