How to Deduct Medical Expenses on Your Tax Return

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

The IRS allows you to deduct unreimbursed medical and dental expenses, but only if two conditions are met: you must itemize deductions on your tax return instead of taking the standard deduction, and your total medical expenses must exceed 7.5% of your adjusted gross income (AGI). This means if your AGI is $60,000, you can only deduct medical expenses above $4,500. Most people do not meet this threshold, which is why few households claim medical deductions.

The 7.5% threshold applies to the 2024 tax year and has remained at this level since 2017. You calculate it by adding up all may have access to medical costs for the year, subtracting the threshold amount, and deducting only what remains. If your medical expenses fall short of the threshold, you cannot deduct any of them.

Key Takeaways

You must itemize deductions and have medical expenses exceeding 7.5% of your AGI to claim any deduction at all.
Deductible expenses include insurance premiums you pay yourself, copays, prescription drugs, dental work, vision care, and travel to medical appointments.
You cannot deduct cosmetic procedures, over-the-counter medications (except insulin), gym memberships, or health insurance premiums paid by your employer.
You report medical deductions on Schedule A (Form 1040) only if your total itemized deductions exceed the standard deduction for your filing status.

What medical expenses the IRS allows you to deduct

The IRS publishes a list of deductible medical expenses in Publication 502. The most common ones include health insurance premiums you pay out of pocket (not those deducted from your paycheck), copayments and coinsurance, prescription medications, dental and vision care, hearing aids and batteries, crutches and wheelchairs, and transportation to medical appointments. You can also deduct the cost of home modifications made for medical reasons—such as installing a wheelchair ramp or widening doorways—if the primary purpose is medical care.

Less obvious deductible expenses include fertility treatments, weight-loss programs prescribed by a doctor for a specific disease, psychiatric care, and certain long-term care insurance premiums (subject to age-based limits). If you pay for a service animal trained to information with a disability, that cost is deductible. You can also deduct mileage driven to medical appointments at the IRS standard mileage rate for medical travel, which changes yearly.

Expenses you cannot deduct

The IRS explicitly excludes certain health-related costs. You cannot deduct cosmetic procedures such as teeth whitening, facelifts, or hair removal unless they are medically necessary to correct a deformity. Over-the-counter medications are not deductible except for insulin, which remains deductible without a prescription. Health insurance premiums paid by your employer (even if deducted from your paycheck) do not count because they are pre-tax.

Gym memberships, general vitamins, and supplements are not deductible unless prescribed by a doctor for a specific medical condition. Toothpaste, mouthwash, and cosmetic dental work are excluded. If you travel to a warmer climate for your health, the travel costs themselves are not deductible, though any medical treatment you receive there is.

How to decide whether itemizing makes sense for you

Before calculating your medical deduction, compare itemizing to the standard deduction. For the 2024 tax year, the standard deduction is $14,600 for single filers, $21,900 for heads of household, and $29,200 for married filing jointly. If your total itemized deductions (medical expenses plus state and local taxes, mortgage interest, charitable donations, and other deductible items) do not exceed your standard deduction, you should take the standard deduction instead and forget the medical deduction.

Many people find that even with medical expenses, their itemized deductions fall short. For example, a single filer with $5,000 in medical expenses and $3,000 in charitable donations has $8,000 in itemized deductions—less than the $14,600 standard deduction. In that case, the standard deduction saves more tax. You should itemize only when your combined deductible expenses clearly exceed the standard deduction for your filing status.

How to calculate and report your medical deduction

Start by gathering receipts and statements for all medical expenses paid during the tax year. Add them up. Then multiply your AGI by 7.5% to find your threshold. Subtract the threshold from your total medical expenses. The result is your deductible amount—but only if it is a positive number. If your medical expenses are less than 7.5% of your AGI, you have no deduction.

Report your medical deduction on Schedule A (Form 1040), which is the itemized deductions form. Line 1 of Schedule A asks for medical and dental expenses. Enter your total medical expenses, then on line 2 enter the threshold amount (7.5% of your AGI), and line 3 shows your deductible amount. You then add Schedule A to your Form 1040 tax return. If you use tax software, it will walk you through this calculation and fill in the form automatically once you enter your medical expenses.

Keeping records and documentation

The IRS does not require you to attach receipts to your return, but you must keep them for at least three years in case of an audit. For each expense, save the receipt or statement showing the date, the provider's name, the service or item purchased, and the amount paid. If you use a credit card or bank statement as proof, that is acceptable as long as it shows the same details.

For mileage to medical appointments, keep a log with the date, destination, purpose, and miles driven. You do not need to save gas receipts—the IRS mileage rate covers fuel and wear and tear. If you claim a home modification, keep the contractor's invoice and any documentation showing the medical necessity. For insurance premiums, save your policy statements or premium notices showing what you paid out of pocket.

Special situations: Medicare, Medicaid, and employer plans

If you are on Medicare, you can deduct your Part B and Part D premiums if you pay them yourself. You can also deduct Medicare Advantage plan premiums and supplemental insurance premiums. Medicaid premiums are deductible if you pay them directly. However, if your state Medicaid program deducts premiums from your benefits, those are generally not deductible because they are not paid by you.

If your employer offers a flexible spending account (FSA) or health savings account (HSA), money you contribute to these accounts reduces your taxable income automatically—you do not need to itemize to get the tax benefit. Any medical expenses you pay from an FSA or HSA are already tax-free and cannot be deducted again on Schedule A. Deduct only out-of-pocket medical expenses that were not paid by insurance, an FSA, an HSA, or any other source.

Frequently Asked Questions

Can I deduct medical expenses for my spouse or children?

Yes, you can deduct medical expenses for yourself, your spouse, and any dependent you claim on your return. You can also deduct expenses for a parent or other relative if they meet the IRS definition of a dependent, even if they do not live with you. The expenses must have been paid during the tax year and not reimbursed by insurance.

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

Deduct the expense in the year you paid it, not when you were reimbursed. If you receive a reimbursement in a later year, you cannot deduct that expense. If the reimbursement comes in the same year, subtract it from your total medical expenses before calculating your deduction.

Can I deduct medical expenses paid with a credit card?

Yes. The deduction applies in the year you charged the expense, not when you paid the credit card bill. The IRS considers the charge date as the payment date. Keep your credit card statement and the itemized receipt from the provider as proof.

Does the 7.5% threshold change every year?

The 7.5% threshold has been in place since 2017 and applies to the 2024 tax year. Congress can change it, but it has remained stable for several years. Check the IRS website or your tax software each year to confirm the current threshold before filing.

What if my medical expenses are high but my income is also high?

The 7.5% threshold applies to everyone regardless of income level. A person earning $200,000 with $20,000 in medical expenses can deduct only the amount above $15,000 (7.5% of $200,000). High income does not lower the threshold, but it does mean you need proportionally higher medical expenses to exceed it.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.