Medical expenses are deductible only if they exceed a threshold, and only if you itemize instead of taking the standard deduction

You can deduct medical and dental expenses, but only the amount that exceeds 7.5% of your adjusted gross income (AGI). If your AGI is $60,000, for example, you can only deduct medical costs above $4,500. This means most people with moderate health expenses will not benefit from the deduction because the standard deduction — a flat amount everyone can take without itemizing — is usually larger.

The deduction applies only to expenses you paid out of pocket during the tax year. Insurance premiums you paid yourself count. Money your insurance company paid does not. You must also itemize your deductions on Schedule A instead of taking the standard deduction, which requires your total itemized deductions to exceed the standard deduction amount for your filing status.

The IRS publishes a list of what counts as a medical expense. Common deductible items include doctor visits, hospital stays, prescription medications, dental work, vision care, hearing aids, and medical equipment like crutches or wheelchairs. Cosmetic procedures do not count unless they are medically necessary — for example, reconstructive surgery after an injury or illness.

Key Takeaways

  • You can only deduct medical expenses that exceed 7.5% of your adjusted gross income, and only if you itemize deductions instead of taking the standard deduction.
  • Deductible expenses include doctor visits, hospital bills, prescription medications, dental work, and medical equipment you paid for yourself.
  • Insurance premiums you paid, including health insurance and long-term care insurance, count toward the deduction.
  • Cosmetic procedures, over-the-counter medications, and expenses covered by insurance do not may have access to.
  • You must keep receipts and records of all medical expenses to support your deduction if the IRS asks.

What counts as a deductible medical expense

The IRS allows deductions for a broad range of health-related costs. Doctor and dentist visits, hospital stays, surgery, X-rays, and lab tests all count. Prescription medications and insulin are deductible. So are medical devices: hearing aids, glasses, contact lenses, crutches, wheelchairs, and oxygen equipment.

Insurance premiums you pay yourself are deductible, including health insurance, dental insurance, vision insurance, and long-term care insurance. If you are self-employed, you may also deduct health insurance premiums as a business expense on Schedule C, which is separate from the medical deduction and does not have the 7.5% threshold.

Travel to receive medical care can count. If you drive to a doctor's appointment or hospital, you can deduct mileage at the IRS rate for that year (check the IRS website for the current rate). Lodging and meals while traveling for medical treatment may also be deductible if the trip is primarily for medical reasons.

What does not may have access to as a deductible expense

Over-the-counter medications like aspirin, cold medicine, and antacids do not count, even if a doctor recommends them. Cosmetic procedures — teeth whitening, Botox, facelifts, hair removal — are not deductible unless they treat a specific medical condition or injury. General health expenses like gym memberships, vitamins, and nutritional supplements are not deductible.

Expenses your insurance company paid are not deductible. If your insurance covered a doctor visit, you cannot deduct that visit. You can only deduct the out-of-pocket costs you actually paid: copays, coinsurance, deductibles, and premiums.

Childcare, maternity clothes, and cosmetic dentistry (like veneers for appearance only) do not may have access to. Fertility treatments and surrogacy expenses may be deductible in some cases, but the rules are complex — consult a tax professional if this applies to you.

How the 7.5% threshold works in practice

The threshold is calculated on your adjusted gross income, which is your total income minus certain deductions like contributions to a traditional IRA or student loan interest. To find your AGI, look at line 11 of Form 1040.

Multiply your AGI by 0.075 to find the threshold. Only medical expenses above that amount are deductible. If your AGI is $80,000, the threshold is $6,000. If you spent $8,500 on medical care, you can deduct only $2,500 ($8,500 minus $6,000). If you spent $5,500, you cannot deduct any of it.

The threshold applies to your household's combined medical expenses for the year. If you are married filing jointly, you add up all medical expenses for both spouses and explore the threshold once. If you are single, you use only your own expenses.

Itemizing versus the standard deduction

To claim the medical deduction, you must itemize deductions on Schedule A instead of taking the standard deduction. The standard deduction for 2024 is $14,600 for single filers and $29,200 for married couples filing jointly (these amounts change yearly).

Itemizing makes sense only if your total itemized deductions — medical expenses plus mortgage interest, property taxes, charitable donations, and other deductible items — exceed the standard deduction. Most people find the standard deduction is larger, so they do not benefit from itemizing.

If you are close to the standard deduction threshold, you might benefit from bunching medical expenses into a single tax year. For example, if you are planning elective dental work or vision correction, scheduling it in a year when you have other large medical expenses might push you over the threshold.

Record-keeping and documentation

Keep receipts, invoices, and statements for all medical expenses you claim. The IRS may ask to see proof of what you deducted. Your records should show the date, the provider's name, the service or item provided, and the amount you paid out of pocket.

Insurance statements that show what you paid versus what the insurance company paid are especially useful. If you claim mileage for medical travel, keep a log of the dates and miles driven. For lodging and meals during medical travel, keep receipts.

You do not need to file receipts with your tax return, but you must have them available if the IRS requests them during an audit. Keep records for at least three years after you file your return.

Special situations: self-employed and business owners

If you are self-employed, you can deduct health insurance premiums as a business expense on Schedule C. This deduction does not have the 7.5% threshold and does not require you to itemize. You can take it even if you claim the standard deduction.

If you have employees, you can deduct the cost of providing health insurance to them as a business expense. If you are an S-corporation or partnership owner, the rules differ slightly — consult a tax professional about your specific situation.

Contributions to a Health Savings Account (HSA) are deductible if you have a high-deductible health plan. The contribution limit changes yearly. Money in an HSA can be used tax-free for may have access to medical expenses, making it a powerful tool for managing health costs.

Frequently Asked Questions

Can I deduct health insurance premiums if I take the standard deduction?

If you are self-employed, yes — you can deduct health insurance premiums on Schedule C regardless of whether you itemize. If you are an employee, no — you can only deduct premiums if you itemize deductions on Schedule A, and only the amount above the 7.5% threshold.

Are prescription glasses and contacts deductible?

Yes. The cost of glasses, contact lenses, and eye exams are deductible medical expenses. You can deduct the full cost of the exam and lenses, but only if your total medical expenses exceed the 7.5% threshold and you itemize.

Can I deduct therapy or mental health counseling?

Yes. Therapy, counseling, and psychiatric care are deductible medical expenses. Costs include the therapist's fees, medications prescribed for mental health conditions, and hospital stays for mental health treatment.

What if I paid medical expenses in one year but did not receive the bill until the next year?

You deduct the expense in the year you paid it, not the year you received the bill. If you paid a doctor in December but the invoice arrived in January, the expense goes on the prior year's return.

Can I deduct COVID-19 tests or vaccines?

Yes. COVID-19 tests, vaccines, and treatments are deductible medical expenses. Masks and hand sanitizer purchased for medical purposes may also may have access to, though the rules are less clear for general-use items.