Pub 502

Lifetime Care--Advance Payments

   You can include in medical expenses a part of a life-care fee or "founder's fee" you
   pay either monthly or as a lump sum under an agreement with a retirement home.
   The part of the payment you include is the amount properly allocable to medical
   care. The agreement must require a specified fee payment as a condition for the
   home's promise to provide lifetime care that includes medical care. 

   Dependents with disabilities. You can include in medical expenses advance
   payments to a private institution for lifetime care, treatment, and training of your
   physically or mentally impaired dependent upon your death or when you become
   unable to provide care. The payments must be a condition for the institution's future
   acceptance of your dependent and must not be refundable. 

   Payments for future medical care. Generally, you are not allowed to include in
   medical expenses current payments for medical care (including medical insurance)
   to be provided substantially beyond the end of the year. This rule does not apply in
   situations where the future care is purchased in connection with obtaining lifetime
   care of the type described earlier.