You can only deduct medical expenses that exceed 7.5% of your adjusted gross income

The IRS allows you to deduct medical and dental expenses, but only the amount that goes above 7.5% of your adjusted gross income (AGI). This is called the medical expense threshold. If your AGI is $60,000, for example, you can only deduct medical expenses above $4,500 (7.5% of $60,000). Any expenses below that threshold cannot be deducted.

You must also itemize deductions on your tax return to claim medical expenses. Most people take the standard deduction instead, which is a flat amount the IRS sets each year. For 2024, the standard deduction is $14,600 for single filers and $29,200 for married couples filing jointly. If your medical expenses plus other itemized deductions (like mortgage interest or charitable donations) add up to more than the standard deduction, itemizing will save you more money.

The 7.5% threshold applies to the tax year you file for. You cannot carry medical expenses forward to a future year or back to a previous year.

Key Takeaways

  • Only medical expenses above 7.5% of your AGI can be deducted, and you must itemize deductions to claim them.
  • Common deductible expenses include doctor visits, prescription medications, dental work, vision care, and health insurance premiums you paid yourself.
  • You cannot deduct cosmetic procedures, over-the-counter medications, or expenses reimbursed by insurance or a health savings account.
  • You need receipts, invoices, and proof of payment for every expense you claim, and the IRS may ask to see them.
  • If your medical expenses fall short of the 7.5% threshold, taking the standard deduction will usually save you more money than itemizing.

What counts as a deductible medical expense

The IRS has a broad definition of medical care: any expense for diagnosis, cure, mitigation, treatment, or prevention of disease, or for any purpose affecting any part of your body structure or function. This includes doctor and dentist visits, hospital stays, prescription medications, and medical equipment.

Specific expenses you can deduct include: prescription drugs and insulin, dental work (fillings, crowns, root canals, orthodontia), vision care (glasses, contacts, eye surgery), hearing aids and batteries, crutches and wheelchairs, home modifications for disability access (ramps, grab bars, widened doorways), therapy (physical, occupational, speech), psychiatric and psychological treatment, and health insurance premiums you paid out of pocket (such as COBRA or a plan you bought yourself).

You can also deduct the cost of travel to receive medical care: mileage to doctor appointments, parking fees, tolls, and lodging if you must travel overnight for treatment. For mileage, you can either deduct the actual cost of gas and oil or use the IRS standard mileage rate, which changes each year.

What you cannot deduct

Cosmetic procedures are never deductible unless they are medically necessary to treat an injury or disease. Teeth whitening, facelifts, hair removal, and similar procedures do not count. Over-the-counter medications and supplements are not deductible, with one exception: insulin purchased without a prescription is deductible.

You cannot deduct any expense that was reimbursed by insurance, an employer health plan, a health savings account (HSA), a flexible spending account (FSA), or any other source. If you received a reimbursement after you filed your return, you must file an amended return to remove that expense.

General health expenses that are not medical care do not count: gym memberships, weight loss programs (unless prescribed by a doctor for a specific condition), vitamins and general supplements, and cosmetic dental work like whitening. Maternity clothes, baby food, and diaper services are also not deductible.

How to calculate your deductible amount

Start by finding your AGI from your tax return. Multiply your AGI by 0.075 (7.5%). This is your threshold. Add up all your medical expenses for the year. Subtract the threshold from your total expenses. The result is the amount you can deduct.

Here is a worked 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.

Keep a spreadsheet or list as you go through the year. Write down the date, the provider or pharmacy name, what the expense was for, and the amount paid. This makes the calculation easier when you file and gives you a record if the IRS asks questions.

Documentation you need to keep

The IRS does not require you to attach receipts to your return, but you must keep them in case of an audit. For each expense, save the receipt or invoice showing the date, the provider's name, what was provided or prescribed, and the amount you paid. If you paid by check or credit card, that payment record counts as proof.

For prescriptions, keep the pharmacy receipt showing the drug name, the date filled, and the price. For doctor and dentist visits, keep the invoice or statement from the provider. For medical equipment or supplies, keep the receipt and any documentation showing the item was medically necessary.

If you paid for someone else's medical care (a spouse, child, or dependent parent), you can include those expenses in your deduction. Keep documentation showing the relationship and that you paid the bill.

When itemizing makes sense versus taking the standard deduction

Itemizing is worth doing only if your total itemized deductions exceed the standard deduction for your filing status. Add up your medical expenses (the deductible portion after the 7.5% threshold), mortgage interest, property taxes, charitable donations, and any other deductible expenses. If that total is higher than the standard deduction, itemize. If not, take the standard deduction.

For 2024, the standard deduction is $14,600 for single filers, $29,200 for married filing jointly, $21,900 for head of household, and $14,600 for married filing separately. These amounts change each year. If you are over 65 or blind, you get an additional standard deduction.

Many people find that their medical expenses alone do not reach the threshold to make itemizing worthwhile. Combining medical expenses with other deductions (like charitable giving or mortgage interest) can push you over the standard deduction limit.

Special situations: HSAs, FSAs, and insurance reimbursements

If you have a health savings account (HSA) or flexible spending account (FSA), you cannot deduct expenses you paid from those accounts. The money in these accounts is already tax-free, so deducting it again would be double-dipping. The same rule applies to any expense covered by insurance or reimbursed by your employer.

If you paid a medical expense out of pocket and later received a reimbursement, you must remove that expense from your deduction. If you already filed your return, file Form 1040-X (Amended U.S. Individual Income Tax Return) to correct it.

Long-term care insurance premiums have special rules. You can deduct a portion of the premium based on your age, but not the full amount. The IRS publishes the deductible amounts each year.

Frequently Asked Questions

Can I deduct medical expenses for my adult child?

Only if you claim them as a dependent on your tax return. Your child must live with you for the entire year, be a U.S. citizen or resident alien, and meet income limits. If they meet these requirements, you can deduct their medical expenses as part of your itemized deductions.

What if I had a major surgery or hospital stay that pushed my expenses way over the threshold?

You deduct the full amount above the 7.5% threshold in the year you paid it. If you paid $50,000 in medical expenses and your threshold is $6,000, you deduct $44,000. You cannot split the deduction across multiple years.

Do I need to report the names and addresses of doctors and hospitals I paid?

No. You only need to report the total amount of deductible medical expenses on Schedule A. The IRS does not require you to list individual providers on your return, but keep your receipts in case of an audit.

Can I deduct the cost of a medical procedure done in another country?

Yes, if it is a legitimate medical procedure. Dental work, surgery, and other treatments performed abroad count the same way as treatment in the United States. Keep receipts showing the provider's name, the date, what was done, and the amount paid in U.S. dollars.

What happens if I deduct medical expenses and then get reimbursed later?

You must file an amended return (Form 1040-X) to remove the reimbursed amount from your deduction. File it in the same tax year you received the reimbursement. If you do not correct it, the IRS may assess additional tax and penalties.