You can reduce your federal income tax through medical expenses, but only if your total medical costs exceed a specific threshold and you itemize deductions instead of taking the standard deduction.

The IRS allows you to deduct may have access to medical and dental expenses on your federal tax return, but the rules are strict. You can only claim medical deductions if your total medical expenses for the year exceed 7.5% of your adjusted gross income (AGI). If they do, you can deduct the amount above that 7.5% threshold.

For example, if your AGI is $60,000, the threshold is $4,500. If you spent $7,000 on medical bills, you could deduct $2,500 ($7,000 minus $4,500). This deduction only helps you if you itemize deductions on Schedule A instead of claiming the standard deduction—and for most people, the standard deduction is larger, so medical deductions do not result in a tax refund.

Key Takeaways

  • Medical expenses must exceed 7.5% of your adjusted gross income before you can deduct any of them on your federal return.
  • You must itemize deductions on Schedule A to claim medical expenses; most taxpayers benefit more from the standard deduction.
  • may have access to expenses include doctor visits, hospital stays, prescription medications, dental work, vision care, and some travel costs to receive medical care.
  • A tax deduction reduces your taxable income but does not automatically mean you will receive a refund—you only get money back if your total deductions and credits exceed what you owe.
  • State and local tax returns have different rules; some states do not allow medical deductions at all.

What counts as a may have access to medical expense

The IRS has a detailed list of what you can deduct. may have access to medical expenses include doctor and dentist visits, hospital stays, surgery, prescription medications, insulin, medical equipment (like crutches or wheelchairs), vision and hearing care, and mental health treatment. You can also deduct mileage for driving to medical appointments at the IRS standard mileage rate, or actual parking and tolls.

Expenses that do not count include cosmetic surgery (unless it is reconstructive after injury or illness), over-the-counter medications you buy without a prescription, gym memberships, vitamins, and general health products. Long-term care insurance premiums are deductible only up to certain age-based limits set by the IRS each year.

When itemizing deductions actually saves you money

For 2024, the standard deduction is $14,600 for single filers and $29,200 for married couples filing jointly. If your medical expenses plus other deductible items (mortgage interest, state and local taxes, charitable donations) do not add up to more than the standard deduction, you will not benefit from itemizing.

You benefit from medical deductions only if: (1) your medical expenses exceed 7.5% of your AGI, (2) you have other deductible expenses that push your total itemized deductions above the standard deduction, and (3) you are in a tax bracket where reducing your taxable income actually lowers your tax bill. If all three conditions are met, you may owe less tax—but that is not the same as receiving a refund. A refund happens only when your total tax credits and withholdings exceed what you owe.

How to claim medical expenses on your tax return

To claim medical deductions, you will need to file Form 1040 with Schedule A (Itemized Deductions). List all your may have access to medical expenses for the year, add them up, subtract 7.5% of your AGI, and enter the result on Schedule A, line 1. Keep receipts, invoices, and statements from doctors, hospitals, pharmacies, and other providers—the IRS does not require you to submit them with your return, but you must have them if the IRS asks.

If you use tax software, it will walk you through the Schedule A questions and calculate your deduction automatically. If you file by hand or with a tax professional, bring all your medical records and receipts to your appointment. The deduction is only as large as the expenses you can document.

Medical expenses paid through insurance or HSAs

You can only deduct medical expenses you actually paid out of pocket. If your health insurance covered a bill, you cannot deduct it. However, you can deduct the insurance premiums you paid yourself—including health insurance premiums if you are self-employed, long-term care insurance (within limits), and Medicare premiums if you are retired.

If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), money you withdraw from these accounts to pay medical bills is already tax-free, so you cannot deduct those expenses again. The same rule applies to medical expenses paid with a dependent care FSA or Archer MSA.

State tax returns and medical deductions

State income tax rules vary widely. Some states follow federal rules and allow medical deductions; others do not allow them at all. A few states have different thresholds or different lists of what counts as a medical expense. You will need to check your state's tax instructions or speak with a tax professional about whether you can claim medical deductions on your state return.

Even if your state does not allow medical deductions, you can still claim them on your federal return if you meet the federal requirements.

When medical bills lead to a refund

A tax refund happens when your total tax credits (like the Earned Income Tax Credit or Child Tax Credit) plus your withholdings from paychecks or estimated tax payments exceed the tax you owe. A medical deduction reduces your taxable income, which can lower your tax bill, but it does not directly create a refund.

If you owe $3,000 in federal tax and a medical deduction saves you $800, you now owe $2,200 instead—but you do not receive $800. You only get a refund if you have already paid more than $2,200 through withholding or estimated payments. Medical deductions help most when combined with other deductions and tax credits that together reduce your bill below what you have already paid.

Frequently Asked Questions

Can I deduct medical bills I paid in a previous year?

No. You can only deduct medical expenses paid in the tax year you are filing for. If you paid a bill in December 2023 but did not receive the invoice until January 2024, you deduct it in 2024. If you paid it in 2023, it belongs on your 2023 return.

What if my medical expenses were paid by my employer or a charity?

You cannot deduct expenses someone else paid. Only out-of-pocket costs you paid yourself count. If your employer reimbursed you through a health plan, that money is not deductible.

Do I need receipts to claim medical deductions?

You do not have to attach receipts to your return, but you must keep them for your records. If the IRS audits you, you will need to show proof that you paid the expenses. Bank statements, credit card statements, and invoices from providers all count as proof.

Can I deduct medical bills for my adult child?

Only if you can claim them as a dependent on your return. If your adult child is independent and files their own return, they must claim their own medical expenses. If they are your dependent, you can include their medical expenses in your total.

Will a medical deduction reduce my Medicare premiums or benefits?

No. A medical deduction on your federal tax return does not affect your Medicare premiums, Social Security benefits, or other government programs. It only reduces your federal taxable income for that year.