Most health expenses are not tax deductible, but some are if you itemize and meet a high threshold

You can only deduct medical and dental expenses if two things are true: you itemize deductions on your tax return instead of taking the standard deduction, and your total may have access to medical expenses exceed a percentage of your adjusted gross income (AGI). For the 2024 tax year, that threshold is 7.5% of your AGI. If your AGI is $60,000, for example, you can only deduct medical expenses above $4,500.

Most people do not itemize, which means they take the standard deduction instead. The standard deduction for 2024 is $14,600 for single filers and $29,200 for married filing jointly. Because the standard deduction is usually larger than the sum of all itemized deductions a household can claim, most taxpayers get no tax benefit from medical expenses at all.

Even if you do itemize, you must have enough may have access to expenses to clear the 7.5% threshold. This combination — itemizing plus exceeding the threshold — is why medical deductions help only a small number of households, usually those with very high medical bills or very low income.

Key Takeaways

  • Medical expenses are deductible only if you itemize deductions and your total may have access to medical costs exceed 7.5% of your adjusted gross income.
  • may have access to expenses include doctor visits, dental work, prescription medications, medical equipment, and health insurance premiums you pay yourself, but not cosmetic procedures or over-the-counter drugs.
  • Most taxpayers benefit more from the standard deduction than from itemizing, so medical expenses provide no tax savings for them.
  • Certain health savings accounts (HSAs) and flexible spending accounts (FSAs) let you set aside pre-tax dollars for medical costs, which is often more valuable than a deduction.

Which medical expenses actually count

The IRS publishes a detailed list of deductible medical expenses in Publication 502. The most common ones are doctor and dentist visits, prescription medications, eyeglasses and contact lenses, hearing aids, crutches, wheelchairs, and medical equipment prescribed by a doctor. You can also deduct health insurance premiums you pay yourself — for example, if you are self-employed or pay for a policy out of pocket — but not premiums your employer deducts from your paycheck.

Expenses that do not count include cosmetic procedures (unless medically necessary), over-the-counter medications like aspirin or cold medicine, vitamins and supplements, gym memberships, and weight loss programs. Teeth whitening, hair transplants, and most cosmetic dental work are not deductible. If you are unsure whether a specific expense qualifies, Publication 502 has a full list, or you can ask a tax professional.

You can deduct mileage to and from medical appointments, using the IRS mileage rate for medical travel. You can also deduct lodging and meals if you travel out of state for medical treatment, though the meals deduction is limited. Keep receipts and records for everything you claim.

How to calculate whether you meet the threshold

Start with your adjusted gross income (AGI) — the number on line 11 of your Form 1040. Multiply that by 0.075 (which is 7.5%). That result is your threshold. You can only deduct medical expenses that exceed this amount.

Example: Your AGI is $80,000. Your threshold is $80,000 × 0.075 = $6,000. If you spent $7,500 on may have access to medical expenses during the year, you can deduct $1,500 ($7,500 minus $6,000). If you spent $5,500, you cannot deduct any of it because you did not reach the threshold.

The threshold applies to your household total, not individual expenses. If you are married filing jointly, you combine both spouses' medical expenses and compare them to the household AGI. If you are single, you use your own AGI and your own medical expenses.

Itemizing versus taking the standard deduction

To claim medical deductions, you must file Schedule A (Itemized Deductions) instead of taking the standard deduction. Schedule A also includes other deductions like state and local taxes (capped at $10,000), mortgage interest, and charitable donations. You should itemize only if your total itemized deductions exceed the standard deduction for your filing status.

For 2024, the standard deduction is $14,600 for single filers, $29,200 for married filing jointly, and $21,900 for head of household. If your medical expenses plus other itemized deductions add up to more than these amounts, itemizing saves you money. If not, the standard deduction is better.

Many households with significant medical expenses still do not benefit because their other itemized deductions are small. A single person with $8,000 in medical expenses and no other deductible expenses would not itemize, because $8,000 is less than the $14,600 standard deduction.

Health savings accounts and flexible spending accounts as alternatives

If your employer offers a Health Savings Account (HSA) or Flexible Spending Account (FSA), these often provide a better tax benefit than deducting medical expenses. With an HSA or FSA, you contribute pre-tax dollars — money that never gets taxed at all — to pay for medical costs. This is more valuable than a deduction, which only reduces the income you pay tax on.

An HSA is available only if you have a high-deductible health plan. You can contribute up to $4,150 for individual coverage or $8,300 for family coverage in 2024 (these limits change yearly). Money you do not spend rolls over to the next year and grows tax-free. An FSA is more flexible in terms of may be able to access but has a "use it or lose it" rule — money you do not spend by the end of the year is forfeited.

If you have access to either account, maxing it out usually saves more in taxes than trying to itemize medical deductions. Ask your employer's benefits department whether these accounts are available to you.

Self-employed health insurance deduction

If you are self-employed, you can deduct health insurance premiums you pay for yourself and your family as a business expense, not as an itemized deduction. This deduction is taken on Form 1040 line 21 and does not require you to itemize. You can deduct premiums for medical, dental, and vision coverage, as well as long-term care insurance.

This deduction is available only if you have net profit from self-employment and cannot exceed your net self-employment income. If you have no profit or a loss, you cannot claim this deduction. You also cannot claim it if you are may be able to access for health insurance through your spouse's employer.

What records to keep

Keep receipts, invoices, and statements from doctors, dentists, pharmacies, and medical suppliers for at least three years. If you claim mileage to medical appointments, keep a log with dates, destinations, and miles driven. For health insurance premiums, keep copies of your 1098-T form (if you are a student) or your insurance statements.

The IRS does not require you to attach receipts to your tax return, but you must have them if the IRS asks. Many people photograph receipts or scan them into a folder on their computer to make them straightforward to find later. If you use tax software, most programs have a place to upload images of receipts.

Frequently Asked Questions

Can I deduct over-the-counter medications like pain relievers or allergy medicine?

No. Over-the-counter drugs are not deductible unless they are prescribed by a doctor. Prescription versions of the same medication are deductible, but the over-the-counter version is not, even if a doctor recommends it.

What if I paid medical bills for my adult child or parent?

You can deduct medical expenses you paid for someone else only if that person is your dependent for tax purposes. Your adult child or parent must meet the IRS definition of dependent, which includes a gross income test. If they do not may have access to as your dependent, their medical expenses are not deductible on your return.

Does health insurance I pay through my employer paycheck count?

No. Premiums deducted from your paycheck are already excluded from your taxable income, so you cannot deduct them again. Only premiums you pay out of pocket — for example, if you are self-employed or buy a policy on your own — are deductible.

Can I deduct the cost of a gym membership if my doctor recommends it for my health?

No. Gym memberships and general fitness expenses are not deductible, even with a doctor's recommendation. The IRS treats them as personal expenses, not medical care.

What if my medical expenses are very high one year but low the next?

You calculate the deduction separately each year based on that year's AGI and expenses. A year with high medical bills might push you over the 7.5% threshold and allow you to itemize, while a year with low bills might not. This is one reason some people with chronic conditions benefit from HSAs — they can set aside money across multiple years.