Medical expenses are deductible only if they exceed a threshold, and only if you itemize

You can deduct medical and dental costs on your federal tax return, but only under two conditions: your total medical expenses for the year must exceed 7.5% of your adjusted gross income (AGI), and you must choose to itemize deductions instead of taking the standard deduction. If your medical costs don't clear that 7.5% threshold, you get no deduction at all. If itemizing doesn't give you a bigger deduction than the standard deduction for your filing status, you won't benefit from listing medical costs separately.

The 7.5% threshold is the barrier most people hit. For someone with an AGI of $60,000, that means medical expenses must total at least $4,500 before any of them become deductible. For someone with an AGI of $100,000, the threshold is $7,500. Only the amount above the threshold counts.

Key Takeaways

  • Medical expenses are deductible only when they total more than 7.5% of your adjusted gross income, and only if you itemize deductions on Schedule A.
  • Deductible costs include insurance premiums you pay yourself, out-of-pocket medical and dental care, prescription drugs, and equipment like wheelchairs or hearing aids.
  • You cannot deduct health insurance premiums paid by your employer, cosmetic procedures, or over-the-counter medications without a prescription.
  • If your medical expenses are close to the threshold, bunching costs into a single tax year by delaying or accelerating procedures may push you over the limit.
  • The IRS Form 1040 Schedule A is where you report medical expenses; keep receipts and invoices for at least three years.

What counts as a deductible medical expense

The IRS allows you to deduct costs paid for diagnosis, cure, mitigation, treatment, or prevention of disease, or for treatment affecting any part or function of the body. That includes doctor visits, hospital stays, surgery, prescription medications, and mental health treatment. Dental work—fillings, root canals, cleanings, orthodontia—is deductible. Vision care, including eye exams, glasses, and contact lenses, counts. So do hearing aids and their repairs.

Insurance premiums you pay out of your own pocket are deductible: health insurance, dental insurance, vision insurance, and long-term care insurance. If you're self-employed, you can deduct health insurance premiums as a business expense on Schedule C instead of itemizing, which is often more valuable. Medical equipment and supplies—crutches, wheelchairs, blood glucose monitors, nebulizers—are deductible if prescribed by a doctor. Transportation to medical appointments, including mileage at the IRS rate (which changes yearly) or actual taxi and bus fares, counts.

Nursing home care is deductible if the primary reason for being there is medical care. Home modifications made for medical reasons—a wheelchair ramp, grab bars, a stair lift—are deductible, though only the portion of the cost that exceeds the home's increase in value. If a modification costs $5,000 and increases your home's value by $2,000, you can deduct $3,000.

What does not count as deductible

Cosmetic procedures are not deductible unless they are medically necessary to correct a deformity caused by injury or disease. A facelift for appearance is not deductible; reconstructive surgery after a car accident is. Over-the-counter medications are not deductible unless you have a prescription for them—aspirin you buy at the drugstore without a prescription does not count, but prescribed aspirin does.

Health insurance premiums paid by your employer are not deductible because they come out before your income is taxed. Premiums for life insurance, disability insurance, or car insurance are not deductible. Gym memberships and general wellness programs are not deductible, even if your doctor recommends exercise. Teeth whitening and cosmetic dentistry are not deductible. Maternity clothes, baby formula, and childcare are not medical expenses.

How to calculate whether you can deduct anything

Start with your adjusted gross income (AGI)—the number on line 11 of your Form 1040. Multiply it by 0.075 (7.5%). That is your threshold. Add up every medical expense you paid during the tax year. Subtract the threshold from that total. If the result is zero or negative, you have no deduction. If it is positive, that amount is what you can deduct.

Example: Your AGI is $80,000. Your threshold is $80,000 × 0.075 = $6,000. You paid $7,200 in medical costs during the year. Your deductible amount is $7,200 − $6,000 = $1,200. You can deduct $1,200 on Schedule A.

Next, check whether itemizing is worth it. Look up the standard deduction for your filing status and age in the current year's tax instructions. If your total itemized deductions (medical plus mortgage interest, property taxes, charitable donations, and other deductible items) exceed the standard deduction, itemize. If not, take the standard deduction and ignore the medical expenses.

Bunching medical costs into one year

If your medical expenses are close to the 7.5% threshold, you may be able to push over it by timing when you pay. This is called "bunching." If you know you need a dental crown, new glasses, and a medical procedure, and you're near the threshold, you could schedule them all in the same calendar year instead of spreading them across two years. You pay for them all in December of one year rather than some in December and some in January.

This works only if you have control over the timing and your doctor or dentist allows it. You cannot deduct costs you haven't actually paid, so prepaying for future care doesn't help unless you pay in the current year. If you're on a payment plan, only the payments you actually made in the tax year count.

Documentation and record-keeping

Keep receipts, invoices, and statements from every medical provider, pharmacy, and insurance company. The IRS does not require you to attach these to your return, but you must have them if the IRS asks. Keep records for at least three years from the date you file your return, though six years is safer for major expenses.

Your records should show the date of service, the provider's name, what was done or purchased, and the amount you paid. If you paid by credit card or check, your bank or card statement is proof. If you paid cash, a receipt from the provider is essential. For mileage to medical appointments, keep a log with dates, destinations, and miles driven, or use the IRS standard mileage rate for medical travel.

When to talk to a tax professional

If your medical expenses are substantial—more than a few thousand dollars—or if you're self-employed, a tax professional can help you understand whether itemizing makes sense and whether you can deduct health insurance premiums as a business expense instead. They can also advise on bunching costs or timing major procedures to maximize your deduction in a particular year.

If you had a major medical event, surgery, or hospitalization, or if you're caring for a dependent with significant medical needs, a professional can make sure you're not missing deductible costs. They can also help if you're unsure whether a particular expense qualifies—the rules are specific, and a wrong choice can trigger an audit.

Frequently Asked Questions

Can I deduct health insurance premiums I pay myself?

Yes, if you itemize deductions. Premiums for health, dental, vision, and long-term care insurance you pay out of pocket are deductible medical expenses, subject to the 7.5% threshold. If you're self-employed, you can deduct health insurance premiums as a business expense on Schedule C, which is often better than itemizing.

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

You deduct the cost in the year you paid it, not the year you received the service. If you paid a hospital bill in December 2024 for surgery you had in November 2024, the deduction goes on your 2024 return. If you paid it in January 2025, it goes on your 2025 return.

Can I deduct my spouse's medical expenses if we file jointly?

Yes. If you file a joint return, you can include medical expenses for yourself, your spouse, and any dependent you claim on your return. All expenses are combined and measured against your household AGI.

Is prescription drug cost information from a pharmaceutical company deductible?

No. If a drug manufacturer or nonprofit gives you a discount or pays part of your prescription cost, you can only deduct the amount you actually paid out of pocket, not the amount the information program paid.

Can I deduct the cost of a medical procedure I'm planning for next year?

No. You can only deduct costs you actually paid in the tax year. Prepaying for a procedure scheduled for next year does not count as a deduction in the current year, even if you pay in December.