For those individuals who have accumulated substantial wealth over their lifetime, the clock is ticking to take advantage of a huge tax break that will, in all likelihood, never reappear again. The tax break I am referring to is the lifetime gift and estate tax exemption. In 2012 that exemption level is $5.12 million but is scheduled to revert to its 2002 level of $1 million on Jan. 1, 2013. My guess is that Congress will act at some point, regardless of who is elected president, to make changes that would establish a $3.5 million estate tax exemption going forward, but notwithstanding that possibility, the lifetime gifting limit could very well remain at $1 million going forward.

The current lifetime exemption of $5.12 million (double that for married couples) means that a well-to-do person could give away more than $5 million before the end of 2012 without incurring any gift tax, thereby reducing the size of the person’s estate. Ideally, the remaining value of the estate would be small enough to escape estate taxes entirely.

It is certainly within the realm of possibility that, if Mitt Romney is elected, the estate tax could be repealed entirely. Again, my guess is that the political pressure on him to avoid “benefiting the rich” might forestall any repeal from actually becoming law. If President Obama wins re-election, he has already indicated that he favors a $3.5 exemption, with a 35 percent estate tax rate.

So you pays your money, you takes your choice. My advice would be to act now to take advantage of this gifting bonanza. The rub is that the process of getting all of one’s ducks in a row to actually get all this gifting done before the end of this year calls for action now. The reason: estate planning involves many interlocking parts and each demands careful planning and execution, particularly if one’s estate contains real estate or other non-cash items that will have to be properly appraised. The IRS will not accept a property valuation unless is has been performed by an acknowledged expert. Moreover, there could be a year- end crush to get such appraisals finished by year end.

“December is far too late,” said California estate-planning attorney Janet Brewer, who is affiliated with the legal-advice website “Even if a lawyer has time to meet with a client, it’s simply too difficult to finish the process in three or four weeks.”

On another topic, one of the least-known taxes that will be imposed in 2013 to help pay for the Patient Protection and Affordable Care Act is a new tax on medical devices. Medical device manufacturers employ 409,000 people in 12,000 plants across the country. The PPACA will impose a new 2.3 percent excise tax on gross sales from these medical device manufacturers, regardless of a company’s profitability or lack thereof. This tax will inexorably be passed onto the purchasers of these devices, pushing up the overall cost of healthcare.

Another tacit tax increase that will also hit in 2013 is the AGI threshold for claiming an itemized deduction for medical expenses. That cutoff level will be raised from its current 7.5 percent level to 10 percent of AGI. Sadly, this provision will be felt most by older, infirmed Americans who incur high prescription costs and other medical expenses each year.

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Greg Roberts is a certified financial planner with 35 years of financial and estate planning experience.