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 may have access to medical and dental expenses on Schedule A (Itemized Deductions), but the deduction only works if two conditions are met: your total medical expenses must exceed 7.5% of your adjusted gross income (AGI) for the tax year, and you must choose to itemize deductions rather than claim the standard deduction. For most people, the standard deduction is larger, so medical deductions rarely save money unless you have unusually high expenses or other itemizable deductions that push you over the threshold.

The 7.5% threshold is the key barrier. If your AGI is $60,000 and your medical expenses are $3,000, you can only deduct the amount above $4,500 (7.5% of $60,000)—in this case, nothing. You would need medical expenses of at least $4,500 to deduct even $1. This rule applies to the tax year in which you paid the expenses, not the year you received treatment.

Key Takeaways

  • Medical expenses must exceed 7.5% of your adjusted gross income before you can deduct any amount, and you must itemize deductions on Schedule A to claim them.
  • may have access to expenses include insurance premiums, prescription drugs, dental work, vision care, therapy, hospital stays, and mileage to medical appointments, but not cosmetic procedures or over-the-counter drugs.
  • You can only deduct expenses you paid out of pocket; insurance reimbursements and amounts paid by others do not count.
  • Most taxpayers benefit more from the standard deduction than from itemizing, so medical deductions help only if you have other large deductible expenses like mortgage interest or charitable donations.

What counts as a deductible medical expense

The IRS publishes a detailed list of what qualifies. Deductible expenses include health insurance premiums (including Medicare premiums and long-term care insurance), prescription medications, dental and vision care, mental health therapy and counseling, hospital and surgical fees, medical equipment (wheelchairs, hearing aids, crutches), and mileage driven to medical appointments at the standard rate set by the IRS each year.

Expenses that do not may have access to include cosmetic surgery (unless it is reconstructive after an injury or illness), over-the-counter medications like aspirin or cold medicine, vitamins and supplements (unless prescribed by a doctor for a specific condition), gym memberships and fitness programs, and cosmetic dental work. If you are unsure whether a specific expense qualifies, the IRS website has a searchable list, or you can ask a tax professional.

If you paid for a family member's medical expenses and they are your dependent, those expenses count toward your deduction. However, if they are not your dependent or if they paid for their own care, you cannot include their expenses.

How to calculate your deductible amount

Start by adding up all may have access to medical expenses you paid during the tax year. Then calculate 7.5% of your adjusted gross income (AGI)—your AGI is on line 11 of Form 1040. Subtract that 7.5% figure from your total medical expenses. The result is the amount you can deduct, but only if it is greater than zero.

Example: Your AGI is $80,000. Your medical expenses total $8,500. Seven and a half percent of $80,000 is $6,000. You can deduct $8,500 minus $6,000, which equals $2,500. This $2,500 would be added to any other itemized deductions (charitable donations, mortgage interest, state and local taxes up to $10,000) on Schedule A.

If your total itemized deductions (including the medical deduction) are less than the standard deduction for your filing status, you will not benefit from itemizing. For 2024, the standard deduction is $14,600 for single filers and $29,200 for married filing jointly. If your itemized deductions total $12,000, you would claim the standard deduction instead and get no benefit from the medical expenses.

Keeping records and documentation

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 statements from doctors, dentists, hospitals, pharmacies, and insurance companies. If you claim mileage to medical appointments, keep a log with the date, destination, and miles driven.

If you received a reimbursement from insurance or an employer health plan, reduce your deduction by that amount. For example, if you paid $5,000 in dental work and your insurance reimbursed $2,000, you can only count $3,000 toward your deduction. Insurance statements usually show what was reimbursed, so check those carefully.

If you use a health savings account (HSA) or flexible spending account (FSA), expenses paid from those accounts cannot also be deducted on your tax return—you get the tax break when you contribute to the account, not again when you spend the money.

When itemizing makes sense for medical expenses

Itemizing becomes worthwhile when you have multiple large deductible expenses in the same year. A person with $6,000 in medical expenses, $8,000 in charitable donations, and $5,000 in state and local taxes would have $19,000 in itemized deductions—well above the standard deduction. In that case, the medical expenses help push the total over the threshold.

Some people deliberately bunch expenses into a single tax year to exceed the standard deduction. For example, if you are planning elective dental work or vision correction, scheduling it in a year when you also have other deductible expenses (or when your spouse has high medical costs) can make itemizing worthwhile. This strategy works only if you can control the timing of the expense.

Retirees and people with high out-of-pocket medical costs are more likely to benefit from medical deductions because their medical expenses are often substantial. If you are over 65, you may also be able to deduct Medicare premiums and supplemental insurance, which can add up quickly.

Self-employed and business owner considerations

If you are self-employed, you can deduct health insurance premiums (including Medicare premiums and long-term care insurance) directly on Form 1040, separate from itemized deductions. This is called the self-employed health insurance deduction and does not require you to itemize. You can claim this deduction even if you take the standard deduction.

Other medical expenses beyond insurance premiums still follow the 7.5% threshold rule and require itemizing. So a self-employed person might deduct their insurance premiums on Form 1040 and then itemize to deduct additional medical expenses if the total exceeds 7.5% of AGI.

If you have a business and pay for an employee's health insurance, those premiums are a business expense deducted on your business tax form, not on Schedule A. The rules differ depending on the business structure (sole proprietorship, S-corp, LLC), so consult a tax professional if you are unsure.

Frequently Asked Questions

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

No. Medical expenses can only be deducted if you itemize deductions on Schedule A. If your itemized deductions (including medical expenses) are less than the standard deduction for your filing status, you will claim the standard deduction instead and receive no benefit from the medical expenses.

What if my spouse has high medical expenses and we file jointly?

You combine both spouses' medical expenses and compare the total to 7.5% of your combined AGI. If the combined expenses exceed the threshold, you can deduct the amount over 7.5%. This often makes it easier to reach the threshold when filing jointly.

Can I deduct medical expenses paid in a previous year?

No. You can only deduct medical expenses in the tax year you paid them. If you paid a bill in December 2024, it goes on your 2024 return. If you paid it in January 2025, it goes on your 2025 return, even if the service was provided in 2024.

Does health insurance from my employer count toward the deduction?

Employer-paid health insurance premiums are not deductible because they are not paid by you. However, if you pay part of the premium through payroll deductions, that portion may be deductible if you itemize. Check your W-2 and pay stubs to see what you actually paid out of pocket.

What if I paid medical expenses for my adult child?

You can deduct those expenses only if your adult child is your dependent for tax purposes. If they are not claimed as your dependent, their medical expenses do not count, even if you paid for them. Your child would need to claim the expenses on their own return if they meet the threshold.