You can deduct medical expenses, but only if they exceed a threshold and you itemize instead of taking the standard deduction

The IRS lets you deduct medical and dental expenses on Schedule A (Itemized Deductions), but there is a catch: your total medical expenses must exceed 7.5% of your adjusted gross income (AGI) before you can deduct any of them. If your AGI is $60,000, for example, you would need medical expenses over $4,500 to deduct anything at all. You also have to choose itemized deductions instead of the standard deduction, which means adding up all your deductible expenses (medical, state taxes, mortgage interest, charitable donations) and comparing that total to the standard deduction amount for your filing status.

The expenses that count include doctor visits, hospital stays, prescription medications, dental work, vision care, hearing aids, and certain medical equipment. You can also deduct premiums you paid for health insurance, long-term care insurance, and Medicare premiums if you are self-employed. Travel costs to receive medical care—mileage, parking, and lodging—count too, though you use the IRS mileage rate for medical travel rather than actual gas costs.

Key Takeaways

  • Medical expenses are deductible only on Schedule A (Itemized Deductions), and only the amount above 7.5% of your AGI counts.
  • You must choose itemized deductions over the standard deduction for medical expenses to matter, which means totaling all your deductible expenses and comparing to your standard deduction amount.
  • may be able to access expenses include doctor and dental visits, prescriptions, medical equipment, health insurance premiums, and mileage to medical appointments.
  • Cosmetic procedures, over-the-counter medications (except insulin), and expenses reimbursed by insurance do not count as deductible medical expenses.

What counts as a deductible medical expense

The IRS has a specific list of what qualifies. Doctor visits, hospital stays, surgery, X-rays, and lab work all count. Prescription medications and insulin count, but over-the-counter drugs like aspirin or cold medicine do not—unless you have a prescription for them. Dental work including cleanings, fillings, root canals, and orthodontia is deductible. Vision care (eye exams, glasses, contact lenses) and hearing aids are in. Medical equipment such as crutches, wheelchairs, blood pressure monitors, and glucose monitors qualifies.

Health insurance premiums you paid out of pocket count toward the total. If you are self-employed, you can deduct health insurance premiums even without itemizing, but that is a separate deduction on Form 1040. Long-term care insurance premiums are deductible up to an age-based limit set by the IRS each year. Travel to receive medical care—mileage at the IRS medical mileage rate (21 cents per mile for 2024, though this changes yearly), parking, tolls, and lodging while away from home for treatment—all count.

Expenses that do not may have access to

Cosmetic procedures do not count unless they are medically necessary to treat an injury or illness. A facelift for appearance is not deductible; reconstructive surgery after an accident is. Gym memberships and general health supplements are not deductible, even if your doctor recommends exercise. Over-the-counter medications without a prescription do not count. Teeth whitening, cosmetic dentistry, and orthodontia for purely cosmetic reasons (not to correct a bite problem) fall into a gray area—the IRS generally does not allow them.

Any expense reimbursed by insurance, an employer health plan, or a health savings account (HSA) cannot be deducted again. If your insurance paid $500 of a $700 dental bill, you can only count the $200 you paid out of pocket. Expenses paid with pre-tax dollars through a Flexible Spending Account (FSA) or HSA also cannot be deducted on your tax return.

Understanding the 7.5% threshold and itemization

The 7.5% threshold is the key barrier. To use it, calculate your AGI from your tax return, multiply it by 0.075, and subtract that number from your total medical expenses. Only the remainder is deductible. If your AGI is $80,000 and your medical expenses total $8,000, the threshold is $6,000 (80,000 × 0.075). You can deduct only $2,000 ($8,000 − $6,000).

You also have to choose itemized deductions over the standard deduction. For 2024, the standard deduction is $14,600 for single filers and $29,200 for married filing jointly (these amounts change yearly). Add up all your deductible expenses: medical expenses above the threshold, state and local taxes (capped at $10,000), mortgage interest, charitable donations, and other may be able to access items. If that total exceeds your standard deduction, itemizing makes sense. If not, take the standard deduction and you cannot deduct medical expenses at all.

How to report medical expenses on your tax return

You report medical expenses on Schedule A (Form 1040), which is the Itemized Deductions form. Line 1 of Schedule A asks for medical and dental expenses. Enter your total medical expenses, then on line 2 you subtract 7.5% of your AGI (the IRS calculates this for you based on your AGI from Form 1040). The result goes on line 3 as your deductible medical expense amount. You then add up all your itemized deductions and compare the total to your standard deduction. If itemized deductions are higher, you file Schedule A with your return.

Keep receipts and documentation for every expense you claim. The IRS does not require you to attach receipts to your return, but you must have them if the IRS asks. For mileage, keep a log showing the date, destination, and miles driven. For insurance premiums, keep the 1098-T (education-related health insurance) or statements from your insurance provider. For medical procedures and equipment, keep invoices and receipts showing what was purchased and the cost.

When medical expenses make itemizing worthwhile

Itemizing for medical expenses usually makes sense only if you have other deductible expenses that push your total above the standard deduction. A person with $8,000 in medical expenses above the threshold but no other deductions would not benefit—the standard deduction is higher. But someone with $6,000 in medical expenses, $5,000 in state and local taxes, and $3,000 in charitable donations might find that itemizing ($14,000 total) exceeds the standard deduction ($14,600 for single filers in 2024), so itemizing barely helps.

High-income earners with significant medical expenses are more likely to benefit. Someone with $100,000 in medical expenses, $10,000 in state taxes, and $5,000 in charitable donations would have $115,000 in itemized deductions, far above the standard deduction. Retirees with large medical bills and no mortgage interest to deduct sometimes find that medical expenses alone push them over the standard deduction threshold, especially if they also have charitable donations or property taxes to include.

Special situations: HSAs, FSAs, and employer plans

If you contribute to a Health Savings Account (HSA) or Flexible Spending Account (FSA) through your employer, those contributions come out before taxes are calculated. You cannot deduct the same expense twice—once through the HSA/FSA and again on your tax return. The money you withdraw from an HSA or FSA to pay medical expenses is already tax-free, so claiming it again as a deduction would be double-dipping.

If you are self-employed, you can deduct health insurance premiums directly on Form 1040 (line 17) without itemizing. This is separate from Schedule A and does not require you to meet the 7.5% threshold. Self-employed health insurance deductions reduce your AGI, which can lower your overall tax bill even if you do not itemize.

Frequently Asked Questions

Can I deduct over-the-counter medications?

No, unless you have a prescription for them. Aspirin, cold medicine, and allergy pills bought without a prescription do not count. Insulin is the one exception—it is deductible even without a prescription. If your doctor writes a prescription for an over-the-counter drug, you can then deduct it.

What if I had a really expensive medical year but my income was also high?

High income makes the 7.5% threshold harder to cross. If your AGI is $200,000, the threshold is $15,000. You would need medical expenses over $15,000 to deduct anything. High earners often find that medical expenses alone do not push them over the standard deduction, even with large bills.

Can I deduct dental work and vision care?

Yes, both count. Dental cleanings, fillings, root canals, and orthodontia are deductible. Eye exams, glasses, contact lenses, and contact solution are deductible. Cosmetic dentistry and teeth whitening are generally not deductible unless medically necessary.

Do I need to attach receipts to my tax return?

No, the IRS does not require receipts to be attached. But you must keep them in case the IRS asks to verify your deductions. Keep invoices, receipts, insurance statements, and a mileage log for at least three years after you file.

Can I deduct my spouse's medical expenses if we file jointly?

Yes, you can combine medical expenses for you, your spouse, and any dependents on one Schedule A. The 7.5% threshold applies to your combined household AGI, so filing jointly sometimes makes it easier to exceed the threshold than filing separately.