Medical expenses are deductible only if they exceed a threshold and you itemize deductions instead of taking the standard deduction

You can deduct medical and dental expenses, but only under specific conditions. The Internal Revenue Service (IRS) allows you to deduct medical expenses that exceed 7.5% of your adjusted gross income (AGI) — and only if you choose to itemize deductions on your tax return rather than take the standard deduction. This means most people cannot deduct medical expenses because the standard deduction is larger than their medical costs.

For example, if your AGI is $60,000, you can only deduct medical expenses above $4,500 (7.5% of $60,000). If your medical expenses total $5,000, you could deduct only $500. If they total $4,200, you cannot deduct any of them.

The threshold of 7.5% applies to the 2024 tax year. This percentage can change year to year, so check the IRS website or your tax software for the current year's rate when you file.

Key Takeaways

  • Medical expenses are deductible only if they exceed 7.5% of your adjusted gross income in the current tax year.
  • You must itemize deductions on your tax return to claim medical expenses — the standard deduction usually makes itemizing unnecessary for most filers.
  • Deductible expenses include doctor visits, dental work, prescriptions, medical equipment, and some travel costs to receive care.
  • Insurance premiums you pay yourself are deductible, but employer-paid premiums and reimbursed expenses are not.
  • Keep receipts and statements from healthcare providers and pharmacies to prove your expenses if the IRS asks.

What counts as a deductible medical expense

The IRS has a specific list of medical expenses you can deduct. These include doctor and dentist visits, hospital stays, surgery, prescription medications, and medical equipment like wheelchairs, crutches, or hearing aids. You can also deduct the cost of eyeglasses, contact lenses, and vision correction surgery.

Mental health care counts: therapy, psychiatry, and treatment for substance use disorder are all deductible. Physical therapy, chiropractic care, and acupuncture are deductible if a doctor prescribes them. You can deduct the cost of a guide dog or service animal if it is trained to help with a medical condition.

Travel to receive medical care is deductible. If you drive to a doctor's office, hospital, or treatment facility, you can deduct mileage at the IRS rate for that year (not the actual cost of gas). If you fly or take a train to receive care, the transportation cost is deductible. Hotel stays during treatment are deductible, but meals are not.

Insurance premiums you pay out of pocket are deductible — this includes health insurance, dental insurance, and vision insurance. Long-term care insurance premiums are deductible up to an age-based limit set by the IRS each year.

What does not count as deductible

Expenses your insurance company reimbursed are not deductible. If you paid $500 for a doctor visit and your insurance paid you back $400, you can only count the $100 you actually paid out of pocket.

Health insurance premiums paid by your employer are not deductible because they are already excluded from your taxable income. The same applies to premiums paid through a pre-tax payroll deduction at work. Cosmetic procedures like teeth whitening, Botox, or elective surgery are not deductible unless they treat a medical condition or injury.

Over-the-counter medications like aspirin, cold medicine, and antacids are not deductible unless you have a prescription for them. Vitamins and supplements are generally not deductible. Gym memberships and general wellness expenses are not deductible, even if a doctor recommends exercise.

Itemizing versus the standard deduction

To claim medical expenses, you must itemize deductions on Schedule A of your tax return. When you itemize, you add up all your deductible expenses — medical, state and local taxes, mortgage interest, charitable donations — and report that total instead of taking the standard deduction.

The standard deduction for 2024 is $14,600 for single filers and $29,200 for married couples filing jointly. These amounts change each year. If your itemized deductions (including medical expenses) total less than the standard deduction, you should take the standard deduction instead — it will save you more in taxes.

Example: You are single with $5,000 in medical expenses, $3,000 in state taxes, and $2,000 in charitable donations. Your total itemized deductions are $10,000. The standard deduction is $14,600. You should take the standard deduction because $14,600 is larger than $10,000.

How to track and report medical expenses

Keep all receipts, invoices, and explanation of benefits (EOB) statements from your healthcare providers and pharmacies. The IRS does not require you to attach these documents to your return, but you must have them if the IRS asks to verify your deduction.

Create a spreadsheet or folder organized by month or provider. Include the date, the provider's name, the type of service or medication, and the amount you paid out of pocket. If you drove for medical care, record the date, destination, and mileage.

Your tax software will ask you to enter your total medical expenses. You do not need to list each individual expense on your return — just the total amount. However, keeping detailed records helps you calculate the correct total and proves your expenses are real if questioned.

Medical expenses for dependents

You can deduct medical expenses you paid for your spouse and your dependents, even if they do not live with you. A dependent must meet the IRS definition of a dependent for the year — generally, someone you claim on your return who is related to you and meets income and citizenship tests.

If you paid medical expenses for an adult child who is not your dependent, you cannot deduct those expenses. If you paid for a parent's medical care and claim them as a dependent, you can deduct those expenses as long as they meet the dependent test.

Special situations: HSAs and FSAs

If you contribute to a Health Savings Account (HSA) or Flexible Spending Account (FSA) through your employer, those contributions reduce your taxable income and let you pay for medical expenses with pre-tax dollars. Money you withdraw from an HSA or FSA to pay for medical expenses is not taxable income, so you cannot also deduct those same expenses on your tax return.

HSAs are available only if you have a high-deductible health plan. FSAs are offered by some employers. Both accounts let you set aside money before taxes are taken out, which is often more valuable than deducting medical expenses after the fact.

Frequently Asked Questions

Can I deduct health insurance premiums I pay myself?

Yes, if you are self-employed or pay premiums out of pocket. Premiums for health, dental, and vision insurance are deductible. Premiums paid through your employer's payroll are already excluded from your taxable income, so you cannot deduct them again. If you are self-employed, you may be able to deduct premiums as a business expense rather than as an itemized deduction.

What if my medical expenses are less than 7.5% of my income?

You cannot deduct them. The IRS requires medical expenses to exceed 7.5% of your AGI before any amount is deductible. If your AGI is $50,000 and your medical expenses are $3,000, they do not exceed the $3,750 threshold, so you have no deduction.

Do I need to report each medical expense separately on my tax return?

No. You add up all your deductible medical expenses and report the total on Schedule A. You do not list individual doctor visits or prescriptions. Keep your receipts in case the IRS asks for proof, but you only enter the total amount on your return.

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

No. General fitness and wellness expenses are not deductible, even with a doctor's recommendation. Physical therapy prescribed by a doctor is deductible, but a gym membership is not.

What if I paid medical expenses in one year but was reimbursed in a different year?

Deduct the expenses in the year you paid them, not the year you were reimbursed. If you were reimbursed in a later year, you cannot deduct those expenses because you did not actually pay them out of pocket in that year.