You can claim medical expenses on your federal tax return, but only if you itemize deductions and your total medical costs exceed a threshold set by the IRS.

The IRS allows you to deduct medical and dental expenses, but with two important limits. First, you must itemize deductions on Schedule A instead of taking the standard deduction — most people take the standard deduction because it is larger. Second, you can only deduct the amount of medical expenses that exceeds 7.5% of your adjusted gross income (AGI). If your AGI is $60,000 and your medical expenses are $5,000, you can deduct only $500 ($5,000 minus $4,500, which is 7.5% of $60,000).

This means medical expense deductions help only people with very high medical costs relative to their income. If you spent $2,000 on medical care but your AGI is $80,000, the 7.5% threshold is $6,000 — you cannot deduct anything. You need to know your AGI and your actual out-of-pocket medical spending before you decide whether to itemize.

Key Takeaways

  • Medical expenses are deductible only if you itemize deductions on Schedule A, which means your total itemized deductions must exceed the standard deduction for your filing status.
  • You can deduct only the medical expenses that exceed 7.5% of your adjusted gross income, so high medical costs relative to your income are required for any deduction.
  • Deductible expenses include doctor visits, dental work, prescription medications, medical equipment, and some travel costs to receive care, but not cosmetic procedures or over-the-counter drugs.
  • You claim medical deductions when you file your tax return; you do not file a separate claim or contact the IRS beforehand.
  • Keeping receipts and records of all medical payments is essential, because the IRS may request proof if your return is audited.

What medical expenses the IRS allows you to deduct

The IRS publishes a list of deductible medical expenses in Publication 502. Deductible expenses include doctor and dentist visits, hospital stays, prescription medications, medical equipment (crutches, wheelchairs, hearing aids), vision care and glasses, mental health treatment, and some travel costs to receive medical care. You can also deduct health insurance premiums you paid yourself, including COBRA premiums if you were laid off.

Expenses that do not count include cosmetic procedures (unless they are reconstructive after injury or illness), over-the-counter medications, vitamins and supplements, gym memberships, and general wellness programs. Teeth whitening is cosmetic and not deductible. Prescription acne medication is deductible; over-the-counter acne cream is not. The distinction often comes down to whether a doctor prescribed the treatment or whether it treats a diagnosed medical condition rather than appearance or general health.

If you paid for a dependent's medical care, you can include those expenses too, even if you cannot claim them as a dependent for other tax purposes. Keep records showing what you paid, when, and to whom — the name of the provider, the date of service, and the amount you paid out of pocket.

How to calculate whether you should itemize

Before you spend time gathering medical receipts, determine whether itemizing will actually reduce your taxes. You need to know three numbers: your AGI, your total medical expenses, and the standard deduction for your filing status.

Your AGI appears on your tax return (line 11 on Form 1040 for the 2023 tax year). Multiply your AGI by 0.075 to find the threshold. Subtract that threshold from your total medical expenses. If the result is zero or negative, you cannot deduct anything. If it is positive, that is your potential medical deduction.

Next, add up all your other itemized deductions: state and local taxes (capped at $10,000), mortgage interest, charitable donations, and casualty losses. Add that total to your medical deduction. If the sum exceeds the standard deduction for your filing status (for 2023, $13,850 for single filers, $27,700 for married filing jointly), then itemizing saves you money. If it does not, take the standard deduction instead and ignore the medical expenses.

Gathering and organizing your medical expense records

The IRS does not require you to send receipts with your return, but you must keep them for at least three years in case of an audit. Organize your records by provider and by year. For each expense, record the date, the provider's name, what service or product you received, and the amount you paid out of pocket.

If you paid by credit card or check, your bank or credit card statement serves as a record. If you paid in cash, ask the provider for a receipt at the time of payment. For ongoing care (physical therapy, mental health treatment), ask for an itemized statement at the end of the year showing all dates and amounts. Insurance explanations of benefits (EOBs) show what your insurance paid and what you owed; use these to verify your out-of-pocket costs.

Do not include amounts your insurance paid. If you had a $500 doctor visit and insurance paid $400, you deduct only the $100 you paid. If you received a refund from a provider or insurance company, subtract that from your total. Keep the documentation showing the refund so you can explain the adjustment if audited.

Where to claim medical deductions on your tax return

Medical expenses are claimed on Schedule A (Form 1040), which is the itemized deductions form. You complete Schedule A by listing your medical expenses on line 1, entering your AGI on line 2, calculating 7.5% of your AGI on line 3, and subtracting line 3 from line 1 to get your deductible amount on line 4. You then transfer that amount to Form 1040.

If you use tax software (TurboTax, H&R Block, TaxAct), the software walks you through Schedule A and calculates the threshold automatically. If you file by hand or with a tax preparer, provide them with your list of medical expenses and your AGI, and they will complete the form.

You file Schedule A along with your Form 1040 and any other forms required by your situation. There is no separate claim process for medical deductions — they are part of your annual tax return filed by the April 15 important date (or October 15 if you file an extension).

What happens if the IRS questions your medical deductions

If the IRS audits your return and questions your medical deductions, they will ask you to provide documentation. Send copies of receipts, invoices, insurance statements, and bank records showing the payments you claimed. Do not send originals; keep those for your records.

The IRS may disallow deductions if you cannot document them, if they do not meet the definition of deductible medical care, or if you claimed amounts your insurance actually paid. If you made an error, you can file an amended return (Form 1040-X) to correct it. An amended return can reduce your deduction and increase the tax you owe, or it can increase your deduction and result in a refund.

Audits of medical deductions are not common unless the amount is very large relative to your income or the expenses include items that are clearly not deductible. Keeping good records and being honest about what you claim protects you if questions arise.

Medical expenses you paid in prior years

You can only deduct medical expenses paid in the tax year you claim them. If you paid a doctor bill in December 2023, you deduct it on your 2023 return filed in 2024. If you paid it in January 2024, it goes on your 2024 return filed in 2025.

If you did not itemize in a prior year but now have enough deductions to itemize, you can file an amended return for that year. You have three years from the original filing date to amend and claim a refund. If you filed your 2023 return on April 15, 2024, you can amend it until April 15, 2027. File Form 1040-X (Amended U.S. Individual Income Tax Return) with the corrected Schedule A showing your medical deductions.

Frequently Asked Questions

Can I deduct medical expenses my insurance paid?

No. You deduct only the amount you paid out of pocket. If your insurance covered the full cost, you have nothing to deduct. If you paid a copay or coinsurance, you deduct only that amount you paid, not the full bill.

What if I do not have receipts for some medical expenses?

The IRS requires documentation. If you cannot produce a receipt, you cannot deduct that expense. Bank or credit card statements showing a payment to a medical provider can sometimes substitute for a receipt, but they do not show what service you received. Ask your provider for a statement or receipt as soon as possible, even for past years.

Can I deduct medical expenses for my adult child?

Yes, if you paid the expenses. You do not have to claim your child as a dependent on your return. Keep records showing you paid the bill, not your child. If your child paid and you reimbursed them, keep documentation of both the original payment and your reimbursement.

Does claiming medical deductions trigger an audit?

Not automatically. Audits are selected randomly or when something on your return looks unusual. A reasonable medical deduction that you can document is unlikely to cause problems. Very large deductions relative to your income, or expenses that clearly do not may have access to, are more likely to draw attention.

What if I had a major medical event and my expenses are very high?

High medical expenses are exactly the situation where deductions help most. Gather all your receipts and records, calculate your AGI and the 7.5% threshold, and determine whether itemizing saves you money. If your medical costs are $20,000 and your AGI is $80,000, the threshold is $6,000, so you can deduct $14,000 — a significant reduction in taxable income.