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, but with a hard floor: your total medical costs must exceed 7.5% of your adjusted gross income (AGI) before you can deduct any of them. If your AGI is $60,000, that means you need more than $4,500 in may have access to medical expenses before the first dollar counts. Most people do not reach that threshold, which is why the standard deduction — a flat amount you can take without listing anything — works better for them.

You also have to itemize deductions on Schedule A instead of taking the standard deduction. Itemizing means listing out all your deductible expenses (medical, state taxes, mortgage interest, charitable gifts) and adding them up. If that total is less than the standard deduction for your filing status, you get no benefit from itemizing at all. For 2024, the standard deduction is $14,600 for single filers and $29,200 for married filing jointly.

The expenses that count are narrow: they must be for diagnosis, cure, mitigation, treatment, or prevention of disease, or for treatment affecting any part or function of the body. Cosmetic procedures do not count unless they are reconstructive after an accident or illness. Gym memberships and general wellness programs do not count either, even if your doctor recommends exercise.

Key Takeaways

  • Medical expenses are deductible only if they total more than 7.5% of your adjusted gross income, and you must itemize deductions to claim them.
  • may have access to expenses include doctor visits, hospital stays, prescription medications, dental work, vision care, and medical equipment prescribed by a doctor.
  • You cannot deduct cosmetic surgery, gym memberships, over-the-counter medications (with rare exceptions), or general wellness expenses.
  • If your medical expenses plus other itemized deductions do not exceed the standard deduction for your filing status, itemizing gives you no tax benefit.
  • You can deduct mileage to medical appointments at the IRS rate, plus parking and tolls, but not the cost of a general vehicle.

What counts as a deductible medical expense

The IRS publishes a list in Publication 502, but the practical categories are: doctor and dentist visits, hospital and surgical facility charges, prescription medications, insulin, medical equipment (crutches, wheelchairs, hearing aids, glasses, contact lenses), vision and dental care, mental health treatment, and physical therapy. You can also deduct the cost of a guide dog or service animal, including food and care specific to that animal's role.

Less obvious items that do count: the cost of a wig if hair loss is caused by disease, the cost of a breast prosthesis after mastectomy, weight-loss surgery if recommended by a doctor for a specific condition, and the cost of a home modification (ramp, grab bars, widened doorways) if it is medically necessary and does not add value to your home. You can deduct the cost of a home air purifier if prescribed by a doctor for a respiratory condition, but not a general air purifier for comfort.

Medications available over the counter — aspirin, cold medicine, allergy pills — do not count, with one exception: insulin counts even though it is available without a prescription in some states. Vitamins and supplements do not count unless prescribed by a doctor for a specific deficiency.

What does not count

Cosmetic procedures are off-limits unless they are reconstructive — meaning they repair damage from an accident, burn, or disease rather than improve appearance for its own sake. A facelift does not count. Reconstructive surgery after a car accident does. Teeth whitening does not count; a crown to repair a broken tooth does.

Gym memberships, fitness classes, and general wellness programs do not count, even if your doctor recommends exercise. The same applies to weight-loss programs that are not medically supervised, diet foods, and nutritional supplements. Cosmetic dentistry — veneers, bonding for appearance, teeth whitening — does not count, but root canals, fillings, and orthodontia do.

You cannot deduct the cost of a vehicle itself, even if you buy one because of a disability. You can deduct mileage to medical appointments, parking, and tolls, but not the vehicle purchase or general maintenance.

How to calculate the 7.5% threshold

Start with your adjusted gross income (AGI) from your tax return — this is your income after certain deductions like student loan interest, but before itemized deductions. Multiply that number by 0.075. The result is your threshold. Only medical expenses above that amount can be deducted.

Example: if your AGI is $80,000, your threshold is $6,000. If you spent $8,500 on medical expenses, you can deduct $2,500 (the amount over $6,000). If you spent $5,500, you cannot deduct any of it because it falls short of the threshold.

Keep receipts and invoices for everything: doctor bills, hospital statements, pharmacy receipts, dental invoices, and mileage logs. The IRS does not require you to attach them to your return, but you must have them if you are audited. Many people use a spreadsheet or a folder to track expenses throughout the year.

Itemizing versus the standard deduction

You can only claim medical deductions if you itemize. That means adding up medical expenses, state and local taxes (capped at $10,000), mortgage interest, charitable gifts, and other deductible expenses, then comparing the total to the standard deduction. If the total is higher, you itemize. If it is lower, you take the standard deduction instead and get no benefit from the medical expenses.

For 2024, the standard deduction is $14,600 for single filers, $29,200 for married filing jointly, and $21,900 for head of household. These numbers change each year. If you are over 65 or blind, you get an additional standard deduction amount.

Many people with high medical expenses also have high charitable giving or state taxes, which makes itemizing worthwhile. If your only large deduction is medical, itemizing may not help unless the medical bills are very large.

Deducting mileage and travel to medical appointments

You can deduct the mileage you drive to and from doctor visits, hospitals, dental appointments, and other medical care. For 2024, the IRS mileage rate for medical travel is 21 cents per mile. You can also deduct parking fees and tolls. Keep a log with the date, destination, and miles driven, or use your car's odometer to calculate the distance.

If you fly or take a train to a medical appointment, you can deduct the cost of the ticket. If you need someone to drive you because of your condition, you can deduct their mileage at the same rate, but not their meals or lodging. If you stay overnight for treatment, you can deduct lodging (hotel, not meals) if the trip is primarily for medical care and you cannot get the treatment locally.

Do not deduct the cost of a vehicle purchase or general maintenance. You are deducting only the cost of using the vehicle for medical travel, calculated by mileage.

Medical expenses for dependents and spouses

You can include medical expenses you paid for your spouse and your dependents, even if they do not live with you. A dependent is generally someone you claim on your return — a child, parent, or other relative who meets the IRS definition. You must have paid more than half their total support for the year.

If you are married and file jointly, you combine your medical expenses with your spouse's. If you file separately, each of you calculates your own threshold based on your own AGI, and you can only deduct the medical expenses you paid yourself.

If your child is an adult and you do not claim them as a dependent, you cannot deduct their medical expenses, even if you paid them. The person claimed as a dependent on the return is the one whose medical expenses count.

Frequently Asked Questions

Can I deduct over-the-counter medications?

No, with one exception: insulin counts even though it is available without a prescription. Aspirin, cold medicine, allergy pills, and other over-the-counter drugs do not count. If your doctor prescribes a medication that is also sold over the counter, you can deduct the cost only if you have a prescription for it.

What if I did not reach the 7.5% threshold this year but expect to next year?

You cannot carry expenses forward or backward. Medical expenses are deductible only in the year you paid them. If you had $4,000 in expenses this year and expect $5,000 next year, you cannot combine them. Each year stands alone.

Can I deduct cosmetic surgery?

Cosmetic surgery does not count unless it is reconstructive — meaning it repairs damage from an accident, burn, or disease. A facelift is cosmetic and does not count. Surgery to repair a broken nose or remove a scar from an accident does count.

Do I need to report medical expenses on my tax return if I do not itemize?

No. If your itemized deductions do not exceed the standard deduction, you take the standard deduction and do not report medical expenses at all. There is no benefit to listing them.

Can I deduct the cost of a gym membership if my doctor recommends it?

No. Even with a doctor's recommendation, gym memberships and general fitness programs do not count. The IRS considers these general wellness expenses, not medical treatment. Weight-loss surgery prescribed for a medical condition does count, but the gym membership itself does not.