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 unreimbursed 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. You also have to itemize deductions rather than claim the standard deduction, which means adding up all your may be able to access expenses (medical, state taxes, mortgage interest, charitable donations) and comparing the 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 some equipment like crutches or wheelchairs. You can also deduct mileage to medical appointments (using the IRS mileage rate for medical travel, which changes yearly), health insurance premiums you pay yourself, and long-term care insurance premiums up to certain limits based on your age. Expenses reimbursed by insurance or an employer health plan do not count—only what you actually paid out of pocket.

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 itemize deductions instead of taking the standard deduction, which means your total itemized deductions must exceed the standard deduction for your filing status to benefit.
  • may be able to access expenses include doctor and dental visits, prescriptions, medical equipment, health insurance premiums you pay yourself, and mileage to medical appointments.
  • Expenses paid by insurance, an employer plan, or a health savings account (HSA) or flexible spending account (FSA) do not count as deductible medical expenses.

Which medical expenses the IRS allows you to deduct

The IRS publishes a detailed list in Publication 502, but the main categories are straightforward. Doctor, dentist, and eye doctor visits count. Hospital bills, surgery, lab tests, X-rays, and prescription drugs count. Over-the-counter medications do not count unless prescribed by a doctor. Dental work including cleanings, fillings, root canals, and orthodontia count. Hearing aids, glasses, contact lenses, and the exams to fit them count.

Medical equipment and supplies also may have access to: crutches, wheelchairs, walkers, canes, artificial limbs, guide dogs for the blind, and oxygen equipment. You can deduct the cost of a home modification if it is medically necessary—for example, a ramp for a wheelchair or a bathroom grab bar—but only the portion that exceeds the increase in your home's value. Long-term care insurance premiums count, but the deduction is limited by your age (the older you are, the higher the limit). Health insurance premiums you pay yourself count, including COBRA continuation coverage and premiums for policies you buy on your own, but not premiums paid by your employer or taken from your paycheck before taxes.

When itemizing makes sense versus taking the standard deduction

You can only deduct medical expenses if you itemize deductions on Schedule A. The standard deduction for 2024 is $14,600 for single filers and $29,200 for married filing jointly (these amounts change yearly). If your total itemized deductions—medical expenses above the 7.5% threshold, plus state income taxes, property taxes, mortgage interest, charitable donations, and other may be able to access items—add up to more than the standard deduction, itemizing saves you money. If not, the standard deduction is better.

For many people, medical expenses alone do not reach the 7.5% threshold, and even when they do, the deductible portion may not be enough to beat the standard deduction. However, if you have high medical costs in a single year (surgery, ongoing treatment, or multiple family members with expenses), or if you also have large charitable donations or mortgage interest, itemizing may work in your favor. You can use IRS Form 1040 Schedule A to calculate both scenarios and see which is larger.

How to calculate the deductible amount

Start by adding up all your unreimbursed medical expenses for the year. Include doctor visits, prescriptions, dental work, medical equipment, insurance premiums you paid, and mileage to medical appointments. Do not include expenses paid by insurance, an employer plan, an HSA, or an FSA—those are already tax-advantaged and cannot be deducted again.

Next, calculate 7.5% of your AGI. Your AGI appears on your tax return (Form 1040, line 11 for 2024). Subtract that 7.5% amount from your total medical expenses. The result is your deductible medical expense amount. For example: if your AGI is $80,000, the threshold is $6,000. If your medical expenses total $8,500, you can deduct $2,500 ($8,500 minus $6,000). If your expenses total $5,500, you cannot deduct any of them because they do not exceed the threshold.

Medical expenses you cannot deduct

The IRS does not allow deductions for cosmetic surgery unless it is reconstructive (for example, after an accident or mastectomy). Teeth whitening, hair replacement, and most weight-loss programs do not count. Gym memberships and general health foods do not count, even if recommended by a doctor, because they benefit general health rather than treating a specific condition.

Expenses paid by insurance or an employer health plan are not deductible—the insurance company or employer already received a tax benefit. The same applies to amounts paid from a health savings account (HSA) or flexible spending account (FSA); those accounts are already tax-advantaged, so you cannot deduct the same expense twice. Maternity clothes, babysitting, and travel for general health reasons do not count. If you travel for medical treatment, you can deduct the cost of transportation and lodging, but only the portion directly tied to the medical care, not meals or sightseeing.

How to report medical expenses on your tax return

You report medical expenses on Schedule A (Form 1040), which is the itemized deductions form. On line 1 of Schedule A, enter your total unreimbursed medical and dental expenses. On line 2, enter 7.5% of your AGI (which you calculate from your Form 1040). Subtract line 2 from line 1 and enter the result on line 3. That is your deductible medical expense amount.

Then add up all your other itemized deductions (state and local taxes, mortgage interest, charitable donations, and so on) and enter the total on Schedule A. Compare this total to the standard deduction for your filing status. If the Schedule A total is larger, you itemize and report the amount on Form 1040. If the standard deduction is larger, you take the standard deduction instead and do not file Schedule A. Keep receipts, invoices, and insurance statements for all medical expenses in case the IRS asks for proof.

Special situations: HSAs, FSAs, and dependent care

If you have a health savings account (HSA) or flexible spending account (FSA), expenses paid from those accounts are already tax-free and cannot be deducted again on your tax return. However, if you have leftover medical expenses not covered by your HSA or FSA, those can count toward the 7.5% threshold if you itemize. The same rule applies to expenses covered by insurance: the insurance company paid them, so you cannot deduct them.

If you paid medical expenses for a dependent (a child, parent, or other relative you claim on your return), those expenses count toward your deductible total as long as the dependent meets the IRS definition of a dependent for that year. You do not need to be related to claim someone as a dependent for medical expense purposes, but you do need to provide more than half their financial support for the year. Keep records showing who the expenses were for and your relationship to them.

Frequently Asked Questions

Can I deduct health insurance premiums I pay myself?

Yes, if you are self-employed or pay premiums out of pocket (not through an employer payroll deduction). Include them in your total medical expenses and explore the 7.5% threshold. Premiums paid by your employer or deducted from your paycheck before taxes do not count because they are already tax-advantaged.

What if my medical expenses are in one year but I did not itemize?

You can only deduct medical expenses in the year you paid them if you itemize that year. If you took the standard deduction, you cannot go back and deduct medical expenses from that year. However, you can amend your return (Form 1040-X) within three years if itemizing would have saved you money.

Do over-the-counter medications count?

Only if a doctor prescribed them. Aspirin, cold medicine, or allergy pills you buy on your own do not count. Prescription medications always count, even if you buy them over the counter without a prescription in some states.

Can I deduct mileage to medical appointments?

Yes. Use the IRS medical mileage rate (which changes yearly—check IRS.gov for the current rate) and multiply it by the number of miles you drove to doctor visits, hospitals, or other medical appointments. Keep a log of dates and mileage. You can deduct either mileage or actual expenses (gas, parking, tolls), but not both.

What if I paid medical expenses for my adult child?

You can deduct them only if your child qualifies as your dependent for that tax year. This usually means you provided more than half their financial support. If your child is independent and pays their own taxes, they would deduct their own medical expenses on their return, not you.