You can deduct medical expenses, but only if you itemize deductions and your expenses exceed a specific threshold

The IRS allows you to deduct unreimbursed medical and dental expenses on your federal tax return, but the rules are strict. You can only claim them if you itemize deductions instead of taking the standard deduction, and only the amount that exceeds 7.5% of your adjusted gross income (AGI) in the tax year you're filing. This means if your AGI is $60,000, you can only deduct medical expenses above $4,500. For most people, this threshold is too high to reach, which is why most taxpayers don't claim medical deductions.

The deduction covers a wide range of expenses: doctor visits, hospital stays, prescription medications, dental work, vision care, hearing aids, and some medical equipment. It also includes mileage to medical appointments and health insurance premiums you paid yourself (not those deducted from your paycheck). What it does not cover: cosmetic procedures, general wellness expenses like vitamins, or procedures your insurance denied as medically unnecessary.

Key Takeaways

  • You must itemize deductions on Schedule A to claim medical expenses; the standard deduction is higher for most filers, so this route rarely makes financial sense.
  • Only medical expenses above 7.5% of your adjusted gross income count toward the deduction, which eliminates most people from claiming anything.
  • may be able to access expenses include doctor visits, prescriptions, dental work, hospital stays, and some medical equipment, but not cosmetic procedures or over-the-counter wellness products.
  • If you received insurance reimbursement for an expense, you cannot deduct that same expense on your taxes.
  • You need to keep receipts and documentation for every expense you claim, and the IRS may request proof during an audit.

When itemizing deductions makes sense

Itemizing is only worth doing if your total itemized deductions exceed the standard deduction for your filing status. For 2024, the standard deduction is $14,600 for single filers and $29,200 for married filing jointly. If your medical expenses plus other deductible items (mortgage interest, property taxes, charitable donations, state income taxes) add up to more than these amounts, itemizing may save you money.

Run the math before you file. Add up your medical expenses that exceed the 7.5% threshold, then add any other deductible expenses. If the total is higher than the standard deduction, itemizing is worth your time. If not, take the standard deduction and move on. Many tax software programs will calculate both scenarios for you automatically.

What counts as a deductible medical expense

The IRS has a long list of covered expenses. Doctor and dentist visits, hospital stays, surgery, prescription medications, and mental health treatment all may have access to. So do medical devices like wheelchairs, crutches, hearing aids, and continuous positive airway pressure (CPAP) machines. Eyeglasses, contact lenses, and vision correction surgery (LASIK) are deductible. Mileage to medical appointments counts at the IRS rate for medical travel, which varies by year.

Health insurance premiums you pay yourself are deductible, including Medicare premiums if you're self-employed. Long-term care insurance premiums are also covered, though there are age-based limits on how much you can deduct. Nursing home care qualifies if the primary reason for being there is medical care, not just custodial or personal care.

Expenses that do not may have access to include cosmetic surgery (unless it's reconstructive after an accident or illness), teeth whitening, general wellness products like vitamins or supplements, gym memberships, and over-the-counter medications like cold medicine or pain relievers. Procedures your insurance company denied as not medically necessary are also not deductible.

How to document and organize your expenses

Keep every receipt, invoice, and explanation of benefits (EOB) from your insurance company. The IRS does not require you to submit these documents with your return, but you must have them if the agency audits you. Organize them by category—doctor visits, prescriptions, hospital, dental, equipment—and by date. A straightforward spreadsheet with the date, provider name, type of service, and amount is enough.

If you received insurance reimbursement for an expense, subtract that amount from what you claim. You cannot deduct the same expense twice. If your insurance paid $500 of a $800 doctor bill, you can only deduct $300. Your EOB will show what was paid and what you owe; use that to track what's actually out of your pocket.

Keep records for at least three years after you file. The IRS typically has three years to audit a return, though it can go back further if there's a substantial error. Digital copies are fine, but make sure they're legible and clearly labeled.

The 7.5% threshold and how it affects your deduction

This threshold eliminates most medical deductions. If your AGI is $50,000, you need medical expenses above $3,750 to deduct anything. If it's $100,000, you need expenses above $7,500. The higher your income, the higher the bar. For someone with a moderate income and typical medical expenses, this threshold is almost impossible to clear unless you had a major health event, surgery, or ongoing expensive treatment.

The threshold applies to the tax year the expenses occurred in, not when you paid them. If you had a surgery in December 2024 but paid the bill in January 2025, the expense counts toward your 2024 taxes, not 2025. Some people with high medical expenses in a single year bunch their deductible expenses into one tax year to exceed the threshold, though this requires planning with a tax professional.

Alternatives if the standard deduction is better for you

Most people benefit more from the standard deduction than from itemizing. If that's your situation, you cannot deduct medical expenses on your federal return. However, some states allow medical expense deductions even if you take the standard deduction federally—check your state's tax rules.

If you have significant ongoing medical expenses, a Health Savings Account (HSA) or Flexible Spending Account (FSA) through your employer may be more valuable than a tax deduction. These accounts let you set aside pre-tax money for medical expenses, which reduces your taxable income and lets you use the money tax-free for may have access to medical costs. The contribution limits are higher than most people's deductible medical expenses, and you don't have to exceed a threshold to use the money.

Frequently Asked Questions

Can I deduct medical expenses if I take the standard deduction?

No. You can only claim medical expenses if you itemize deductions on Schedule A. If you take the standard deduction, medical expenses are not deductible on your federal return. Some states have different rules, so check your state's tax guidance.

What if my spouse had the medical expenses but we file jointly?

Medical expenses for you, your spouse, and any dependents you claim can all be combined toward the 7.5% threshold. File jointly and add all may have access to expenses together. If you file separately, each spouse has their own 7.5% threshold based on their own AGI.

Can I deduct medical expenses for my adult child?

Only if you claim them as a dependent on your return. If your adult child is independent and files their own taxes, their medical expenses belong on their return, not yours. If you provide more than half their financial support and they meet other dependent tests, you may be able to claim them.

Do I need to report insurance reimbursements I received?

If you deducted the medical expense in a prior year and received reimbursement in the current year, you may need to report that reimbursement as income. This is called the "tax benefit rule." Consult a tax professional if this applies to you, as the rules vary by situation.

What if I paid medical bills in installments over two years?

Each payment counts in the tax year you made it. If you paid $3,000 in 2024 and $3,000 in 2025, you have $3,000 of deductible expenses in each year (assuming they exceed the threshold). Do not combine them across years.