You can deduct medical expenses, but only if they exceed a threshold and you itemize

The IRS allows you to deduct unreimbursed medical and dental expenses on your federal tax return, but the rules are strict. You can only claim them if you itemize deductions instead of taking the standard deduction, and only the amount that exceeds 7.5% of your adjusted gross income (AGI). For most people, this means your medical bills have to be quite large before they reduce your taxes at all.

The threshold changes your math significantly. If your AGI is $60,000, you cannot deduct any medical expenses until they total more than $4,500. Only the amount above $4,500 counts. This is why medical deductions help mainly people with catastrophic expenses or very low incomes.

Key Takeaways

  • You must itemize deductions on Schedule A to claim medical expenses; the standard deduction is usually larger and simpler for most filers.
  • Only expenses above 7.5% of your adjusted gross income count, which means small medical bills rarely reduce your taxes.
  • Deductible expenses include doctor visits, hospital stays, prescriptions, dental work, vision care, and some equipment and travel costs related to medical care.
  • Insurance premiums you pay yourself, over-the-counter medicines, and cosmetic procedures do not may have access to.
  • You must have receipts and records showing what you paid and when, and you can only claim expenses you paid in the tax year you are filing for.

What counts as a deductible medical expense

The IRS has a long list of medical costs you can deduct. These include doctor and dentist visits, hospital stays, surgery, prescription medications, eyeglasses and contact lenses, hearing aids, crutches, wheelchairs, and insulin. You can also deduct the cost of medical equipment like blood pressure monitors or glucose meters if a doctor prescribed them.

Travel to receive medical care is deductible too. If you drive to a hospital or specialist appointment, you can deduct the mileage at the IRS rate (check the current year's rate on the IRS website). Parking and tolls count. If you fly or take a train for treatment, the full cost of transportation is deductible, and lodging is deductible if the trip is primarily for medical reasons.

Therapy and mental health treatment are deductible, including psychiatrist and psychologist visits. Long-term care insurance premiums are deductible in some cases, though the rules depend on your age. Certain home modifications made for medical reasons—like installing a wheelchair ramp or grab bars—can be deductible, though the calculation is complex.

What does not may have access to

Health insurance premiums you pay yourself are not deductible on Schedule A, though self-employed people can deduct them on a different part of the return. Over-the-counter medicines like aspirin, cold medicine, and antacids do not count unless a doctor prescribed them specifically. Cosmetic procedures—including teeth whitening, facelifts, and hair removal—are never deductible, even if a doctor performs them.

Gym memberships and general wellness expenses do not may have access to, even if you use them for health reasons. Vitamins and supplements are not deductible unless a doctor prescribed them to treat a specific medical condition. Maternity clothes, baby formula, and diaper services are not medical expenses. Toothpaste, mouthwash, and other hygiene products do not count.

Itemizing versus the standard deduction

To claim medical expenses, you must file Schedule A and itemize your deductions instead of taking the standard deduction. The standard deduction for 2024 is $14,600 for single filers and $29,200 for married filing jointly. Itemizing only makes sense if your total deductible expenses—medical bills plus state and local taxes, mortgage interest, charitable donations, and other allowed deductions—exceed the standard deduction.

For most people, the standard deduction is larger. You itemize only if you have significant deductible expenses in multiple categories. A person with $8,000 in medical bills but no other deductible expenses would not benefit from itemizing, because $8,000 is less than the standard deduction. But someone with $8,000 in medical bills plus $10,000 in state taxes and $5,000 in charitable donations would itemize, because the total of $23,000 exceeds the standard deduction.

The 7.5% threshold and how it works

Once you itemize, you can only deduct the medical expenses that exceed 7.5% of your AGI. Your AGI is your total income minus certain deductions—it appears on your tax return. To find your threshold, multiply your AGI by 0.075.

Example: Your AGI is $50,000. Your threshold is $50,000 × 0.075 = $3,750. You paid $6,200 in medical bills during the year. You can deduct $6,200 − $3,750 = $2,450. Only that $2,450 reduces your taxable income. If you had paid only $3,500 in medical bills, you could deduct nothing, because $3,500 is below your $3,750 threshold.

Keeping records and gathering documentation

The IRS requires you to keep receipts and records for every medical expense you claim. Save invoices from doctors and hospitals, pharmacy receipts for prescriptions, insurance statements showing what you paid out of pocket, and mileage logs if you drove for medical care. Keep these records for at least three years after you file.

If you received a bill from a hospital or doctor's office, that bill is your receipt. If you paid with a credit card or check, your statement is proof of payment. Insurance statements showing your out-of-pocket costs are especially important—they show what you actually paid versus what insurance covered. If you claim mileage, write down the dates, destinations, and miles driven, or use a mileage tracking app.

You can only claim expenses you paid in the tax year you are filing for. If you paid a medical bill in January 2024, you claim it on your 2024 return filed in 2025. If the same bill was not paid until January 2025, it goes on your 2025 return.

When medical expenses span multiple years

Sometimes a large medical expense is billed and paid over time. Claim the expense in the year you actually paid it, not the year you received the service. If you had surgery in December 2024 but did not pay the bill until February 2025, the deduction goes on your 2025 return.

If you have a year with very high medical expenses, you might benefit from bunching deductions—paying medical bills you owe in that same year if possible, to push your total above the 7.5% threshold. For example, if you know you will have $5,000 in medical expenses in 2025 and your threshold is $4,500, paying an additional $500 in bills that year gets you a deduction. Paying that same $500 in January 2026 would not help in 2025.

Frequently Asked Questions

Can I deduct health insurance premiums I pay myself?

Health insurance premiums paid by employees are not deductible on Schedule A. However, if you are self-employed, you can deduct health insurance premiums on Form 1040 as a business expense, which is more valuable than itemizing. If you received unemployment benefits, you may be able to deduct premiums you paid while unemployed.

What if my employer reimbursed me for medical expenses?

You cannot deduct expenses your employer reimbursed. Only claim the amount you paid out of your own pocket. If your employer has a flexible spending account (FSA) or health savings account (HSA), money you contribute to those accounts reduces your taxable income automatically—you do not need to itemize.

Can I deduct dental work and vision care?

Yes. Dental visits, cleanings, fillings, root canals, orthodontia, and dentures are deductible. Eyeglasses, contact lenses, and eye exams are deductible. However, cosmetic dental work like teeth whitening is not deductible unless it is medically necessary.

Do I need to report the deduction differently if I use tax software?

Tax software will walk you through Schedule A if you choose to itemize. You enter your medical expenses, and the software calculates the 7.5% threshold automatically and shows you whether itemizing saves you money compared to the standard deduction. The software compares both options and uses whichever is larger.

What if I paid medical bills for a family member?

You can deduct medical expenses you paid for your spouse and dependents, even if they do not live with you. You cannot deduct expenses for an adult child unless they are your dependent for tax purposes. Keep receipts showing you paid the bill, not the family member.