Medical deductions let you subtract certain healthcare costs from your taxable income, but only if those costs exceed a threshold set by the IRS each year

The medical expense deduction works like this: you add up what you paid out of pocket for medical care during the tax year, then subtract a percentage of your adjusted gross income (AGI). Only the amount above that threshold can reduce your taxable income. For the 2024 tax year, the threshold is 7.5 percent of your AGI — meaning if your AGI is $60,000, you can only deduct medical expenses above $4,500.

This deduction is available only if you itemize deductions on your tax return instead of taking the standard deduction. Most people take the standard deduction because it is larger, which means most people cannot use the medical deduction. You need to do the math both ways to see which saves you more in taxes.

Key Takeaways

  • You can only deduct medical expenses that exceed 7.5 percent of your adjusted gross income in 2024, and only if you itemize deductions instead of taking the standard deduction.
  • Deductible expenses include insurance premiums you pay yourself, out-of-pocket costs like copays and deductibles, prescription drugs, and certain medical equipment and home modifications.
  • You cannot deduct health insurance premiums paid by your employer, cosmetic procedures, or general wellness expenses like gym memberships.
  • You report medical deductions on Schedule A (Form 1040) if you itemize, and you must keep receipts and records for every expense you claim.

What counts as a deductible medical expense

The IRS allows you to deduct costs you paid directly for diagnosis, cure, mitigation, treatment, or prevention of disease. This includes insurance premiums you pay out of your own pocket — such as health insurance for self-employed people, Medicare premiums, or long-term care insurance — as well as the actual medical care itself.

Deductible expenses include copays, coinsurance, deductibles you paid to meet your insurance plan's requirements, prescription medications, and over-the-counter drugs (but only if prescribed by a doctor). You can also deduct costs for medical equipment like crutches, wheelchairs, hearing aids, and eyeglasses. Certain home modifications made specifically for medical reasons — such as installing a wheelchair ramp or widening doorways for accessibility — may be deductible, though only the portion that exceeds the increase in your home's value.

Travel costs to receive medical care can be deducted too. You can claim mileage to and from doctor visits, hospitals, or treatment centers, or actual transportation costs like airfare and lodging if you must travel for specialized treatment.

What does not count as a deductible medical expense

The IRS excludes expenses that are not directly tied to treating or preventing a diagnosed medical condition. Cosmetic procedures — including teeth whitening, hair removal, or plastic surgery done for appearance rather than medical necessity — are not deductible. General wellness expenses like gym memberships, vitamins, and weight-loss programs are also off-limits, even if your doctor recommends them.

You cannot deduct health insurance premiums paid by your employer, because those are paid with pre-tax dollars and already reduce your taxable income. If your employer offers a flexible spending account (FSA) or health savings account (HSA), money you set aside there is also pre-tax, so you cannot deduct those expenses again on your tax return.

Dental work and vision care are deductible, but only the actual treatment costs — not cosmetic improvements. Fertility treatments and adoption-related medical expenses are deductible, but surrogacy costs are not.

When itemizing makes sense for medical deductions

To use the medical deduction, you must itemize deductions on Schedule A instead of claiming the standard deduction. For 2024, the standard deduction is $14,600 for single filers and $29,200 for married couples filing jointly. If your total itemized deductions — medical expenses plus mortgage interest, state and local taxes, charitable donations, and other may be able to access items — exceed the standard deduction, itemizing saves you money.

Example: You are married filing jointly with an AGI of $100,000 and paid $12,000 in medical expenses. Your threshold is 7.5 percent of $100,000, which is $7,500. You can deduct $12,000 minus $7,500 = $4,500 in medical expenses. If your other itemized deductions (mortgage interest, property taxes, charitable gifts) total $20,000, your total itemized deductions are $24,500 — more than the $29,200 standard deduction. In this case, you would take the standard deduction instead, and the medical deduction does not help you.

If the same couple had $35,000 in other itemized deductions, the total would be $39,500, which exceeds the standard deduction of $29,200 by $10,300. Now itemizing makes sense, and the medical deduction is part of that benefit.

How to report medical deductions on your tax return

If you decide to itemize, you report medical expenses on Schedule A (Form 1040), which is part of your federal tax return. List your total medical and dental expenses paid during the tax year, then subtract 7.5 percent of your AGI. The result goes on the line for medical and dental expenses.

You do not send receipts to the IRS with your return, but you must keep them for your records in case of an audit. Save receipts, invoices, insurance statements showing what you paid out of pocket, mileage logs for medical travel, and any documentation of home modifications. The IRS can ask for these records for up to three years after you file.

If you use tax software, it will walk you through the itemization process and calculate the threshold for you. If you work with a tax professional, bring a list of all medical expenses paid during the year, organized by category.

Medical expenses paid in different years

You can only deduct medical expenses paid during the tax year you are filing for. If you paid a bill in December 2024 for a procedure done in 2024, you deduct it on your 2024 return. If you paid that same bill in January 2025, it goes on your 2025 return, even though the care happened in 2024.

This timing rule matters if you are on the edge of the 7.5 percent threshold. Some people deliberately pay medical bills in a year when they expect higher expenses, to push past the threshold and make itemizing worthwhile. For example, if you know you will have major dental work or surgery in a specific year, you might pay outstanding medical bills from the previous year in that same year to combine them and exceed the threshold.

Special situations: HSAs, FSAs, and insurance reimbursements

If you contribute to a health savings account (HSA) or flexible spending account (FSA), those contributions are made with pre-tax dollars, which means you already get a tax break. You cannot deduct those same expenses again on your tax return. However, if you withdraw money from an HSA or FSA and use it for non-medical expenses, that withdrawal is taxable income.

If your insurance company reimburses you for a medical expense, you cannot deduct that expense. You can only deduct the amount you actually paid out of pocket. If you received reimbursement in a different year than you paid the expense, the timing of the reimbursement does not change when you deduct it — you deduct it in the year you paid it, and you report the reimbursement as income in the year you received it.

Frequently Asked Questions

Can I deduct medical expenses for my spouse or children?

Yes, if they are your dependents or spouse, you can deduct their medical expenses on your return. You do not have to be the one who paid the bill — if you paid medical costs for a dependent family member, those expenses count toward your deduction threshold.

What if I did not reach the 7.5 percent threshold this year?

You cannot deduct any medical expenses if your total is below the threshold. You cannot carry unused medical expenses forward to next year. However, if you expect high medical costs next year, you might time elective procedures or pay outstanding bills in that year instead.

Does the medical deduction threshold ever change?

The IRS sets the threshold each year. It has been 7.5 percent since 2013, but Congress can change it. Check the IRS website or your tax software each year to confirm the current threshold for the year you are filing.

Can I deduct the cost of my pet's medical care?

No. The IRS only allows deductions for medical care for you and your dependents. Veterinary expenses are not deductible, even if the pet is a service animal — though service animals may may have access to for other tax benefits depending on your situation.

What if I am self-employed and pay my own health insurance?

Self-employed people can deduct health insurance premiums as a business expense on Schedule C, separate from the medical deduction. This is usually a better deal because it reduces your self-employment income before the 7.5 percent threshold applies. Do not claim the same premiums twice.