The IRS indicated in an informal ruling that costs incurred for health and wellness coaching under a health savings account, flexible spending account, or other tax-preferred account could be a qualified expense when a physician or other qualified medical professional diagnoses a patient with a specific disease or chronic health risk and recommends the coaching (IRS INFO 2022-005). The coaching must be done to prevent or alleviate a disease or chronic health risk.
Things to consider in determining whether the costs of health and wellness coaching are deductible as medical expenses:
Items directly reducing income. Personal deductions such as for mortgage interest, state and local taxes, and charitable contributions are allowed only if deductions are itemized on Schedule A, but deductions such as for alimony, capital losses, moving expenses to a new job location, business losses, student loan interest, and IRA and Keogh deductions are deducted from gross income even if itemized deductions are not claimed.