Medical expenses are deductible only if you itemize deductions and your total medical costs exceed a threshold set by the IRS

You can deduct medical and dental expenses on your federal tax return, but only if two conditions are met: you must itemize deductions instead of taking the standard deduction, and your total may have access to medical expenses must 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 expenses above $4,500. The IRS updates the 7.5% threshold each year, so check the current year's rules on IRS.gov before calculating.

Most people take the standard deduction because it is simpler and often larger than their itemized deductions. Itemizing only makes sense if your medical expenses, combined with other deductible expenses like mortgage interest or charitable donations, exceed your standard deduction for that year. For 2024, the standard deduction is $14,600 for single filers and $29,200 for married filing jointly—these amounts change annually.

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.
  • Deductible expenses include doctor visits, hospital care, prescription drugs, dental work, vision care, and some medical equipment and supplies.
  • You cannot deduct cosmetic procedures, over-the-counter medications (with rare exceptions), health club memberships, or expenses paid by insurance.
  • You report medical deductions on Schedule A (Form 1040) when you file your federal tax return.
  • State and local taxes (SALT) have their own deduction limits separate from medical expenses, capped at $10,000 per year.

What counts as a deductible medical expense

The IRS allows you to deduct expenses paid for diagnosis, cure, mitigation, treatment, or prevention of disease, or for treatment affecting any part or function of the body. This includes doctor and dentist visits, hospital stays, surgery, prescription medications, medical equipment (like wheelchairs or crutches), and mental health treatment. You can also deduct vision care, hearing aids, and the cost of replacing teeth.

Less obvious deductible expenses include travel to receive medical care (mileage at the IRS rate or actual transportation costs), lodging while receiving treatment away from home, and certain home modifications made for medical reasons—such as installing a ramp or widening doorways for mobility issues. Nursing care and in-home care services count if they are medically necessary. You can deduct premiums for long-term care insurance up to limits based on your age, and you can deduct health insurance premiums if you are self-employed.

Keep receipts and invoices for everything you claim. The IRS may request documentation years later, and without proof you will lose the deduction.

What does not count as deductible

Cosmetic procedures are never deductible unless they are medically necessary to repair damage from injury or disease. Teeth whitening, facelifts, and hair removal for appearance alone do not may have access to. Over-the-counter medications like aspirin, cold medicine, and antacids are generally not deductible, though insulin is an exception. Vitamins and supplements are not deductible unless prescribed by a doctor for a specific medical condition.

Health club memberships and gym fees are not deductible, even if your doctor recommends exercise. Cosmetic dentistry such as teeth whitening or veneers is not deductible. Expenses paid by insurance—either reimbursed or covered by your plan—cannot be deducted. If your insurance covers a procedure, you deduct only the amount you paid out of pocket, not what the insurance paid.

How to calculate and report your deduction

Start by adding up all your may have access to medical expenses for the tax year. Then subtract 7.5% of your AGI. The remainder is your deductible amount. For example, if your AGI is $50,000 and your medical expenses total $6,000, you subtract $3,750 (7.5% of $50,000) and can deduct $2,250.

You report this deduction on Schedule A (Form 1040), which is the form you use to itemize deductions. You will need to list your medical expenses in the section labeled "Medical and Dental Expenses." The IRS provides Publication 502 (Medical and Dental Expenses) with detailed guidance and examples. You can read it free from IRS.gov or request a copy by phone.

If you are married filing jointly, you calculate the threshold based on your combined AGI. If you are married filing separately, each spouse calculates their own threshold based on their individual AGI.

When itemizing makes financial sense

Itemizing is worth doing only if your total itemized deductions exceed your standard deduction. Add up medical expenses (after the 7.5% threshold), mortgage interest, property taxes, state income taxes (capped at $10,000 total with other state and local taxes), charitable donations, and any other deductible expenses. If the sum is larger than your standard deduction, itemize. If not, take the standard deduction.

Some people are close to the threshold and can push over it by timing large medical expenses strategically. For instance, if you are planning elective surgery or dental work, scheduling it in a year when you already have high medical costs may let you reach the threshold. This is legal tax planning and worth discussing with a tax professional if you are near the edge.

Medical expenses paid for dependents and spouses

You can deduct medical expenses you paid for your spouse and your dependents, even if they do not live with you, as long as they meet the IRS definition of a dependent for that year. You do not have to be the one who received the care—if you paid your adult child's dental bill or your parent's hospital costs, those expenses count toward your deduction.

The expenses must have been paid during the tax year you are filing for. If you paid a 2024 medical bill in January 2025, it goes on your 2025 return, not your 2024 return. Keep documentation showing the date you paid and who received the care.

State and local tax deductions are separate

Do not confuse medical deductions with state and local tax (SALT) deductions. If you paid state income tax or property tax, those are deductible separately on Schedule A, but the total of all SALT deductions is capped at $10,000 per year. Medical expenses are not part of this cap and are deducted in their own section of Schedule A.

This separation matters because you can have a large medical deduction and still be limited on how much state and local tax you can deduct. The two work independently on your return.

Frequently Asked Questions

Can I deduct health insurance premiums?

If you are self-employed, you can deduct health insurance premiums for yourself, your spouse, and your dependents on Form 1040 (not on Schedule A). If you are an employee, your employer-provided health insurance is typically paid with pre-tax dollars and is not deductible again. If you pay premiums out of pocket for coverage, you can deduct them only if you itemize and they exceed 7.5% of your AGI.

What if I paid medical expenses in one year but was reimbursed in a different year?

Deduct the expense in the year you paid it. If you are reimbursed later, you must report the reimbursement as income in the year you receive it. This can be complicated, so keep records showing when you paid and when you were reimbursed.

Can I deduct the cost of a medical procedure my insurance denied?

Yes, if you paid for it out of pocket. The fact that insurance would not cover it does not make it non-deductible. As long as it is a legitimate medical expense, you can deduct the amount you paid, subject to the 7.5% threshold.

Do I need to itemize every year to deduct medical expenses?

No. You choose whether to itemize or take the standard deduction each year based on which is larger. In some years you may itemize (and deduct medical expenses), and in other years you may take the standard deduction. There is no requirement to be consistent year to year.

What records should I keep?

Keep receipts, invoices, and statements from doctors, hospitals, pharmacies, and insurance companies showing what you paid and when. If you claim mileage to medical appointments, keep a log with dates and miles. The IRS typically has three years to audit, but keeping records for at least five years is safer.