Medical and dental costs you can deduct
You can deduct health expenses on your federal tax return, but only if you itemize deductions instead of taking the standard deduction, and only if your total medical expenses exceed 7.5% of your adjusted gross income (AGI). The IRS calls these may have access to medical expenses. They include doctor visits, hospital stays, prescription medications, dental work, vision care, and mental health treatment.
The 7.5% threshold is the key limit. If your AGI is $60,000, you can only deduct medical expenses above $4,500. This means most people with moderate medical costs will not reach the threshold. You add up all your may have access to expenses for the year, subtract 7.5% of your AGI, and deduct only what remains.
Expenses must be for diagnosis, cure, mitigation, treatment, or prevention of disease, or for treatment affecting any part or function of the body. Cosmetic procedures like teeth whitening or Botox do not count unless they are medically necessary (for example, reconstructive surgery after an accident). Gym memberships and general wellness programs do not count, even if your doctor recommends exercise.
Key Takeaways
- You can only deduct medical expenses if you itemize deductions and your total medical costs exceed 7.5% of your adjusted gross income for the year.
- Deductible expenses include doctor and hospital bills, prescription drugs, dental and vision care, mental health treatment, and medical equipment like wheelchairs or hearing aids.
- You cannot deduct cosmetic procedures, gym memberships, over-the-counter vitamins, or general wellness expenses unless they treat a specific diagnosed condition.
- You must keep receipts, invoices, and statements from providers and pharmacies to prove your expenses when you file.
What counts as a medical expense
Beyond the obvious doctor and hospital bills, the IRS allows deductions for a wide range of health-related costs. Prescription medications count, but over-the-counter drugs like aspirin or cold medicine do not—unless you have a prescription for them. Medical equipment such as wheelchairs, crutches, hearing aids, glasses, and contact lenses all may have access to. If you need a home modification for a medical reason—a wheelchair ramp, grab bars, or a stair lift—the cost of installation counts, though not the cost of the home itself.
Mental health treatment, including therapy and psychiatric care, is fully deductible. So are fertility treatments, including in vitro fertilization (IVF). If you travel for medical care that is not available locally, you can deduct the cost of transportation and lodging, though meals are not included. Nursing home care counts if the primary reason for admission is medical care, not just custodial or personal care.
Insurance premiums for health coverage can sometimes be deducted, but the rules depend on your situation. If you are self-employed, you may deduct health insurance premiums on your federal income tax return (not as an itemized deduction, but as an adjustment to income). If you are an employee, premiums you pay through payroll deduction are usually already pre-tax, so you cannot deduct them again. Medicare premiums and long-term care insurance premiums may be deductible if you meet income limits.
Expenses that do not may have access to
The IRS excludes many health-related costs. Cosmetic surgery does not count unless it directly treats an injury or disease. Teeth whitening, hair removal, and anti-wrinkle treatments are not deductible. Vitamins and supplements are generally not deductible, even if recommended by a doctor, because they are considered general health maintenance rather than treatment of a specific condition. The exception is if a supplement is prescribed by a doctor to treat a diagnosed deficiency or illness.
Expenses for general fitness do not may have access to. Gym memberships, yoga classes, swimming lessons, and sports equipment are not deductible, even if your doctor recommends exercise. However, if you need physical therapy for an injury or condition, that is deductible. Maternity clothes, diapers, and childcare are not medical expenses. Toothpaste and mouthwash are not deductible, though dental work is.
Cosmetic dentistry like teeth whitening or veneers does not count. However, orthodontia (braces) does count because it treats a medical condition of the teeth and jaw. If you are unsure whether an expense qualifies, the IRS publication 502 (Medical and Dental Expenses) lists hundreds of specific items and provides the clearest guidance.
How to track and document your expenses
Keep every receipt, invoice, and statement from doctors, dentists, hospitals, pharmacies, and medical suppliers. The IRS does not require you to submit these documents with your tax return, but you must have them if the IRS asks. Take photos of receipts if they fade over time. For ongoing treatments or prescriptions, ask your pharmacy or provider for an annual summary statement showing all charges for the year.
Create a straightforward spreadsheet or folder organized by month or by provider. Include the date, the provider's name, the type of expense, and the amount paid. If you paid out of pocket, note that. If insurance reimbursed you, note the reimbursement amount—you can only deduct the portion you actually paid. For travel to medical care, keep receipts for gas, airfare, hotel, and parking, and note the medical reason for the trip.
If you use a health savings account (HSA) or flexible spending account (FSA), those contributions reduce your taxable income automatically, so you do not need to itemize to benefit from them. However, if you have medical expenses beyond what those accounts cover, you can still itemize and deduct the additional costs if they exceed the 7.5% threshold.
When itemizing makes sense versus the standard deduction
The standard deduction for 2024 is $14,600 for single filers and $29,200 for married filing jointly (these amounts change each year). You can only deduct medical expenses if your total itemized deductions—medical expenses plus state and local taxes, mortgage interest, charitable donations, and other allowable deductions—exceed the standard deduction. For most people, the standard deduction is larger, so itemizing does not help.
You should itemize only if your total itemized deductions are higher than the standard deduction. If you have high medical expenses in a single year, that year might be the one where itemizing pays off. Some people bunch deductible expenses into one year to cross the threshold—for example, scheduling elective dental work or vision care in the same year as a major medical event.
A tax professional can help you calculate whether itemizing is worth it in your situation. The difference between the standard deduction and your itemized deductions is real money, so it is worth checking before you file.
Medical expenses for dependents and family members
You can deduct medical expenses you pay for your spouse and your dependents, even if they do not live with you. The person must be your dependent for tax purposes, which usually means you provide more than half their financial support for the year. If you pay for your adult child's medical care and they meet the dependency test, those expenses count toward your deduction.
If you are divorced or separated and pay medical expenses for your ex-spouse or former dependent, the rules are strict. Generally, you can only deduct expenses for someone who was your dependent for at least part of the year. Custody arrangements and support agreements affect this, so check with a tax professional if your situation is complex.
Frequently Asked Questions
Can I deduct my health insurance premiums?
If you are an employee, your premiums paid through payroll are usually already pre-tax, so you cannot deduct them again. If you are self-employed, you can deduct health insurance premiums as an adjustment to income (not as an itemized deduction). Medicare premiums may be deductible if your income is below certain limits. Check IRS publication 502 for your specific situation.
What if my insurance reimbursed me for some of my medical expenses?
You can only deduct the amount you actually paid out of pocket. If insurance covered part of the bill, subtract the reimbursement from the total cost before counting it toward your deduction. For example, if a surgery cost $5,000 and insurance paid $3,000, you can only count the $2,000 you paid.
Do I need to report my medical expenses to the IRS even if I do not itemize?
No. If you take the standard deduction, you do not report medical expenses on your return. You only report them if you itemize deductions. However, keep your receipts for your records in case the IRS asks questions about your return.
Can I deduct over-the-counter medications like pain relievers or cold medicine?
Generally, no. Over-the-counter drugs are not deductible unless you have a prescription for them. If your doctor prescribes ibuprofen or another OTC medication, you can deduct it. Vitamins and supplements are also not deductible unless prescribed to treat a specific diagnosed deficiency.
What if I had a very expensive medical year—can I deduct all of it?
You can deduct the amount that exceeds 7.5% of your AGI, but only if you itemize deductions and your total itemized deductions exceed the standard deduction. If your AGI is $80,000, the first $6,000 of medical expenses does not count. Only expenses above that threshold are deductible, and only if itemizing makes sense for your overall tax situation.