Most personal medical costs are not tax deductible
The IRS does not let you deduct most medical expenses you pay out of your own pocket. You cannot deduct the cost of a doctor's visit, prescription drugs, dental work, glasses, hearing aids, or therapy sessions on your federal tax return — even if you paid the full amount yourself. The only medical expenses that may have access to for a tax deduction are those that exceed a threshold (7.5% of your adjusted gross income for the 2024 tax year) and are itemized on Schedule A instead of taking the standard deduction.
This means that for most households, medical expenses do not lower their taxes at all. You have to spend a very large amount on medical care in a single year before you reach the threshold where deductions begin to help. If you take the standard deduction instead of itemizing — which most people do — your medical bills have no tax benefit whatsoever.
Key Takeaways
- Routine medical expenses like doctor visits, prescriptions, and dental care are never deductible unless you itemize deductions and your total medical spending exceeds 7.5% of your adjusted gross income.
- Health insurance premiums you pay yourself are not deductible on your federal return, though self-employed people can deduct them as a business expense.
- Cosmetic procedures, gym memberships, and over-the-counter medications are never deductible under any circumstances.
- Long-term care insurance premiums have limits on how much you can deduct, and the amount depends on your age.
- If you use a Health Savings Account (HSA) or Flexible Spending Account (FSA), you avoid taxes on that money entirely, which is better than trying to deduct expenses later.
Health insurance premiums you pay yourself
If you buy your own health insurance as an individual, you cannot deduct the premiums on your federal tax return. This applies whether you purchase coverage through the ACA marketplace, a private insurer, or directly from a health plan. The premiums are straightforward not deductible for most people filing as employees.
The one exception is for self-employed people. If you are self-employed and pay your own health insurance premiums, you can deduct them as a business expense on Schedule C, which reduces your taxable income. This is called the self-employed health insurance deduction, and it applies to you, your spouse, and your dependents — but only for months when you were actually self-employed and had net profit.
Cosmetic procedures and elective treatments
The IRS treats cosmetic procedures as personal expenses, not medical ones. You cannot deduct the cost of teeth whitening, Botox, facelifts, hair transplants, or other cosmetic surgery. This is true even if a doctor performs the procedure.
The line between cosmetic and medical is sometimes unclear. Reconstructive surgery after an accident or illness may be deductible, but the same surgery done for appearance alone is not. If you are unsure whether a procedure qualifies, keep all documentation from your doctor explaining the medical necessity, because the IRS may ask for proof that the procedure treated a condition rather than improved appearance.
Gym memberships and general wellness expenses
You cannot deduct gym memberships, fitness classes, or general wellness programs, even if you use them to manage a medical condition like diabetes or heart disease. The IRS does not treat these as medical expenses because they are available to the general public and are not prescribed by a doctor as treatment for a specific condition.
The same rule applies to weight loss programs, diet supplements, and nutritional counseling — unless a doctor prescribes the program as treatment for a diagnosed medical condition and you can show that the program is not available to the general public. Even then, the deduction is difficult to claim and the IRS scrutinizes these claims closely.
Over-the-counter medications and supplies
Over-the-counter medications like aspirin, cold medicine, antacids, and pain relievers are never deductible on your tax return. This has been the rule since 2021, when the IRS tightened the definition of deductible medical expenses. You also cannot deduct over-the-counter medical supplies like bandages, heating pads, or blood pressure monitors.
Prescription medications are deductible if you itemize and exceed the income threshold, but over-the-counter versions of the same drug are not. If your doctor prescribes a medication and you fill it at a pharmacy, it counts as a deductible medical expense — but if you buy the generic version without a prescription, it does not.
Long-term care insurance with limits
Long-term care insurance premiums are partially deductible, but only up to an age-based limit. For 2024, the limits are $450 for people age 40 and under, $850 for people 41 to 50, $1,690 for people 51 to 60, $4,510 for people 61 to 70, and $5,640 for people over 70. You can only deduct the amount that falls within your age bracket, and only if you itemize deductions and exceed the 7.5% threshold.
These limits change each year, so check the current year's limits when you file. The limits explore to may have access to long-term care insurance contracts only — not to life insurance policies that include a long-term care rider, and not to policies that pay a fixed daily benefit regardless of actual costs.
Why Health Savings Accounts and Flexible Spending Accounts are better
Instead of trying to deduct medical expenses after you pay them, you can avoid taxes on the money in the first place by using a Health Savings Account (HSA) or Flexible Spending Account (FSA). Money you contribute to these accounts is not taxed, and you can withdraw it tax-free to pay for may have access to medical expenses.
An HSA is available if you have a high-deductible health plan, and the money rolls over year to year if you do not spend it. An FSA is offered through some employers, and you must spend the money within the plan year or lose it. Both accounts cover a wider range of expenses than the tax deduction does — including over-the-counter medications and supplies — so they are usually a better option than trying to itemize deductions.
Frequently Asked Questions
Can I deduct the cost of my child's braces?
No, unless you itemize deductions and your total medical expenses for the year exceed 7.5% of your adjusted gross income. Orthodontic work is considered a medical expense, so it counts toward that threshold, but you cannot deduct it on its own. Most families do not spend enough on medical care to reach the threshold, so braces are usually not deductible.
What if my employer pays part of my health insurance premium?
Premiums your employer pays are not taxable to you and are not deductible by you — your employer deducts them as a business expense. You only pay taxes on the portion of the premium you contribute yourself, and that portion is not deductible on your personal return.
Are fertility treatments and adoption expenses deductible?
Fertility treatments like IVF and medications are deductible medical expenses if you itemize and exceed the 7.5% threshold. Adoption expenses are not deductible as medical expenses, but you may be able to claim an adoption tax credit if you meet income limits — that is a different benefit with its own rules.
Can I deduct the cost of therapy or counseling?
Mental health treatment from a licensed therapist or psychiatrist is a deductible medical expense if you itemize and exceed the 7.5% threshold. However, life coaching, wellness counseling, or general counseling not provided by a licensed mental health professional is not deductible.
What if I paid medical bills for someone else?
You can deduct medical expenses you paid for your spouse or dependent, as long as they meet the IRS definition of dependent and you itemize deductions. You cannot deduct medical expenses you paid for an adult child who is not your dependent, even if you helped them out.