What a Medical Expense Deduction Is

A medical expense deduction lets you subtract certain healthcare costs from your taxable income if you itemize deductions on your tax return instead of taking the standard deduction. The IRS allows you to deduct medical and dental expenses that exceed a threshold — currently 7.5% of your adjusted gross income (AGI). If your AGI is $60,000 and your medical expenses total $6,000, you can deduct $1,500 (the amount over $4,500, which is 7.5% of $60,000).

This deduction covers a wide range of healthcare costs: doctor visits, hospital stays, prescription medications, dental work, vision care, hearing aids, and even some equipment like crutches or wheelchairs. It can also include health insurance premiums you pay yourself, long-term care insurance premiums (within limits), and mileage for trips to medical appointments. The key requirement is that the expenses must be for you, your spouse, or your dependents.

Key Takeaways

  • You can only deduct medical expenses that exceed 7.5% of your adjusted gross income, and only if you itemize deductions instead of taking the standard deduction.
  • Deductible expenses include doctor visits, hospital bills, prescription drugs, dental work, vision care, and some medical equipment and insurance premiums.
  • You must keep receipts, invoices, and proof of payment for every medical expense you claim, because the IRS may request documentation.
  • Expenses paid through a Health Savings Account (HSA) or Flexible Spending Account (FSA) cannot be deducted again on your tax return.
  • The threshold of 7.5% applies to all taxpayers regardless of age, though this percentage can change if Congress passes new tax legislation.

When Itemizing Makes Sense for Medical Expenses

Itemizing deductions is only worth doing if your total itemized deductions — medical expenses plus mortgage interest, state and local taxes, charitable donations, and other deductible items — exceed the standard deduction for your filing status. For 2024, the standard deduction is $14,600 for single filers and $29,200 for married filing jointly. If your itemized deductions fall short of that number, you will get a larger tax benefit by taking the standard deduction instead.

Medical expenses become more valuable as a deduction when you have a year with unusually high healthcare costs — a major surgery, extended hospital stay, or new chronic condition requiring ongoing treatment. Some people bunch medical procedures into a single tax year to push their expenses over the 7.5% threshold. For example, if you are considering elective dental work or vision correction, timing it in a year when you already have significant medical bills can make itemizing worthwhile.

What Counts as a Deductible Medical Expense

The IRS publishes a detailed list in Publication 502, but the general rule is that an expense must be for diagnosis, cure, mitigation, treatment, or prevention of disease, or for treatment affecting any part or function of the body. This includes obvious costs like hospital bills and doctor visits, but also less obvious ones: acupuncture, chiropractic care, fertility treatments, psychiatric care, and prescription eyeglasses all may have access to. Cosmetic surgery does not may have access to unless it is reconstructive — for example, surgery to repair a birth defect or injury.

Some expenses that surprise people are deductible: the cost of a wig for someone who lost hair due to illness, modifications to your home for accessibility (ramps, grab bars, widened doorways), and even the cost of a guide dog for someone with a disability. Nursing home care qualifies if the primary reason for being there is medical care. However, general health and wellness expenses — vitamins, gym memberships, weight loss programs — do not count unless they are prescribed by a doctor for a specific medical condition.

Insurance premiums you pay yourself are deductible, including health insurance, dental insurance, vision insurance, and long-term care insurance. However, there are limits on long-term care insurance: the deductible amount depends on your age and changes annually. Premiums paid through your employer's plan are usually not deductible because they are already excluded from your taxable income.

Expenses You Cannot Deduct

The IRS does not allow deductions for cosmetic procedures (unless reconstructive), over-the-counter medications (except insulin), general health products like vitamins and supplements, gym memberships, weight loss programs, or travel for general health reasons. You also cannot deduct expenses that were reimbursed by insurance or another source — if your insurance paid for a doctor visit, you cannot deduct it again.

Expenses paid through a Health Savings Account (HSA) or Flexible Spending Account (FSA) create a special rule: you cannot deduct those same expenses on your tax return. These accounts already give you a tax advantage by letting you set aside pre-tax dollars for medical costs, so the IRS does not allow a second deduction. Keep careful records of what you paid through these accounts so you do not accidentally claim them twice.

How to Document and Claim Medical Expenses

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. For each expense, save the receipt or invoice showing the date, the provider's name, the service or item provided, and the amount paid. If you paid by check or credit card, that payment record serves as proof. For large expenses like hospital stays, keep the itemized bill showing what services were provided and what you paid out of pocket.

When you file your return, you will report your total medical expenses on Schedule A (Itemized Deductions), which you attach to Form 1040. You list the total amount you spent on medical care, subtract 7.5% of your AGI, and enter the remainder as your deduction. You do not list individual expenses on the return itself — the IRS just needs the total. However, if you are audited, you will need to produce the documentation for every expense you claimed.

Frequently Asked Questions

Can I deduct medical expenses for my adult child if they are not my dependent?

No. You can only deduct medical expenses for yourself, your spouse, or someone you claim as a dependent on your tax return. If your adult child is not your dependent, their medical expenses are not deductible on your return, even if you paid for them.

What if I paid medical bills in one year but the service was provided in another year?

You deduct the expense in the year you paid it, not the year the service was provided. If you had surgery in December 2023 but did not pay the bill until January 2024, the deduction goes on your 2024 return.

Can I deduct the cost of prescription glasses or contact lenses?

Yes. Prescription eyeglasses, contact lenses, and the cost of eye exams to determine your prescription are all deductible. However, non-prescription sunglasses are not, even if they are recommended for eye health.

Does the 7.5% threshold change every year?

The 7.5% threshold has been in place since 2013 and applies to all taxpayers. Congress can change it, but it has remained stable. Check the IRS website or Publication 502 each year to confirm the current threshold before you file.

What if my spouse and I file separately — do we each get a 7.5% threshold?

Yes. If you file separately, each of you calculates your own 7.5% threshold based on your own AGI. However, filing separately usually results in a higher overall tax, so consult a tax professional before choosing this option.