You can deduct medical expenses only if you itemize deductions and your total medical costs exceed a threshold set by the IRS

The IRS allows you to deduct medical and dental expenses, but only under specific conditions. First, you must itemize deductions on your tax return instead of taking the standard deduction — most people take the standard deduction because it is larger. Second, your medical expenses must exceed 7.5% of your adjusted gross income (AGI). If your AGI is $60,000 and your medical expenses are $5,000, you can only deduct the amount above $4,500 (7.5% of $60,000), which means you deduct $500. If your medical expenses total $4,200, you cannot deduct any of them because they fall below the threshold.

The threshold of 7.5% applies to the 2024 tax year and has remained at that level since 2017. This means most households cannot deduct medical expenses unless they have had a major health event, surgery, or ongoing treatment that pushes costs well above the threshold.

Key Takeaways

  • You can only deduct medical expenses if you itemize deductions, which requires your total itemized deductions to exceed the standard deduction for your filing status.
  • Medical expenses must exceed 7.5% of your adjusted gross income before any portion becomes deductible.
  • Deductible medical expenses include doctor visits, hospital stays, prescription drugs, dental work, vision care, and some medical equipment and supplies.
  • Expenses paid for cosmetic procedures, over-the-counter medications (except insulin), and health club memberships do not may have access to for deduction.
  • You can only deduct expenses you paid out of pocket; insurance reimbursements and employer-paid premiums do not count toward the threshold.

What counts as a deductible medical expense

The IRS recognizes a broad range of medical costs. These include doctor and dentist visits, hospital stays, surgery, prescription medications, insulin, medical equipment (wheelchairs, crutches, hearing aids), eyeglasses and contact lenses, orthodontia, and physical therapy. You can also deduct premiums you pay for health insurance if you are self-employed, long-term care insurance premiums up to an age-based limit, and certain travel costs if you travel primarily for medical treatment.

Mental health treatment, including therapy and psychiatric care, counts as a deductible medical expense. So do fertility treatments, including in vitro fertilization (IVF). Nursing home care and home health aide services can be deducted if they are medically necessary. If you use part of your home exclusively for medical care — for example, a room dedicated to physical therapy equipment — you may be able to deduct a portion of your mortgage interest or rent, though this is complex and requires documentation.

Transportation to and from medical appointments is deductible. You can deduct either the actual cost of gas and parking or use the IRS mileage rate for medical travel, which was 21 cents per mile for 2024. Lodging during medical treatment away from home is deductible, though meals are not.

What does not may have access to for deduction

Cosmetic procedures — including teeth whitening, facelifts, and hair transplants — are not deductible unless they are medically necessary to correct a disfigurement caused by injury or disease. Over-the-counter medications do not may have access to, with the exception of insulin, which can be deducted regardless of whether you need a prescription. Vitamins, supplements, and herbal remedies are not deductible unless prescribed by a doctor for a specific medical condition.

Health club memberships and gym fees are not deductible, even if you use them on doctor's orders for weight loss or general fitness. However, if you have a specific medical condition and a doctor prescribes a particular treatment program at a facility, that program may be deductible. Cosmetic dentistry like veneers or teeth whitening does not count. Expenses paid by insurance or your employer do not count toward your deduction — only out-of-pocket costs you paid yourself.

How to calculate whether you can itemize and deduct

Start by adding up all your medical expenses for the tax year. Include only expenses you paid out of pocket. Then calculate 7.5% of your AGI — you can find your AGI on last year's tax return or estimate it for the current year. Subtract that 7.5% threshold from your total medical expenses. The remainder is the amount you can potentially deduct.

Next, add up all your other itemized deductions: state and local taxes (capped at $10,000), mortgage interest, charitable donations, and other deductible expenses. Compare this total to the standard deduction for your filing status in 2024 — $14,600 for single filers, $29,200 for married filing jointly, and $21,900 for head of household. If your itemized deductions (including the medical deduction) exceed the standard deduction, you should itemize. If not, take the standard deduction instead, and you cannot deduct medical expenses at all.

Many people find that even with significant medical expenses, they still cannot deduct them because the 7.5% threshold is high and the standard deduction is higher than their total itemized deductions. This is especially true for single filers and those without other large deductible expenses like mortgage interest or state taxes.

Keeping records for medical expense deductions

The IRS does not require you to attach receipts to your tax return, but you must keep them in case of an audit. Save receipts, invoices, and statements from doctors, dentists, hospitals, pharmacies, and medical suppliers. For mileage, keep a log showing the date, destination, purpose, and miles driven for each medical trip. For insurance premiums, keep the statements showing what you paid.

If you use a health savings account (HSA) or flexible spending account (FSA), those accounts already offer tax benefits for medical expenses, and you cannot deduct the same expenses twice. Keep separate records for expenses paid from these accounts versus out-of-pocket expenses. If you are reimbursed by insurance after you have already deducted an expense, you must report the reimbursement as income in the year you receive it.

Medical expenses and self-employed health insurance

If you are self-employed, you can deduct health insurance premiums you pay for yourself, your spouse, and your dependents as a business deduction on Schedule C, separate from itemized deductions. This deduction is not subject to the 7.5% threshold and does not require you to itemize. You can deduct premiums for medical, dental, and vision coverage, as well as long-term care insurance premiums up to an age-based limit set by the IRS.

This self-employed health insurance deduction is one of the few medical-related deductions that does not require itemizing, which makes it valuable for self-employed people. However, you cannot use this deduction for any month in which you were may be able to access to be covered by a health plan through an employer — either your own business or a spouse's employer.

When medical expenses span multiple years

You deduct medical expenses in the year you paid them, not the year you incurred them. If you had surgery in December 2024 but did not pay the bill until January 2025, you deduct it in 2025. If you paid a large bill in December that covered treatment in both 2024 and 2025, you must split the deduction between the two years based on when the service was provided.

Some people strategically time medical payments to push expenses into a single tax year so they exceed the 7.5% threshold. For example, if you know you will have significant medical expenses in the coming year, you might pay bills due in December before the year ends, or delay elective procedures until the following year. This strategy works only if you have control over the timing and the expense is not urgent.

Frequently Asked Questions

Can I deduct medical expenses if I take the standard deduction?

No. You can only deduct medical expenses if you itemize deductions, and itemizing requires your total itemized deductions to exceed the standard deduction for your filing status. Most people cannot deduct medical expenses because the standard deduction is larger than their itemized deductions.

What is the 7.5% threshold and how do I calculate it?

The 7.5% threshold means you can only deduct medical expenses that exceed 7.5% of your adjusted gross income. If your AGI is $50,000, the threshold is $3,750. You can deduct only the amount of medical expenses above $3,750. If your total medical expenses are $5,000, you can deduct $1,250.

Can I deduct health insurance premiums?

If you are self-employed, you can deduct health insurance premiums as a business deduction on Schedule C, separate from itemized deductions. If you are an employee, you cannot deduct premiums paid with after-tax dollars. Premiums paid through a payroll deduction are already excluded from your taxable income.

Are over-the-counter medications deductible?

Most over-the-counter medications are not deductible. The only exception is insulin, which can be deducted whether or not you need a prescription. Vitamins, supplements, and other OTC drugs do not count, even if a doctor recommends them.

What if I am reimbursed by insurance after I deduct an expense?

If you deduct a medical expense and later receive insurance reimbursement for it, you must report the reimbursement as income in the year you receive it. You cannot deduct an expense and then receive a tax-free reimbursement for the same cost.