Medical bills are deductible only if they exceed 7.5% of your adjusted gross income, and only if you itemize deductions instead of taking the standard deduction
You can deduct medical and dental costs on your federal tax return, but the rules are strict. The Internal Revenue Service (IRS) allows you to deduct medical costs only if two conditions are met: first, your total medical costs for the year must exceed 7.5% of your adjusted gross income (AGI), and second, you must choose to itemize deductions on your tax return rather than claim the standard deduction.
For the 2024 tax year, you can deduct medical costs that exceed 7.5% of your AGI. This means if your AGI is $50,000, you would need medical costs over $3,750 before you could deduct any of them. The IRS has kept this threshold at 7.5% since 2013, though Congress could change it in the future.
Most people do not reach this threshold because the standard deduction (the flat amount everyone can deduct without itemizing) is usually larger than the value of their medical deductions. You only benefit from deducting medical costs if your total itemized deductions—medical costs plus mortgage interest, property taxes, charitable donations, and other deductible expenses—exceed your standard deduction for your filing status.
Key Takeaways
- Medical costs are deductible only if they exceed 7.5% of your adjusted gross income in 2024, and only if you itemize deductions instead of taking the standard deduction.
- Deductible medical costs include doctor visits, hospital stays, prescription drugs, dental work, vision care, and some medical equipment and supplies, but not cosmetic procedures or over-the-counter medications.
- You must file IRS Form 1040 with Schedule A (Itemized Deductions) to claim medical deductions; you cannot claim them if you take the standard deduction.
- The 7.5% threshold applies to your adjusted gross income, not your total income, so you calculate it after certain adjustments are made to your income.
Which medical costs the IRS allows you to deduct
The IRS maintains a specific list of medical costs you can deduct. These include doctor and dentist visits, hospital stays, surgery, prescription medications, medical equipment (such as crutches, wheelchairs, or hearing aids), vision care and eyeglasses, dental work including crowns and orthodontia, and mental health treatment. You can also deduct costs for medical transportation, such as mileage to and from medical appointments or ambulance services.
Costs that do not count include over-the-counter medications (except insulin), cosmetic procedures, gym memberships or general wellness programs, and most insurance premiums you pay with pre-tax dollars through an employer. If you pay for long-term care services, those costs may be deductible under specific rules, but you should verify this with a tax professional because the rules depend on your age and the type of care.
If you pay for a dependent's medical costs, you can include those in your deduction even if you do not claim them as a dependent on your return, as long as you paid more than half their total support for the year. This rule allows you to deduct medical costs for adult children or parents you help support financially.
How to calculate whether you will benefit from deducting medical costs
Start by adding up all your medical costs for the year. Include what you paid out of pocket, not what insurance paid. Then calculate 7.5% of your adjusted gross income (AGI). Your AGI appears on your tax return and is your total income minus certain deductions like contributions to traditional IRAs or student loan interest.
Subtract that 7.5% threshold from your total medical costs. Only the amount above the threshold is deductible. For example, if your AGI is $60,000 and your medical costs are $6,000, the threshold is $4,500 (7.5% of $60,000). You can deduct $1,500 ($6,000 minus $4,500).
Next, add up all your other itemized deductions: mortgage interest, property taxes, state and local taxes (capped at $10,000), charitable donations, and other deductible expenses. Compare this total (including your medical deduction) to your standard deduction for your filing status. If your itemized deductions are larger, you benefit from itemizing. If the standard deduction is larger, you will pay less tax by taking the standard deduction and not claiming medical costs at all.
Standard deduction amounts for 2024
| Filing Status | Standard Deduction |
|---|---|
| Single | $14,600 |
| Married filing jointly | $29,200 |
| Married filing separately | $14,600 |
| Head of household | $21,900 |
| may have access to widow(er) | $29,200 |
These amounts increase each year for inflation. If you are 65 or older or blind, you are may have access to to an additional standard deduction amount. The IRS publishes updated standard deduction amounts each January for the tax year you are filing.
For 2025, the standard deduction amounts will be higher than 2024 due to inflation adjustments. You should check the IRS website or your tax software for the current year's amounts before you file your return.
How to claim medical deductions on your tax return
To claim medical deductions, you must file IRS Form 1040 (the main individual income tax form) and attach Schedule A (Itemized Deductions). You cannot claim medical deductions if you file Form 1040-SR (for people 65 and older) without Schedule A, or if you take the standard deduction.
On Schedule A, you will find a line for medical and dental costs. Enter the amount of your medical costs that exceeds the 7.5% threshold. You do not need to list each individual medical cost; you simply report the total. However, you should keep receipts, invoices, and records of all medical costs you claim in case the IRS asks you to verify them.
If you use tax software to file your return, the software will walk you through the process of entering medical costs and will calculate the threshold for you. If you file by hand or work with a tax professional, make sure you have documentation of all costs before you begin.
Medical costs paid through health savings accounts and flexible spending accounts
If you contribute to a Health Savings Account (HSA) or a Flexible Spending Account (FSA), money you withdraw from these accounts to pay for medical costs is already tax-free. You cannot deduct those same costs again on your tax return. You can only deduct medical costs you paid out of your own pocket with after-tax money.
If you have money left over in an FSA at the end of the year, you lose it (with limited exceptions). HSAs roll over year to year, so unused funds remain available. Neither account allows you to deduct costs twice—once through the account and again on your tax return. Keep track of which medical costs you paid from HSA or FSA funds so you do not accidentally claim them as deductions.
Frequently Asked Questions
Can I deduct health insurance premiums I pay myself?
Self-employed health insurance premiums are deductible, but not as a medical deduction on Schedule A. Instead, you deduct them as a business expense on Schedule C or as an adjustment to income on Form 1040. If you are an employee and pay premiums with after-tax money, you cannot deduct them. Premiums paid through your employer with pre-tax money are not deductible because they were never taxed in the first place.
What if I paid medical bills in one year but the doctor's office billed me in a different year?
You deduct medical costs in the year you paid them, not the year you received the service or the bill. If you paid a medical bill in December 2024 for a procedure done in 2023, you deduct it in 2024. Keep records showing the date you paid, not the date of service.
Can I deduct costs for my spouse's medical care?
Yes, if you are married filing jointly, you can include your spouse's medical costs in your deduction. If you are married filing separately, you can only deduct your spouse's costs if you paid them and your spouse had no income for the year. Married couples filing jointly combine all medical costs for both spouses and apply the 7.5% threshold to their combined AGI.
Does the 7.5% threshold change every year?
The percentage itself (7.5%) has been the same since 2013, but Congress can change it. The IRS does not adjust it for inflation. You should check the current year's IRS instructions for Form 1040 or Schedule A to confirm the threshold has not changed before you file.
What if my medical costs are very high because of a major illness or surgery?
High medical costs in a single year make it more likely you will exceed the 7.5% threshold and benefit from itemizing. However, you still must compare your total itemized deductions (medical plus all others) to your standard deduction. Some people with very high medical costs in one year find it worthwhile to bunch other deductible expenses into that same year—for example, making charitable donations or paying property taxes early—to maximize their itemized deductions.