Hire your spouse, deduct 100% of family medical expenses through a §105 HRA.
IRC §105 lets a business reimburse an employee 100% of qualified medical expenses tax-free — INCLUDING the employee's spouse and dependents. Sole prop hires spouse as legit W-2 employee → spouse's 'family' medical benefits cover the owner. All medical, dental, vision, LTC premiums, deductibles = business deduction. Requires bona fide employment (real work, real hours, W-2). Best via TASC, BASE, or CoreDocuments as plan admin.
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Max HSA, pay medical out-of-pocket, invest the balance, reimburse decades later.
Reimburse employees for individual health premiums — tax-free, no group plan needed.
Reimburse up to $6,350 single / $12,800 family in premiums + medical, tax-free.
$75/mo DPC subscription + high-deductible catastrophic plan = better care at half the cost.
Travel and $50/night lodging for medical care count toward the medical deduction.
Time elective procedures to clear the 7.5%-AGI floor in one big year.
Manage MAGI to avoid Medicare's income-based premium surcharges (up to $6K/yr extra).
$200–$450/mo cost-sharing plans (Medi-Share, CHM, Samaritan, Sedera).