It's an odd time to be a tax professional

We like concrete rules. We look at the absolutes and tell you what the tax implications are for purchases, investments and major financial decisions. In 2014, however, we are entering uncharted territory with Obamacare and all the tax implications it leaves in its wake. It's a weird feeling when I find myself talking to someone over 65, telling them that if they need to get their knee replaced that they really should do it now. Your doctor is supposed to tell you when to get your knee replaced, but I know that if you do it now you will achieve significant tax savings.

In practice, the Affordable Care Act has proved to be anything but affordable. You can prepare for the continuing roll out of Obamacare in three steps:

Step one: go talk with your tax professional. Several parts of Obamacare have a direct impact on investors over 65, most importantly the 3.8 percent Medicare surtax on net investment income, if your adjusted gross income is over a certain threshold. Older Americans typically have bigger investment accounts, because they've spent their whole lives working and saving. Starting in 2013, Obamacare takes 3.8 percent off the top of the investments and dividends working Americans planned to live on in retirement.

For example, your IRA will be taxed on net investment income, which means some of the money you were counting on will go to the IRS instead of providing for you in retirement. You can minimize that amount by taking more out of Social Security, which isn't taxed, and less from your IRA. Even if your tax situation seems simple to you, you need to take advantage of all the available deductions to retain as much of your hard-earned money as possible.

Step two: find out your health insurance costs. Americans need to go to the Affordable Care Act health exchange and figure out what their health care will cost them. To date, health insurance premiums have gone up, not down. Young, healthy Americans have not flocked to Obamacare as predicted, and health-care providers have responded with high premiums.

In the past, taxpayers have been able to itemize their medical expenses and deduct any medical care that exceeded 7.5 percent of gross adjusted income. This is especially important to seniors in assisted living and retirement facilities who could deduct medical-related expenses from their care and reduce their tax liability. Obamacare raises that threshold to 10 percent, now for people under age 65 and in a few years for those over age 65, meaning it will take more medical bills to be able to benefit from deductions on your 2017 taxes.

Additionally, medical devices are going to face a new 2.3 percent tax in 2014, levied on the manufacturer or importer of the device. As with most manufactured goods, increases in costs eventually get passed on to the consumer. Dental implants, dentures, hip and knee replacements are expected to be part of the as-yet-unreleased medical-device list.

Finally, by 2018, so-called "Cadillac" plans for medical insurance will be hit by a 40 percent excise tax, targeting individuals with premium health care plans—with an annual cost of $10,200 for an individual or $27,500 for an employee and spouse/family coverage. The Obamacare logic holds that plans with low deductibles encourage unnecessary testing and excess health spending, and the tax will offset those inefficiencies.

Step three: calculate a new projection for how much money you will need to add to your current savings to retire. As we learn the rules and implications of Obamacare, we are able to calculate the increase in taxes and medical costs shouldered by Americans. Americans will need more money to retire than ever before—maybe you'll need to work longer or start socking away money in retirement accounts and savings earlier.

As tax professionals, we are here to offer you the tax guidance you need to have a secure retirement. You may want to look into that knee replacement sooner, rather than later.

Paul Oman can be reached at 713.482.2960 or by going to www.omanberry.com.