Medical expenses you can deduct on your federal tax return
You can deduct medical and dental expenses on your federal tax return if you itemize deductions instead of taking the standard deduction. The expenses must be for you, your spouse, or your dependents, and they must exceed 7.5% of your adjusted gross income (AGI) in the tax year you're claiming them. Only the amount above that 7.5% threshold is deductible.
The IRS maintains a specific list of what counts as a medical expense. Common deductible items include doctor and dentist visits, prescription medications, hospital stays, surgery, mental health counseling, and physical therapy. You can also deduct the cost of medical equipment like wheelchairs, crutches, hearing aids, and prescription eyeglasses. Transportation to medical appointments—either mileage in your own car or public transit fares—counts as well.
Keep receipts and records for everything you claim. The IRS may ask you to prove that expenses were actually medical in nature and that you paid them in the year you're deducting them. If you use a health savings account (HSA) or flexible spending account (FSA), expenses paid through those accounts cannot also be deducted on your tax return.
Key Takeaways
- Medical expenses are only deductible if they exceed 7.5% of your adjusted gross income, and only the amount above that threshold can be claimed.
- Deductible expenses include doctor visits, prescription drugs, hospital care, dental work, mental health treatment, and medical equipment like hearing aids and wheelchairs.
- You must itemize deductions on your tax return to claim medical expenses—you cannot use the standard deduction and claim them at the same time.
- Transportation to medical appointments, including mileage and parking, is deductible, but only if you keep records of the trips and their purpose.
- Expenses paid through an HSA or FSA cannot be deducted again on your tax return, since they were already excluded from your taxable income.
What counts as a deductible medical expense
The IRS recognizes a broad range of medical costs. In addition to obvious expenses like doctor visits and hospital bills, you can deduct prescription medications, insulin, and other drugs prescribed by a doctor. Dental work including cleanings, fillings, root canals, and orthodontia all count. Vision care—eye exams, glasses, contact lenses, and laser eye surgery—is deductible.
Mental health and substance abuse treatment, including therapy sessions and inpatient rehabilitation, are fully deductible. Physical therapy, occupational therapy, and chiropractic care count if they treat a specific medical condition. Medical equipment and supplies are deductible: wheelchairs, crutches, walkers, canes, hearing aids, artificial limbs, oxygen equipment, and diabetic testing supplies all may have access to.
Less obvious expenses also count. You can deduct the cost of a wig if hair loss is caused by a medical condition, the cost of a guide dog for someone with blindness, and the cost of modifying your home for medical reasons—such as installing a wheelchair ramp or a stair lift. Nursing care, whether in-home or in a facility, is deductible if it is primarily for medical reasons rather than general living information.
Medical expenses that do not may have access to for deduction
The IRS does not allow deductions for cosmetic procedures unless they correct a deformity caused by injury or disease. Teeth whitening, facelifts, and hair removal for appearance alone do not count. Over-the-counter medications and vitamins are not deductible unless they are prescribed by a doctor for a specific medical condition.
General health and wellness expenses do not may have access to. Gym memberships, weight loss programs, and health club fees are not deductible, even if your doctor recommends exercise. Cosmetic dentistry such as teeth whitening or veneers is not deductible unless it is part of reconstructive work following an injury or disease.
Expenses for a spouse or dependent who does not meet the IRS definition of a dependent cannot be deducted. If you claim someone as a dependent, you can deduct their medical expenses, but if they are an adult who supports themselves, their expenses do not count on your return.
How to calculate your medical deduction
Start by adding up all medical expenses you paid during the tax year. Include doctor bills, prescription costs, medical equipment, therapy sessions, hospital stays, dental work, and transportation. Then calculate 7.5% of your adjusted gross income (AGI)—this is the threshold amount.
Only expenses that exceed this threshold can be deducted. For example, if your AGI is $60,000, the threshold is $4,500. If your total medical expenses are $6,000, you can deduct only $1,500 ($6,000 minus $4,500). If your expenses total $4,200, you cannot deduct any of them because they do not exceed the threshold.
You can only claim medical expenses if you itemize deductions on Schedule A of your tax return. Compare the total of your itemized deductions (medical expenses plus mortgage interest, state and local taxes, charitable donations, and other deductible items) to the standard deduction for your filing status. If itemized deductions are higher, itemize. If the standard deduction is higher, take it instead—you cannot claim medical expenses if you use the standard deduction.
Transportation and lodging related to medical care
The cost of traveling to and from medical appointments is deductible. If you drive your own vehicle, you can deduct either the actual cost of gas and oil or the standard mileage rate set by the IRS for medical travel. The mileage rate changes each year; check the IRS website for the current rate. Keep a log of the date, destination, and miles driven.
Parking fees and tolls paid while traveling to medical appointments are deductible in addition to mileage. If you use public transportation—bus, train, or taxi—keep receipts showing the date and amount paid. Flights and hotels for travel to receive medical treatment at a distant facility are also deductible.
If a family member must travel with you for medical reasons—such as a caregiver driving you to chemotherapy—their transportation costs are deductible as part of your medical expenses. However, meals during travel are generally not deductible unless you are staying overnight for inpatient medical care.
Insurance premiums and long-term care costs
Health insurance premiums you pay out of pocket are deductible, including premiums for medical, dental, and vision coverage. If you are self-employed, you may be able to deduct health insurance premiums as a business expense rather than as a medical expense—check with a tax professional about which method benefits you more.
Long-term care insurance premiums are partially deductible, but the amount depends on your age. The IRS sets annual limits on how much of the premium you can claim. These limits increase each year and vary by age group. If you pay for long-term care services directly—such as nursing home care or in-home care—those costs are deductible if the primary purpose is medical care.
Medicare premiums, including Part B and Part D, are deductible if you pay them yourself. Supplemental insurance (Medigap) premiums are also deductible. However, premiums paid through payroll deduction from your Social Security check cannot be deducted because they were already excluded from your taxable income.
Record-keeping and documentation
Keep receipts, invoices, and statements for all medical expenses you plan to deduct. These should show the date of service, the provider's name, the type of service or item, and the amount paid. If you paid by check or credit card, your bank or credit card statement serves as proof of payment.
For mileage, maintain a log showing the date, destination, medical purpose, and miles driven. For insurance premiums, keep copies of the bills or statements showing what you paid. If you claim medical equipment, keep the receipt and any documentation showing it was prescribed or recommended by a healthcare provider.
The IRS does not require you to submit receipts with your tax return, but you must have them available if the IRS requests proof. Keep records for at least three years after you file the return claiming the deduction. If you file late, keep records for longer.
Frequently Asked Questions
Can I deduct the cost of over-the-counter pain relievers and cold medicine?
No, over-the-counter medications are not deductible unless a doctor prescribes them for a specific medical condition. Aspirin, ibuprofen, cough syrup, and allergy medicine purchased without a prescription do not count, even if you use them regularly for a chronic condition.
What if my employer pays part of my health insurance premium?
You can only deduct premiums you pay yourself. If your employer pays part of the premium through a payroll deduction, that amount is already excluded from your taxable income and cannot be deducted again. You can deduct only the portion you pay out of pocket.
Can I deduct the cost of a gym membership if my doctor recommended it?
No. Even with a doctor's recommendation, general fitness and wellness expenses are not deductible. Gym memberships, weight loss programs, and health club fees do not count as medical expenses, regardless of the reason you use them.
If I use an HSA or FSA, can I also deduct those medical expenses on my tax return?
No. Money you contribute to an HSA or FSA is already excluded from your taxable income, so you cannot deduct the same expenses again on your return. You can only deduct out-of-pocket medical expenses that were not paid through either account.
Do I need to report which medical expenses I'm deducting, or just the total amount?
You report only the total amount of medical expenses on Schedule A of your tax return. You do not list individual expenses, but you must keep detailed records in case the IRS requests documentation. The IRS may ask for receipts or statements showing what the total includes.