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

The IRS allows you to deduct unreimbursed medical and dental expenses on Schedule A (Itemized Deductions), but with a significant catch: your total medical expenses must exceed 7.5% of your adjusted gross income (AGI) before you can deduct any of them. For example, if your AGI is $60,000, you can only deduct medical expenses above $4,500. This means most people cannot benefit from this deduction because the standard deduction is usually larger.

You must also choose to itemize deductions rather than take the standard deduction. The standard deduction for 2024 is $14,600 for single filers and $29,200 for married filing jointly. If your itemized deductions (medical expenses plus mortgage interest, state and local taxes, charitable donations, and other may be able to access items) do not exceed your standard deduction, itemizing will not help you.

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 $14,600 (single) or $29,200 (married filing jointly) in 2024.
  • may be able to access expenses include doctor visits, prescriptions, dental work, vision care, hearing aids, and some travel costs to receive medical care.
  • Health insurance premiums you pay yourself are deductible, but premiums paid by your employer or through a pre-tax payroll deduction are not.
  • Over-the-counter medications are not deductible unless prescribed by a doctor, and cosmetic procedures do not count.

What medical expenses the IRS allows you to deduct

The IRS has a broad definition of deductible medical expenses. may be able to access costs include doctor and dentist visits, 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 and glucose meters, as well as premiums for health insurance you pay yourself (not insurance paid by your employer).

Mental health treatment, including therapy and psychiatric care, is deductible. So are costs for addiction treatment programs, including inpatient rehabilitation. You can deduct travel expenses to receive medical care — mileage to doctor appointments, airfare for treatment at a specialized clinic, or lodging near a hospital — but only the portion directly tied to the medical purpose.

Over-the-counter medications like aspirin, cold medicine, and antacids are not deductible unless a doctor prescribes them specifically. Cosmetic procedures such as teeth whitening, facelifts, or hair removal are not deductible, even if a doctor performs them. Gym memberships and general wellness programs do not count, even if recommended by your doctor for health reasons.

How to calculate the 7.5% threshold

The threshold is straightforward math, but it eliminates most filers. Take 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.

Example: Your AGI is $80,000. Your threshold is $80,000 × 0.075 = $6,000. Your medical expenses for the year total $9,500. You can deduct $9,500 − $6,000 = $3,500. If your other itemized deductions (mortgage interest, state taxes, charitable donations) total $8,000, your total itemized deductions are $11,000. Since $11,000 exceeds the standard deduction of $14,600 for single filers in 2024, you would still take the standard deduction instead.

The threshold changes each year because it is tied to your AGI, not to inflation. A higher income in one year means a higher threshold, which can make the deduction harder to reach.

When itemizing makes sense versus the standard deduction

Itemizing is worth doing only when your total itemized deductions exceed the standard deduction. In 2024, that means $14,600 for single filers, $29,200 for married filing jointly, and $21,900 for head of household. If you are close to that number, adding medical expenses might push you over the edge.

Married couples with high mortgage interest, significant state and local taxes, and substantial charitable donations are more likely to itemize. Single filers with modest incomes rarely benefit from itemizing unless they have large medical expenses in a single year. If you are on the fence, calculate both scenarios: add up all your itemized deductions (medical expenses above the threshold, mortgage interest, state and local taxes up to $10,000, charitable donations) and compare the total to the standard deduction.

Some people benefit from "bunching" deductions into one year. If you know you will have a large medical expense or can time a charitable donation, concentrating deductions into a single tax year may allow you to itemize that year and take the standard deduction in other years.

Health savings accounts and flexible spending accounts offer better tax breaks

If your employer offers a Health Savings Account (HSA) or Flexible Spending Account (FSA), these usually provide a larger tax benefit than itemizing medical deductions. Money you contribute to an HSA or FSA comes out of your paycheck before taxes, which reduces your taxable income directly. You then use that money to pay for may be able to access medical expenses tax-free.

An HSA is available only if you are enrolled in a high-deductible health plan (HDHP). For 2024, you can contribute up to $4,150 for individual coverage or $8,300 for family coverage. An FSA is more flexible in terms of what health plan you have, but you can contribute only up to $3,200 per year, and you must use the money by the end of the year or lose it (with a limited carryover in some plans).

These accounts are superior to the medical deduction because they reduce your income before the 7.5% threshold is calculated, and they do not require you to itemize. If you have access to either account, maximizing contributions should be your first step before considering the medical deduction.

Self-employed health insurance deduction

If you are self-employed, you can deduct health insurance premiums you pay for yourself and your family as a business expense on Schedule C, not as an itemized deduction. This deduction is taken before calculating your AGI, which makes it more valuable than the medical expense deduction. You can deduct premiums for health, dental, and vision insurance, as well as long-term care insurance.

You cannot deduct more than your net self-employment income, and you cannot use this deduction if you are may be able to access for health insurance through your spouse's employer. This deduction is separate from the medical expense deduction and does not require itemizing.

What records you need to keep

The IRS does not require you to attach receipts to your tax return, but you must keep them for your records in case of an audit. Save receipts, invoices, and explanation of benefits (EOB) statements from your insurance company. For mileage to medical appointments, keep a log with dates, destinations, and miles driven, or use the IRS mileage rate (21 cents per mile for 2024, though this may change).

If you paid for medical care in a previous year but were reimbursed in the current year, you cannot deduct the reimbursed amount. If you received a reimbursement in the same year you paid, reduce your deduction by the reimbursement amount. Keep records of any reimbursements from insurance, employers, or other sources.

Frequently Asked Questions

Can I deduct health insurance premiums I pay through my employer?

No. Premiums deducted from your paycheck before taxes are already excluded from your income, so you cannot deduct them again. Only premiums you pay out of pocket after taxes can be deducted, and only if you itemize and exceed the 7.5% threshold.

What if I had a really expensive medical year — can I deduct all of it?

Only the amount above 7.5% of your AGI. If you spent $20,000 on medical care and your AGI is $60,000, your threshold is $4,500, so you can deduct $15,500. You still must itemize, and your total itemized deductions must exceed the standard deduction.

Are prescription glasses and contacts deductible?

Yes. Eyeglasses, contact lenses, and the cost of eye exams are all deductible medical expenses, as long as they exceed the 7.5% threshold and you itemize.

Can I deduct cosmetic dental work like teeth whitening?

Teeth whitening is not deductible because it is cosmetic. However, dental work that treats a medical condition — such as a root canal, filling, or crown — is deductible. Orthodontics (braces) is also deductible because it corrects a medical condition, not just appearance.

What if I paid medical bills in one year but my insurance reimbursed me in a different year?

Deduct the expense in the year you paid it, then reduce your deduction in the year you received the reimbursement by the amount reimbursed. If the reimbursement comes in the same year as the expense, subtract it from the total before calculating whether you exceed the threshold.