Medical expenses you can deduct
You can deduct medical and dental expenses that exceed 7.5% of your adjusted gross income (AGI) for the tax year. This means if your AGI is $60,000, you can only deduct medical costs above $4,500. The IRS allows deductions for expenses you paid for yourself, your spouse, and dependents — but only if you itemize deductions on Schedule A instead of taking the standard deduction.
The list of deductible expenses is long and includes things most people don't realize count: prescription medications, insulin, hearing aids, glasses and contact lenses, dental work, therapy sessions, and even some over-the-counter items if prescribed by a doctor. Transportation to medical appointments, lodging for treatment out of state, and home modifications for disability access also may have access to. What doesn't count is cosmetic surgery (unless it's reconstructive after injury or illness), general health club memberships, or over-the-counter drugs you buy without a prescription.
Key Takeaways
- You must itemize deductions and your medical expenses must exceed 7.5% of your adjusted gross income before you can deduct any amount.
- Deductible expenses include prescription drugs, dental and vision care, therapy, medical equipment, and transportation to treatment.
- Over-the-counter medications are only deductible if a doctor prescribes them specifically for you.
- Cosmetic procedures, gym memberships, and general wellness products do not count as medical deductions.
- You can deduct expenses for yourself, your spouse, and anyone you claim as a dependent on your return.
Prescription medications and over-the-counter drugs
Prescription medications are always deductible. This includes insulin, blood pressure medication, antibiotics, and any other drug a doctor prescribes. Over-the-counter medications are deductible only if a doctor writes a prescription for them — meaning the doctor specifically directs you to take that exact product for a medical condition.
Aspirin you buy on your own for a headache does not count. But if your doctor prescribes aspirin as part of heart disease treatment, it does. The same rule applies to allergy medicine, cold medicine, pain relievers, and antacids. The prescription itself is the key — the fact that the medication is available without one doesn't matter if your doctor has written one for you.
Dental, vision, and hearing care
Dental expenses are fully deductible, including cleanings, fillings, root canals, crowns, orthodontia, and tooth extractions. Dentures and dental implants count. Cosmetic dental work like teeth whitening does not, unless it's part of a larger procedure that serves a medical purpose.
Vision care includes eye exams, glasses, contact lenses, and the solution you use to clean them. Laser eye surgery (LASIK) is deductible. Hearing aids and the cost of fitting them are deductible. Repairs and replacement batteries for hearing aids also count. Cochlear implants and related surgery are deductible as well.
Mental health and therapy services
Therapy, counseling, and psychiatric care are deductible medical expenses. This includes sessions with a licensed therapist, psychologist, or psychiatrist, whether in person or by video. Medication prescribed by a psychiatrist is deductible as a prescription drug. The cost of inpatient mental health treatment and rehabilitation programs also qualifies.
Support group fees may be deductible if the group is run by a medical professional or hospital and treats a specific medical condition. General life coaching, meditation apps, or wellness retreats are not deductible, even if they improve your mental state.
Medical equipment, supplies, and home modifications
Medical equipment and supplies you need for a diagnosed condition are deductible. This includes crutches, wheelchairs, walkers, canes, blood glucose monitors, testing strips, bandages, and braces. Oxygen equipment and supplies are deductible. Wigs required because of hair loss from medical treatment count. Elastic stockings for circulation problems are deductible.
Home modifications made for medical reasons are deductible, but only the cost of the modification itself, not the increase in home value. If you install a wheelchair ramp, the ramp cost is deductible. If you widen doorways for wheelchair access, that cost is deductible. If you add a bathroom on the first floor because you cannot use stairs, the bathroom addition is deductible. However, if the modification also increases your home's value (like a new bathroom that any buyer would want), you can only deduct the excess of the cost over the increase in value.
Transportation and lodging for medical treatment
The cost of traveling to medical treatment is deductible. This includes mileage to doctor appointments, dental visits, therapy sessions, and hospital stays. For 2024, the standard mileage rate for medical travel is 21 cents per mile (rates change yearly, so check the IRS website for the current year). You can deduct actual expenses instead of mileage if you prefer — gas, tolls, and parking all count.
If you travel out of state for medical treatment, lodging is deductible, but only the room cost, not meals. Airfare or train tickets to reach a medical facility are deductible. A companion's travel expenses are not deductible, even if the companion is necessary to help you travel. However, if a nurse or medical attendant travels with you as part of your treatment, their expenses may be deductible.
What does not count as a medical deduction
Cosmetic surgery is not deductible unless it's reconstructive — meaning it repairs damage from injury, illness, or birth defect. A facelift, liposuction, or teeth whitening for appearance alone does not count. Gym memberships and fitness classes are not deductible, even if your doctor recommends exercise. General health and wellness products like vitamins, supplements, and herbal remedies are not deductible unless a doctor prescribes them for a specific medical condition.
Maternity clothes, baby formula, and childcare are not medical deductions. Cosmetic dentistry like veneers or bonding for appearance is not deductible. Weight loss programs and diet foods are not deductible unless prescribed by a doctor for a specific condition like obesity-related diabetes. Sunscreen and insect repellent are not deductible. Long-term care insurance premiums have their own rules and are not treated as regular medical deductions.
How to track and document medical expenses
Keep receipts and invoices for all medical expenses you plan to deduct. The IRS does not require you to submit receipts with your tax return, but you must have them if the IRS asks. For mileage, keep a log showing the date, destination, and medical purpose of each trip. For prescriptions, keep the pharmacy receipt showing the medication name and that it was prescribed.
If you use a health savings account (HSA) or flexible spending account (FSA), expenses you pay from these accounts cannot also be deducted on your tax return — you get the tax benefit through the account itself. Track which expenses came from these accounts separately so you don't double-count them. For home modifications, keep the contractor's invoice and receipts showing what was done and why it was medically necessary.
Frequently Asked Questions
Can I deduct health insurance premiums?
If you're self-employed, you can deduct health insurance premiums as a business expense, not as a medical deduction. If you're an employee, premiums paid through payroll are already pre-tax and cannot be deducted again. Premiums you pay out of pocket for coverage are not deductible as medical expenses.
What if my doctor recommends a supplement or vitamin?
A doctor's recommendation alone is not enough. The supplement must be prescribed specifically for you to treat a diagnosed medical condition. A general recommendation to take vitamin D for health is not deductible. A prescription for vitamin D because you have a deficiency is deductible.
Can I deduct the cost of a service dog?
Yes, the cost of a service dog trained to perform tasks for a disability is deductible as a medical expense. This includes the purchase price and training. Ongoing care costs like food and veterinary bills are not deductible, because they would be expenses even if the dog were not a service animal.
Do I have to itemize to deduct medical expenses?
Yes. You can only deduct medical expenses if you itemize deductions on Schedule A. If you take the standard deduction, you cannot deduct medical expenses. For 2024, the standard deduction is $14,600 for single filers and $29,200 for married filing jointly, so itemizing only makes sense if your total itemized deductions exceed these amounts.
Can I deduct expenses for an adult child I don't claim as a dependent?
No. You can only deduct medical expenses for yourself, your spouse, and people you claim as dependents on your return. If your adult child is not your dependent, their medical expenses are not deductible on your return, even if you paid for them.