Chapter History S1-F1-C1, Medical Expense Tax Credit

Introduction

The purpose of a Chapter History page is to highlight any amendments to the information contained in a chapter of an income tax folio, including amendments to the information originally contained in an interpretation bulletin that has been cancelled and replaced with a folio chapter. It outlines amendments that have been made as a result of legislative changes and proposed legislative changes, precedential court decisions, as well as new or revised interpretations of the Canada Revenue Agency (CRA).

Except as otherwise noted, all statutory references herein are references to provisions of the Income Tax Act, R.S.C., 1985, c.1 (5th Supp.), as amended and all references to a Regulation are to the Income Tax Regulations, C.R.C., c. 945, as amended.

Update January 30, 2024

¶1.19 is revised to include a reference to new ¶1.146.2.1 (see the corresponding History entry below).

In the English version, ¶1.20 and the headings before ¶1.20 and ¶1.24 are revised to replace the term “medical professionals” with “health professionals,” to reflect the range of health professionals who fall within the scope of subsection 118.4(2) but who do not describe their practice as being in the medical field. The French version already refers to “professionnels de la santé”, but additional revisions were made where needed.

¶1.21 is revised in the French version only for readability.

¶1.22 and ¶1.23 are revised in the French version only to replace the terms “province” and “juridiction” with “territoire de compétence” in order to avoid an inappropriate anglicism.

¶1.30.1 and ¶1.30.2 are added to address the eligibility of fees paid for virtual medical services.

¶1.73(g) is updated to add a reference to a cast as an example of a brace for a limb.

¶1.122(c) is updated to add references to a continuous positive airway pressure machine and a stand-alone nebulizer as additional examples of devices or equipment that do and do not qualify under paragraph 5700(c) of the Regulations.

¶1.122(l) is revised to add a reference to a walking cast as another example of devices that may fall under the scope of paragraph 5700(i) of the Regulations.

¶1.125 is revised to add a reference to liquid meal replacement products as another example of ineligible over-the-counter products.

¶1.130 is updated so that the preamble to the list refers more generically to reproductive technology processes, with artificial insemination and in-vitro fertilization provided as examples of such processes. The first bullet in the list used to refer to in-vitro fertilization (IVF). That bullet has been deleted given that the reference to IVF was incorporated into the preamble. The new first bullet is updated to clarify that eligible expenses can include the costs of egg freezing (which, similar to sperm freezing, would include storage) and sperm washing and thawing. The second bullet in the list has been updated to delete the word “daily” and the phrase “once the in vitro procedure has begun” in relation to ultrasounds and blood tests because reproductive technology processes other than IVF may also require bloodwork and ultrasounds.

¶1.130.1 is deleted and its content is moved to new ¶1.146.2.1.

¶1.142 is updated to add the word “former” prior to the reference to “paragraph 118.2(2)(v)” to reflect that paragraph 118.2(2)(v) was repealed by 2017, c.33, s.44(5). Prior to its repeal, that paragraph dealt with marihuana for medical purposes. Medical marihuana and cannabis are now addressed in paragraph 118.2(2)(u). The Act was updated by S.C. 2022, c.19, s.18(1) to add a new paragraph 118.2(2)(v), which addresses amounts paid to a fertility clinic or donor bank.

¶1.146.1 is revised to replace the phrase “artificial insemination” with the less specific phrase “a reproductive technology process” in order to be more inclusive of other available processes.

¶1.146.2 is revised to reflect a legislative amendment that added paragraph 118.2(2)(v), made by S.C. 2022, c.19, s.18(1) (formerly Bill C-32), applicable to the 2022 and subsequent tax years. The information previously contained in ¶1.146.2 regarding the ineligibility of amounts paid in respect of a surrogate mother (for 2021 and prior tax years) is moved to new ¶1.146.5.

¶1.146.2 is also revised to include a notice to advise of a proposed legislative change to paragraph 118.2(2)(v). This legislative change will add the term "embryos" to the legislation that allows certain costs of obtaining reproductive material for use by an individual in order to become a parent, to be eligible for the medical expense tax credit.

¶1.146.2.1 is added to include the information that was previously in ¶1.130.1 regarding the ineligibility (for 2021 and prior tax years) of fees associated with obtaining ova or sperm. Clarification is also added in the English version only regarding the interchangeable use of the terms egg and ovum in the Chapter.

¶1.146.3 is updated to replace the phrase “artificial insemination” with “reproductive technology.” The change is consistent with the update to the introductory paragraph in ¶1.130.

¶1.146.4 is added below a new heading, “Surrogacy-related expenses” to reflect a legislative amendment that added subsection 118.2(2.21), made by S.C. 2022, c.19, s.18(2) (formerly Bill C-32), applicable to the 2022 and subsequent tax years. As a result of this amendment, certain expenses that an individual incurs in Canada in respect of a surrogate mother or donor are deemed to be medical expenses of the individual if certain conditions are met.

¶1.146.5 is added to reflect the information that was previously in ¶1.146.2 regarding the ineligibility of amounts paid in respect of a surrogate mother, but with the added clarification that the information applies to 2021 and prior tax years.

¶1.153 is revised to clarify that “cohabiting spouse or common-law partner” is a phrase defined under section 122.6

¶1.153.1 is added to clarify that, for the purposes of the refundable medical expense supplement, the adjusted income of a surviving spouse or common-law partner does not include the income of the deceased spouse or common-law partner.

¶1.156 is added to reflect a legislative amendment that added section 122.92, made by S.C. 2022, c.19, s.19 (formerly Bill C-32), applicable to the 2023 and subsequent tax years. Section 122.92 provides a refundable tax credit (the new multigenerational home renovation tax credit) for qualifying expenditures in relation to a qualifying renovation that creates a secondary unit to permit a qualifying individual (a senior or an adult in respect of whom the disability tax credit may be claimed) to live with a qualifying relation. ¶1.156 addresses the interaction between the new credit, the home accessibility tax credit, and the medical expense tax credit.

Update July 28, 2020

¶1.17 and ¶1.133 are revised to replace the reference to the web page “New position on private health services plans – Questions and answers” (which has been archived) with a reference to the web page Private Health Services Plan.

¶1.154 has been updated to refer to line number 31285 in the link for home accessibility expenses. Line 31285 was line 398 before the 2019 tax year.

Update December 18, 2019

¶1.6 is expanded to address situations where a dependant has income during the year.

¶1.18.1 is added to clarify that eligible medical expenses include the goods and services/harmonized sales tax that is added to the cost of certain medical services.

¶1.28.1 is added to clarify that services that are not governed by a medical practitioner/patient relationship (for example, health education programs) are not generally considered medical services for the purpose of the medical expense tax credit.

¶1.57 is revised to clarify that a recreational facility is not considered “another place” for the purposes of paragraph 118.2(2)(e), even if it caters to persons with disabilities.

¶1.61 is revised to clarify that although a concurrent claim is theoretically permitted under both section 118.3 (for the disability tax credit (DTC)) and paragraph 118.2(2)(e), the limitation under paragraph 118.3(1)(c) for claiming the DTC would still apply.

¶1.73(d) is revised to provide examples of what would be considered a wheelchair.

¶1.89 is revised to add prescription swimming goggles as another example of “other devices for the treatment or correction of a defect of vision.”

¶1.91 is revised to add another example of a diabetes-related expense (for a mobile “App”) that does not constitute an eligible medical expense.

¶1.92.1 is added to clarify that only those animals that are both specially trained to assist a patient in coping with their impairment and provided by an organization (or person) one of the main purposes of which is such training of animals (commonly referred to as service animals) may be considered for the purposes of the METC.

¶1.92.2 is added and consists of the comments about expenses of animal care that were originally at the end of ¶1.92.

¶1.122(b), (k), (r), and (dd) are revised to add examples, and therefore, provide additional clarity on whether certain devices or equipment are covered under section 5700 of the Regulations.

¶1.122.1 is added to clarify that although the cost of a particular device or equipment may not be covered under section 5700 of the Regulations, treatments using such a device may qualify as medical services if provided by a medical practitioner who is authorized by the relevant provincial authority to provide such treatments.

¶1.130.1 is added to provide additional clarity on whether certain costs relating to artificial insemination would be eligible medical expenses.

¶1.139 to ¶1.142 are no longer preceded by a notice that alerted readers to a change that was proposed in Budget 2019 regarding cannabis products purchased for medical purposes. The change became law as Bill C-97 received Royal Assent on June 21, 2019.

¶1.139.1 is added to reflect a legislative amendment to paragraph 118.2(2)(u), made by S.C. 2019, c. 29, s. 17 (formerly Bill C-97), which is consequential to the introduction of the Cannabis Act and Cannabis Regulations. The amendment is applicable to expenses incurred on or after October 17, 2018.

¶1.139.2 is added to clarify that a patient must be registered with a "holder of a licence for sale for medical purposes" in order for their purchase of cannabis for medical purposes to qualify for the METC.

¶1.139.3 is added to clarify that certain costs relating to producing one’s own cannabis for medical purposes are not generally eligible expenses.

¶1.140 is revised to reflect the legislative amendment to paragraph 118.2(2)(u), referred to in the History entry for ¶1.139.1 above, which is consequential to the repeal of the Access to Cannabis for Medical Purposes Regulations, effective October 17, 2018.

¶1.154.1 is added to clarify that an expense does not cease to be a qualifying expenditure for the sole reason that it may increase the value of one’s eligible dwelling.

Update May 16, 2019

¶1.21 is revised to reflect a legislative amendment to subsection 118.4(2), made by 2017, c. 20, s. 17(1) (formerly Bill C-44), effective March 22, 2017, adding nurse practitioners to the list of medical professionals.

¶1.27 is revised to reflect a legislative amendment which added subsection 118.2(2.2), made by S.C. 2017, c.20, s. 15(1) (formerly Bill C-44), applicable to the 2017 and subsequent tax years, and further explained in new ¶1.146.3 regarding fertility-related expenses.

¶1.33 is expanded to add a reference to facilities that offer multiple levels of care to their residents.

¶1.92 is revised to reflect an amendment to paragraph 118.2(2)(l), made by 2018, c. 12, s. 12(1) (formerly Bill C74), applicable in respect of expenses incurred after 2017. The paragraph now includes a reference to severe mental impairment.

¶1.107 is revised to refer to Income Tax Folio S1-F3-C4, Moving Expenses.

¶1.115 and ¶1.116 are revised to reflect a legislative amendment to paragraph 118.2(2)(l.9), made by S.C. 2017, c. 33, s. 44(1) (formerly Bill C-63), applicable to expenses incurred after September 7, 2017. This amendment added nurse practitioners to the list of medical practitioners who can prescribe and supervise the administration of therapy.

¶1.117.1 is revised to reflect a legislative amendment to paragraph 118.2(2)(l.92), made by S.C. 2017, c. 33, s. 44(2) and (3) (formerly Bill C-63), applicable to expenses incurred after September 7, 2017. This amendment added nurse practitioners to the list of medical practitioners who can prescribe and supervise the administration of therapy.

¶1.139 to ¶1.142 now appear under a revised heading to reflect the use of the term “cannabis” in the 2017 amendment to paragraph 118.2(2)(u) (see history entry for ¶1.140) as well as the term “marihuana” prior to that amendment. This section of the Chapter has also been updated to alert readers to a change proposed in Budget 2019 regarding cannabis products purchased for medical purposes.

¶1.139 is revised to introduce the paragraphs that discuss the most recent laws and regulations relating to the medical use of marihuana and cannabis during various periods.

¶1.140 is revised to reflect a legislative amendment to paragraph 118.2(2)(u), made by S.C. 2017, c. 33, s. 44(5) (formerly Bill C-63), which also repealed former paragraph 118.2(2)(v). This amendment is applicable for expenses incurred after August 23, 2016.

¶1.141 contains information that was previously in ¶1.142 regarding the costs of growing marihuana.

¶1.142 is revised to reflect a legislative amendment made by S.C. 2017, c. 33, s. 44(4) (formerly Bill C-63), which added paragraph 118.2(2)(v). The amendment is applicable to expenses incurred after June 6, 2013 and before August 24, 2016. (See also the concurrent amendments affecting paragraph 118.2(2)(u) in the history entry for ¶1.140).

¶1.146.1 is added to provide general comments about fertility-related expenses and to explain that these expenses fall under various provisions of the Act depending on what the expenses are for.

¶1.146.2 is added to clarify that fertility-related expenses that an individual pays in respect of a surrogate mother would not generally qualify as medical expenses for the individual.

¶1.146.3 is added to reflect a legislative amendment which adds subsection 118.2(2.2), made by S.C. 2017, c.20, s. 15(1) (formerly Bill C-44), applicable to the 2017 and subsequent tax years. However, if an individual makes a request for a refund in respect of a tax year to the Minister of National Revenue within the time limit specified in paragraph 164(1.5)(a) of the Act, subsection 118.2(2.2) also applies in respect of that tax year.

¶1.147.1 is added to clarify the receipt requirements when claiming the attendant care portion of nursing home expenses under paragraph 118.2(2)(b.1).

¶1.153 is revised to reflect a legislative amendment to the definition of “adjusted income” in section 122.6, made by S.C. 2018, c. 12, s. 16(1), applicable to the 2018 and subsequent tax years. The amendment is consequential to the expansion of the tax on split income rules to individuals over the age of 17 years, and ensures that income is computed without reference to the deduction on account of split income.

¶1.154 is added to reflect a legislative amendment which added subsection 118.041(4), made by S.C. 2015, c. 36, s. 8(1) (formerly Bill C-59), applicable to the 2016 and subsequent tax years.

¶1.155 is added to cross-reference to ¶2.24 of Income Tax Folio S1-F1-C2, Disability Tax Credit, regarding the interaction between the METC and the disability tax credit.

In addition, revisions have been made to the French version of the Chapter for readability and consistency purposes.  

Update December 1, 2016

¶1.153 is revised to reflect the amendment to the heading for subdivision a.1 of Part I, Division E of the Act, made by S.C. 2016, c. 7, s. 27(1), consequential to the introduction of the Canada child benefit (CCB). The CCB replaced the Canada child tax benefit, the national child care benefit supplement, and the universal child care benefit.  The amendment was deemed to have come into force on July 1, 2016.

Update June 21, 2016

¶1.1 is revised to remove a reference to a specific tax year so the information is more broad-based.

¶1.3, 1.7, 1.149, 1.150 and 1.152 are revised to link readers to the indexation chart on the CRA website to see the amounts referred to.

¶1.122(l) is revised to remove the reference to crutches from the common examples of walking aids that fall under the ambit of paragraph 5700(i) of the Regulations. Crutches are specifically listed under paragraph 118.2(2)(i) of the Act and are already listed as such in ¶1.73.

Update January 20, 2016

The Summary and Reference sections of this Chapter are revised to refer readers to Guide RC4065, Medical Expenses. Previously, readers were referred to Guide RC4064, Medical and Disability – Related Information. This guide was cancelled and replaced on January 5, 2016 with Guide RC4064, Disability – Related Information and Guide RC4065, Medical Expenses.

Update November 28, 2015

¶1.17 and 1.133 are updated to add a hyperlinked reference to a CRA webpage with updated information about what qualifies as a private health services plan (PHSP).

Update November 24, 2015

Minor changes have been made to improve the usability of the income tax folios:

Update September 3, 2014

¶1.3, 1.7, 1.149, 1.150 and 1.152 are revised to reflect indexed amounts for 2013.

¶1.92 is revised to reflect a legislative amendment to paragraph 118.2(2)(l), made by S.C. 2014, c. 20 (formerly Bill C-31), applicable to expenses incurred after 2013 to apply to individuals who suffer from severe diabetes.

¶1.117.1 is added to reflect a legislative amendment which adds paragraph (l.92) to subsection 118.2(2), made by S.C. 2014, c. 20. This new paragraph includes as an eligible medical expense remuneration paid for the design of an individualized therapy plan in certain situations. This applies to expenses incurred after 2013.

Update October 18, 2013

Throughout the French version of the Chapter and its Chapter History, general revisions have been made to improve readability. The following changes have also been made to the Chapter.

¶1.2 and ¶1.3 are revised to reflect a legislative amendment to the description of B in subsection 118.2(1) of the English version of the Act, made by S.C. 2013, c. 34 (formerly Bill C-48), s. 249(1), effective for tax years ending after October 31, 2011. The amendment ensures that where an individual has, at the same time, both a spouse and a common-law partner, the individual can claim either the eligible medical expenses in respect of their spouse, or the eligible medical expenses in respect of their common-law partner, but not both.

¶1.10 and ¶1.11 are revised to take into account the clarification that was added to ¶1.2.

¶1.47 is revised to reflect a legislative amendment to subparagraph 118.2(2)(c)(i), made by S.C. 2013, c. 34, s. 249(2), applicable to certifications made after December 20, 2002, which clarifies that certification must be in writing.

¶1.51, ¶1.56, and ¶1.58 are revised to reflect a legislative amendment to subparagraphs 118.2(2)(d) and (e), made by S.C. 2013, c. 34, s. 249(3), applicable to certifications made after December 20, 2002, which clarifies that certification must be in writing.

¶1.70 is revised to reflect legislative amendments to paragraphs 118.2(2)(g) and (h), made by S.C. 2013, c. 34, s. 249(4) and s. 249(5), respectively, both applicable to certifications made after December 20, 2002, which clarify that certification must be in writing.

¶1.73(h) and ¶1.78 in the French version are revised to reflect a legislative amendment to subparagraph 118.2(2)(i), made by S.C. 2013, c. 34, s. 249(6), which corrects the spelling of the term iléostomie . The same legislative amendment corrects the spelling of the term ileostomy in the English version of the Act, which is already reflected in the English version of this chapter.

¶1.93 and ¶1.147 in the French version are revised to reflect a legislative amendment to subparagraph 118.2(2)(I.1)(i) of the French version of the Act, made by S.C. 2013, c. 34, s. 249(7), and substitute the phrase "moelle épinière" with "moelle osseuse".

¶1.96 is revised to provide additional guidance on paragraph 118.2(2)(I.2) and paragraph 118.2(2)(I.21).

¶1.97 is revised to more closely reflect the wording of the legislation.

¶1.115 in the English version is revised to reflect a legislative amendment to subparagraph 118.2(2)(I .9)(iii) of the English version of the Act, made by S.C. 2013, c. 34, s. 249(8), applicable to tax years that end after October 31, 2011, to clarify that the person to whom the remuneration is paid cannot be the individual’s common-law partner.

¶1.132 is revised to add a reference to ¶1.24 which clarifies that amounts paid to a dentist for dental services other than for dentures, are also eligible medical expenses.

Update March 28, 2013

General

Income Tax Folio S1-F1-C1, Medical Expense Tax Credit, together with Income Tax Folio S1-F1-C2, Disability Tax Credit and Income Tax Folio S1-F1-C3, Disability Supports Deduction, replaces and cancels Interpretation Bulletin IT-519R2, Medical Expense and Disability Tax Credits and Attendant Care Expense Deduction.

In addition to consolidating the content of the former interpretation bulletin, general revisions have been made to improve readability. Any substantive technical and interpretive changes to the information outlined in the former interpretation bulletin are described below.

Legislative and other changes

The discussions in Interpretation Bulletin IT-519R2 relating to the disability tax credit are now found in Income Tax Folio S1-F1-C2 and the discussions in Interpretation Bulletin IT-519R2 relating to the disability supports deduction (formerly the attendant care deduction) are now found in Income Tax Folio S1-F1-C3. The information in the Chapters is cross-referenced to information in the other Chapters where required.

Throughout the Chapter, all references to "spouse" have been changed to "spouse and common-law partner" based on the 2000 same-sex partner bill.

References to "qualifying medical expenses" have also been replaced with references to "eligible medical expenses" to provide language consistent with discussions on the CRA website.

¶1.1 to 1.4 and ¶1.7 (formerly ¶10 and ¶16 of IT-519R2) are revised to reflect a legislative amendment made by S.C. 2005, c. 19, s. 24(1), which replaced the existing subsection 118.2(1) with a new subsection 118.2(1), effective for the 2004 and subsequent tax years. These paragraphs of the Chapter also reflect a legislative amendment made to the description of D in subsection 118.2(1) by S.C. 2006, c. 4, s. 62(1), applicable to the 2005 and subsequent tax years and another legislative amendment made to the description of D in subsection 118.2(1) by S.C. 2011, c. 24, s. 27(1), effective for the 2011 and subsequent tax years.

¶1.5 is added to clarify that eligible medical expenses of children of the taxpayer or of the taxpayer’s spouse or common-law partner who are under the age of 18 years are covered under the first calculated amount for the medical expense tax credit calculation (discussed in ¶1.2 and ¶1.3) and not the second calculated amount.

¶1.6 is added to provide the CRA’s general views on the meaning of support for purposes of determining whether a particular individual is a dependant of the taxpayer for purposes of the medical expense tax credit calculation.

¶1.8 is added to define the terms patient and eligible person with a disability for purposes of the Chapter.

¶1.9 (formerly ¶11 of IT-519R2) is expanded to reflect legislative amendments to paragraphs 118.2(1)(b) and (c), made by S.C. 2005, c. 19, s. 24(1), effective for the 2004 and subsequent tax years.

¶1.12 (formerly included in the discussion at ¶12 of IT-519R2) is expanded to highlight exceptions to the general rule that eligible medical expenses are not restricted to those paid in Canada or to services provided in Canada. The paragraph is also expanded to clarify that otherwise eligible medical expenses in respect of certain dependants may only be claimed by an individual where the dependant is a resident of Canada at some time in the year in which the eligible medical expense is incurred.

¶1.13 is added to clarify that an otherwise eligible medical expense, incurred in respect of certain dependants may only be claimed if the dependant was resident in Canada at some time in the year in which the expense was incurred.

¶1.16 and ¶1.17 (formerly ¶66 of IT-519R2) are revised to improve clarity and to reflect a legislative amendment made to paragraph 118.2(3)(b) by S.C.1998, c.19, s. 23(4), effective for the 1997 and subsequent tax years.

¶1.18 and ¶1.19 (formerly ¶18 of IT-519R2) are expanded to clarify that expenses eligible for the medical expense tax credit are limited to those described in subsection 118.2(2), with the expenses being claimed under paragraphs 118.2(2)(m) and (n) being subject to the additional requirements in sections 5700 or 5701 of the Regulations, as applicable.

¶1.20 (formerly ¶2 of IT-519R2) is revised to reflect a legislative amendment made by S.C. 2006, c. 4, s. 63(3) which added a reference to the term medical practitioner to section 118.3, effective for the 2005 and subsequent tax years.

¶1.21 (formerly included in the discussion at ¶3 of IT-519R2) is revised to reflect a number of legislative amendments to subsection 118.4(2). Audiologist was added by S.C. 1998, c. 19, s. 25(1), effective after February 18, 1997. The same 1998 legislative amendment added medical doctor to the list of medical professionals, effective for tax years ended after November 1991. Occupational therapist and psychologist were added by S.C. 1999, c.22, s. 36(1), effective after February 24, 1998. Speech-language pathologist was added by S.C. 2001, c. 17, s. 97(1), effective for certifications made after October 17, 2000. Subsection 118.4(2) was amended by S.C. 2006, c. 4, s. 64(4) to add a reference to physiotherapist, effective for certifications made after February 22, 2005, and to add section 64 to the list of provisions to which subsection 118.4(2) applies, effective for the 2005 and subsequent tax years.

¶1.22 is added to provide the CRA’s view on when an individual is considered to be authorized by the laws of a jurisdiction to act as a medical practitioner.

¶1.23 (formerly included in the discussion at ¶3 of IT-519R2) is revised to refer readers to an updated listing of medical practitioners by province/territory, which is maintained on the CRA website.

¶1.25 (formerly ¶21 and ¶22 of IT-519R2) is revised to improve readability to clarify the individual’s responsibilities for maintaining evidence to support their position that a particular facility is a licensed private hospital should they be asked by the CRA to provide such evidence.

¶1.26 (formerly discussed at ¶19 of IT-519R2) is revised to clarify the meaning of the term medical services and to provide the CRA’s view on the treatment of payments made to a medical practitioner for the completion of health and disability forms.

¶1.27 is added to provide the CRA’s view that payments to medical practitioners are only considered eligible medical expenses when they are paid for medical services relating to existing illnesses and conditions.

¶1.28 (formerly ¶20 of IT-519R2) is revised to clarify the CRA’s view regarding payments made to corporations, partnerships, societies and associations that may be eligible medical expenses.

¶1.29 is added to provide the CRA’s view regarding membership fees, access fees and block fees paid to private medical clinics as eligible medical expenses.

¶1.30 is added to reflect a legislative amendment made by S.C. 2010, c. 12, s. 13(1), which added subsection 118.2(2.1) to the Act, effective for expenses incurred after March 4, 2010, and to reflect the impact of subsection 118.2(2.1) on amounts that might otherwise be eligible medical expenses under paragraph 118.2(2)(a).

¶1.32 (formerly included in the discussion at ¶23 and ¶24 of IT-519R2) is revised to clarify of the CRA’s view regarding the meaning of the terms attendant care and one full-time attendant.

¶1.33 (formerly included in the discussion at ¶23 of IT-519R2) is expanded to clarify the CRA’s view regarding the meaning of the terms nursing home and full-time care in a nursing home.

¶1.34 is added to clarify that paragraphs 118.2(2)(b), (b.1) and (b.2) only apply in respect of costs related to caring for an eligible person with a disability, whereas paragraphs 118.2(2)(c), (d) and (e) apply in respect of costs related to caring for a patient regardless of whether the patient is an eligible person with a disability.

¶1.35 (formerly included in the discussions at ¶6 and ¶26 of IT-519R2) is revised to improve readability and to refer readers to related information on the CRA website.

¶1.39, ¶1.43 and ¶1.49 (formerly ¶25 of IT-519R2) are revised to include a reference to workers’ compensation insurance premiums.

¶1.40 and ¶1.41 (formerly included in the discussion at ¶24 of IT-519R2) are revised to improve readability and to more closely reflect the legislation in paragraph 118.2(2)(b.1). The paragraph was also revised to reflect a legislative amendment made by S.C. 2000, c. 19, 25(2), which added a cross-reference to paragraph 118.2(2)(b.2) to subparagraph 118.2(2)(b.1)(ii), effective for the 1999 and subsequent tax years.

¶1.44 to 1.46 are added to reflect a legislative amendment made by S.C. 2000, c. 19, s. 25(3), which added paragraph 118.2(2)(b.2) to the list of expenditures eligible for the medical expense tax credit, effective for the 1999 and subsequent tax years.

¶1.48 is added to clarify the potential impact of a medical expense claim under paragraph 118.2(2)(c) on a claim for the disability tax credit under section 118.3.

¶1.50 (formerly included in the discussion at ¶27 of IT-519R2) is revised to clarify that the completion of Form T2201, Disability Tax Credit Certificate, is not required for purposes of providing the required certification under paragraph 118.2(2)(c).

¶1.52 and ¶1.53 are added to clarify that the patient does not need to be an eligible person with a disability but where the patient is an eligible person with a disability, a claim under paragraph 118.2(2)(d) may impact a claim for the disability tax credit under section 118.3 in respect of the patient.

¶1.55 (formerly included in the discussion at ¶28 of IT-519R2) is revised to clarify that the completion of Form T2201 is not required for purposes of providing the required certification under paragraph 118.2(2)(d).

¶1.56 (formerly included in the discussion at ¶29 of IT-519R2) is revised to improve clarity.

¶1.57 (formerly included in the discussion at ¶29 of IT-519R2) is revised in two respects. The meaning of the term appropriately qualified person is revised to clarify that a person is not required to have certification powers under the law to provide a certification for purposes of paragraph 118.2(2)(e) and that the principal of the school or the head of the institution or other place may provide the required certification under paragraph 118.2(2)(e).

¶1.57 and ¶1.63 (formerly included in the discussion at ¶29 and ¶30 of IT-519R2) have been revised to remove the reference to a nursing home to clarify that the cost of care in a nursing home is claimed under paragraph 118.2(2)(b), (b.1) or (d) and not paragraph 118.2(2)(e).

¶1.58 (formerly included in the discussion at ¶29 of IT-519R2) is revised to clarify that the certification must be specific as to the school, institution or other place and that in the CRA’s view, it is not sufficient that the certification only refer to the facilities, equipment or personnel that is required by the patient. The example has also been updated to reflect a more common circumstance in which paragraph 118.2(2)(e) would apply.

¶1.59 (formerly included in the discussion at ¶29 of IT-519R2) is expanded to provide CRA’s view on claims under paragraph 118.2(2)(e) where enrolment at a school is considered beneficial to the patient but is not required.

¶1.60 is added to provide the CRA’s view on claims under paragraph 118.2(2)(e) for payments to a facility that functions mainly as a provider of rental accommodations.

¶1.61 is added to provide the CRA’s view on the impact of a claim under paragraph 118.2(2)(e) on a claim for the disability tax credit where the patient is an eligible person with a disability.

¶1.67 (formerly included in the discussion at ¶32 of IT-519R2) is revised to reflect the fact that the urgency of the situation is not generally considered as a factor in determining whether a person engaged in the business of providing transportation services is readily available.

¶1.69 (formerly included in the discussion at ¶34 of IT-519R2) is expanded to reflect the circumstances in which the CRA will consider other reasonable travel expenses incurred during the time that the patient is receiving medical services to be eligible medical expenses.

¶1.71 is added to provide the CRA’s views on claims for transportation and other reasonable travel expenses incurred to transport a patient to and from a school when the fees paid to the particular school can be claimed as eligible medical expenses under paragraph 118.2(2)(e).

¶1.72 (formerly included in the discussions at ¶34 of IT-519R2) is revised by referring readers to the CRA website for information on receipt requirements and the calculation of meal and vehicle expenses under the simplified and detailed methods.

¶1.73 (formerly ¶35 of IT-519R2) is revised to reflect a legislative amendment to paragraph 118.2(2)(i), made by 2006, c. 4, s. 62(2), effective for the 2005 and subsequent tax years. The amendment expanded the provision to also cover the cost of phototherapy equipment for the treatment of psoriasis or other skin disorders and an oxygen concentrator.

¶1.74 is added to clarify that claims under paragraph 118.2(2)(i) may include certain expenses related to the operation of devices listed in the provision.

¶1.79 (formerly ¶41 of IT-519R2) is revised by removing the last sentence. The treatment of expenses related to the operation of devices listed in paragraph 118.2(2)(i) are now discussed in ¶1.74, as the comments apply to operating costs for all devices listed in paragraph 118.2(2)(i).

¶1.81 (formerly ¶45 of IT-519R2) is expanded to provide the CRA’s view on the treatment of the costs of climate controlled storage space for the artificial kidney machine or supplies for the machine.

¶1.87 (formerly ¶49 of IT-519R2) is expanded to clarify the meaning of the phrase other products for purposes of paragraph 118.2(2)(i.1).

¶1.88 is added to refer readers to the discussion of subparagraph 118.2(2)(n)(i) to determine whether medical ointments used by a person in connection with products described in paragraph 118.2(2)(i.1), may be eligible medical expenses.

¶1.90 (formerly ¶51 of IT-519R2) is expanded to clarify that the cost of insulin, oxygen, liver extract injectible for pernicious anaemia or vitamin B12 for pernicious anaemia that are prescribed by a medical practitioner are also eligible medical expense under paragraph 118.2(2)(k).

¶1.91 is added to clarify that paragraph 118.2(2)(k) only covers the cost of insulin for persons with diabetes, but other costs incurred by these persons may be eligible medical expenses under other subsection of 118.2(2).

¶1.92 (formerly ¶52 of IT-519R2) is revised to refer readers to the CRA website for more information on expenses that may be eligible medical expenses under paragraph 118.2(2)(l).

¶1.93 (formerly ¶53) is revised to refer readers to the CRA website for information on calculating meal and vehicle expenses.

¶1.94 to 1.96 (formerly ¶54 of IT-519R2) are expanded to reflect a legislative amendment made by S.C. 2001, c. 17, s. 95(1) which added paragraph 118.2(2)(I.21) to the Act, effective for the 2000 and subsequent tax years, and a legislative amendment made by S.C. 2006, c. 4, s. 62(3), which replaced the existing paragraphs 118.2(2)(l.2) and (l.21) with new paragraphs effective for expenses incurred after February 22, 2005.

¶1.97 to 1.100 are added to provide additional guidance on the application of paragraphs 118.2(2)(l.2) and (l.21).

¶1.102 is added to reflect paragraph 118.2(2)(l.4) which was added to the Act by S.C. 1998, c. 19, s. 23(2), effective for the 1997 and subsequent tax years and the amendment to paragraph 118.2(2)(l.4) made by S.C. 2003, c. 15, s. 73(1), effective for the 2003 and subsequent tax years.

¶1.103 and ¶1.104 are added to reflect paragraph 118.2(2)(I.41) and (I.42) which were added to the Act by S.C. 2003, c. 15, s. 73(1), effective for the 2003 and subsequent tax years.

¶1.105 and ¶1.106 are added to reflect paragraphs 118.2(2)(I.43) and (I.44) and which were added to the Act by S.C. 2006, c. 4, s. 62(4), effective for the 2005 and subsequent tax years.

¶1.107 and ¶1.108 are added to reflect paragraphs 118.2(2)(I .5) and (I.6) which were added to the Act by S.C. 1998, c. 19, s. 23(2), effective for the 1997 and subsequent tax years.

¶1.109 to 1.112 are added to reflect paragraph 118.2(2)(I.7) which was added to the Act by S.C. 1998, c. 19, s. 23(2), effective for the 1997 and subsequent tax years.

¶1.113 and ¶1.114 are added to reflect paragraph 118.2(2)(I.8) which was added to the Act by S.C. 1999, c. 22, s. 34(2), effective for the 1998 and subsequent tax years.

¶1.115 and ¶1.116 are added to reflect paragraph 118.2(2)(I.9) which was added to the Act by S.C. 2000, c. 19, s. 25(4), effective for the 1999 and subsequent tax years.

¶1.117 is added to reflect paragraph 118.2(2)(I.91) which was added to the Act by S.C. 2000, c. 19, s. 25(4), effective for the 1999 and subsequent tax years.

¶1.119 to 1.121 are added to provide additional clarity.

¶1.122 (formerly the Appendix to IT-519R2) is revised to reflect a number of amendments that added paragraphs to the Regulation or amended existing paragraphs of the Regulation: paragraph 5700(c.3) was added by SOR/99-387, s. 1, applicable to the 1997 and subsequent tax years; paragraph 5700(w) was added by SOR/2001-4, applicable to the 1999 and subsequent tax years; paragraph 5700(w) was amended by SOR/2007-212, s. 3(3), applicable to the 2004 and subsequent tax years; paragraph 5700(i) was amended by SOR/2007-212, s. 3(1), applicable to expenses incurred for property acquired after February 22, 2005; paragraph 5700(l.1) was added by SOR/2007-212, s. 3(2), applicable to the 2005 and subsequent tax years; paragraphs 5700(x), (y), and (z) were added by SOR/2007-212, s. 3(4), applicable to the 2005 and subsequent tax years; paragraphs 5700(z.1), (z.2), (z.3), and (z.4) were added by 2009, c. 2, s. 109(1), applicable to the 2008 and subsequent tax years; and paragraph 5700(s.1) was added by 2012, c. 19, s. 18(1), applicable to expenses incurred after 2011. The list of equipment and devices in ¶1.122 was also revised to provide additional clarity on whether certain devices or equipment are covered under section 5700 of the Regulations.

¶1.123 to 1.127 (formerly ¶61 and ¶62 of IT-519R2) are revised to reflect a legislative amendment made by S.C. 2008, c. 28, s. 16(2). The legislative amendment replaced the existing paragraph 118.2(2)(n) with a new paragraph 118.2(2)(n) and the new paragraph was effective for expenses incurred after February 26, 2008. ¶1.124 also discusses section 5701 of the Regulations which was added by 2009, c. 2, s. 110, and deemed to have come into force on February 27, 2008.

¶1.129 is added to clarify the meaning of the phrase other diagnostic procedures or services.

¶1.131 (formerly included in the discussions at ¶57 to 60 of IT-519R2) is revised to improve readability and expanded to add a reference to the cost of liver extract injectible and vitamin B12 treatments for the treatment of pernicious anaemia.

¶1.132 (formerly ¶63 of IT-519R2) is expanded to add a reference to denturists and to explain that the provision covers amounts paid for the making or repairing of an upper or lower denture, or for the making, producing, constructing and furnishing of an upper or lower denture for the patient.

¶1.135 is added to reflect a legislative amendment made to paragraph 118.2(2)(q) by S.C. 1999, c. 22, s.34(3), effective for the 1998 and subsequent tax years.

¶1.136 is added to reflect paragraph 118.2(2)(r) which was added to the Act by S.C. 2003, c. 15, s. 73(2), effective for the 2003 and subsequent tax years.

¶1.137 and ¶1.138 are added to reflect paragraphs 118.2(2)(s) and (t) which were added to the Act by S.C. 2006, c. 4, s. 62(5), effective for the 2005 and subsequent tax years.

¶1.139 to ¶1.142 are added to reflect paragraph 118.2(2)(u) which was added to the Act by S.C. 2006, c. 4, s. 62(5), effective for the 2005 and subsequent tax years.

¶1.143 to 1.146 are added to reflect subsection 118.2(2.1) which was added to the Act by S.C. 2010, c. 12, s. 13(1), effective for expenses incurred after March 4, 2010.

¶1.147 (formerly ¶67 of IT-519R2) is revised to improve clarity, refer readers to relevant information on the CRA website and, to reflect the expanded list of medical practitioners who may prescribe a purchase or provide services that are eligible medical expenses. The legislative amendments that expanded the list of medical practitioners are found at the history note for ¶1.21.

¶1.148 to 1.153 are added to provide general information on the refundable medical expense supplement in section 122.51 which was added to section 122.51 by S.C. 1998, c. 19, s. 32(1), effective for the 1997 and subsequent tax years. The discussion also reflects amendments made to section 122.51 by S.C. 2000, c. 19, s. 32(1), effective for the 1999 and subsequent tax years; S.C. 2000, c. 14, s. 39(1), effective for the 2000 and subsequent tax years; S.C. 2001, c. 17, s. 108(1), effective for the 2001 and subsequent tax years; S.C. 2005, c. 19, s. 26(1), effective for the 2004 and subsequent tax years; S.C. 2003, c. 30, s. 7(1), effective for the 2005 and subsequent tax years; S.C. 2006, c. 4, s. 70(2), effective for the 2006 and subsequent tax years; and S.C. 2007, c. 2, s. 31(1), effective for the 2005 and subsequent tax years.

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