You can deduct medical expenses only if they exceed 7.5% of your adjusted gross income, and only if you itemize deductions instead of taking the standard deduction.

The medical expense deduction lets you subtract certain out-of-pocket health costs from your taxable income, but it has a high bar. The IRS requires that your total medical expenses for the year surpass 7.5% of your adjusted gross income (AGI) before you can deduct any of them. For someone with an AGI of $60,000, that means you need more than $4,500 in may have access to medical costs just to start deducting. You also must choose to itemize deductions on Schedule A instead of claiming the standard deduction — a choice that makes sense only if your total itemized deductions (medical plus charitable, mortgage interest, state taxes, and others) exceed the standard deduction for your filing status.

Because the threshold is steep and the standard deduction is high, most people cannot benefit from this deduction. But if you had a major health event, paid for long-term care, or have chronic conditions requiring ongoing treatment, the deduction may be worth pursuing.

Key Takeaways

  • Medical expenses must exceed 7.5% of your AGI before any amount becomes deductible, and you must itemize deductions to claim them.
  • Deductible expenses include insurance premiums you pay yourself, out-of-pocket costs for doctors and hospitals, prescription drugs, and equipment like wheelchairs or hearing aids.
  • Health insurance premiums paid through your employer's payroll are already tax-free and do not count toward the deduction.
  • Cosmetic procedures, over-the-counter medications, and gym memberships are not deductible even if they improve your health.
  • You report medical expenses on Schedule A (Form 1040) only in the year you paid them, not when you received treatment.

What counts as a deductible medical expense

The IRS maintains a detailed list of what qualifies. Insurance premiums you pay out of pocket count — this includes health insurance, dental insurance, vision insurance, and long-term care insurance premiums. If you are self-employed, you can deduct health insurance premiums on your own return even before calculating the 7.5% threshold, which is a separate and more generous rule. If you pay COBRA premiums to continue coverage after leaving a job, those are deductible.

Medical and dental care costs are deductible: doctor visits, hospital stays, surgery, dental work, orthodontia, eye exams, and prescription eyeglasses or contact lenses. Prescription medications count, but over-the-counter drugs do not — with one exception: insulin is deductible even though it is available without a prescription in most states. Mental health treatment, including therapy and psychiatric care, qualifies. Nursing home care is deductible if the primary reason for admission is medical care, not just custodial or personal care.

Medical equipment and supplies are deductible if prescribed by a doctor: wheelchairs, crutches, hearing aids, artificial limbs, oxygen equipment, and continuous positive airway pressure (CPAP) machines. Costs to modify your home for medical reasons — ramps, grab bars, widened doorways — are deductible. Transportation to medical appointments is deductible at the IRS mileage rate (which changes yearly) or actual costs like taxi or ambulance fees. Lodging during medical treatment away from home is deductible, though meals are not.

What does not count, even if it helps your health

Cosmetic procedures are never deductible, even if a doctor performs them. Botox, facelifts, teeth whitening, and hair transplants do not may have access to. The exception is cosmetic surgery that repairs an injury or birth defect — reconstructive surgery after an accident or cleft palate repair would be deductible.

Over-the-counter medications and supplements are not deductible unless they are insulin. This includes pain relievers, cold medicine, allergy pills, vitamins, and herbal supplements, even if recommended by your doctor. Gym memberships and fitness classes are not deductible, even if your doctor recommends exercise. Cosmetic dentistry like teeth whitening or veneers is not deductible. Weight-loss programs and diet foods are generally not deductible, though a weight-loss program prescribed by a doctor for a specific medical condition (such as obesity-related diabetes) may may have access to — you would need documentation from your physician.

Health insurance premiums paid by your employer through payroll deduction are already excluded from your taxable income and do not count toward the medical expense deduction. The same applies to contributions to a Health Savings Account (HSA) or Flexible Spending Account (FSA) — those reduce your taxable income separately and are not added to medical expenses.

How the 7.5% threshold works in practice

The threshold is calculated on your adjusted gross income, which is your total income minus certain deductions like contributions to traditional IRAs or student loan interest. It is not your gross income before any deductions. You find your AGI on line 11 of Form 1040.

Suppose your AGI is $80,000. Seven and a half percent of $80,000 is $6,000. If you paid $5,500 in may have access to medical expenses during the year, you cannot deduct any of it because it falls short of the threshold. If you paid $7,200, you can deduct only $1,200 (the amount above $6,000). The threshold applies to your household as a whole if you file jointly — you combine all medical expenses paid by you and your spouse.

The 7.5% threshold has been in place since 2013 and applies to the 2024 tax year and beyond. It was temporarily lower (10%) for some years, but Congress set it back to 7.5% and has kept it there.

Itemizing versus the standard deduction

Even if your medical expenses exceed the 7.5% threshold, you benefit from the deduction 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 and $29,200 for married filing jointly (these amounts increase slightly each year for inflation).

If you are single, earn $80,000, and paid $7,200 in medical expenses, you can deduct $1,200 of that. But if your only other itemized deduction is $500 in charitable donations, your total itemized deductions are $1,700. Since $1,700 exceeds the standard deduction of $14,600, you would still take the standard deduction and get no benefit from the medical expense deduction. You would need enough other deductions — mortgage interest, property taxes, charitable giving — to push your total itemized deductions above $14,600 to make itemizing worthwhile.

This is why the medical expense deduction helps mainly people who already itemize for other reasons, or who have very high medical costs in a single year.

Timing and documentation

Medical expenses are deductible in the year you paid them, not the year you received treatment or the year your insurance company reimbursed you. If you had surgery in December 2024 but did not pay the bill until January 2025, the expense counts on your 2025 return. If your insurance company paid the bill in 2024 but you reimbursed them in 2025, the expense is deductible in 2025.

Keep receipts, invoices, and statements from doctors, hospitals, pharmacies, and insurance companies. If you claim mileage for medical travel, keep a log with dates, destinations, and miles driven. The IRS does not require you to attach receipts to your return, but you must have them available if the IRS asks. If you are audited, you will need to show proof that the expenses were actually paid and that they were for medical care.

Report medical expenses on Schedule A (Form 1040), line 1. You will subtract the 7.5% threshold amount and enter the result. If you use tax software, it will calculate this automatically once you enter your medical expenses and AGI.

When medical expenses make the deduction worth claiming

The deduction is most useful in years when you have a major health event: surgery, hospitalization, a new chronic condition diagnosis, or the start of long-term care. If you are over 65 and considering a move to assisted living or a nursing home, the medical portion of those costs may be deductible and could push you over the threshold.

Some people use a strategy called bunching deductions: if you know you will have high medical expenses in one year, you might accelerate other deductible expenses (like charitable donations or property tax payments) into that same year to exceed the standard deduction and itemize. The next year, you return to the standard deduction. This works only if you have control over the timing of those other expenses.

If you are self-employed, remember that you can deduct health insurance premiums on your own return before the 7.5% threshold applies, which is a separate and more generous benefit. This is claimed on Form 1040, line 21, not on Schedule A.

Frequently Asked Questions

Can I deduct health insurance premiums I pay through my employer?

No. Premiums deducted from your paycheck are already excluded from your taxable income, so they are not added to medical expenses. If you pay premiums out of pocket (for example, COBRA coverage after leaving a job), those are deductible as medical expenses subject to the 7.5% threshold.

Is fertility treatment or adoption-related medical care deductible?

Yes. Fertility treatments, in vitro fertilization (IVF), and related medical procedures are deductible. Adoption expenses are not deductible as medical expenses, but you may be able to claim an adoption tax credit if you meet income limits — that is a different benefit.

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

You can deduct medical expenses you paid for anyone you could claim as a dependent, even if you did not actually claim them on your return that year. You can also deduct expenses for your spouse. The expenses must have been paid by you, and you must have had the legal obligation to pay them.

Can I deduct the cost of a medical alert system or home modifications?

A medical alert system prescribed by a doctor for a specific condition is deductible. Home modifications like ramps, grab bars, or widened doorways for medical reasons are deductible. General home improvements that happen to make your home safer (like a new roof) are not deductible even if they reduce injury risk.

Do HSA or FSA contributions count toward the medical expense deduction?

No. Contributions to an HSA or FSA reduce your taxable income separately and are not counted as medical expenses for the 7.5% threshold. Expenses you pay from an HSA or FSA are also not deductible because they were already excluded from your income when you contributed.