Medical expenses you can deduct must exceed 7.5% of your adjusted gross income

You can deduct medical and dental expenses, but only the amount that exceeds 7.5% of your adjusted gross income (AGI) for the tax year. This is called the medical expense threshold. If your AGI is $60,000, you can only deduct medical expenses above $4,500. The IRS publishes the threshold each year; it has been 7.5% since 2013.

The expenses must be for you, your spouse, or a dependent you claim on your return. They must be for diagnosis, cure, mitigation, treatment, or prevention of disease, or for treatment affecting any part or function of the body. Cosmetic procedures generally do not count unless they are reconstructive after injury or illness.

You report deductible medical expenses on Schedule A (Form 1040) if you itemize deductions. Most people use the standard deduction instead, which means they cannot deduct medical expenses at all. You should itemize only if your total itemized deductions (medical expenses plus mortgage interest, property taxes, charitable donations, and other allowed items) exceed the standard deduction for your filing status.

Key Takeaways

  • Medical expenses are deductible only if they exceed 7.5% of your adjusted gross income, and only if you itemize deductions on Schedule A.
  • Deductible expenses include doctor and dentist visits, prescription medications, medical equipment, and health insurance premiums you paid yourself.
  • Cosmetic procedures, over-the-counter medications, and expenses reimbursed by insurance do not count.
  • You must keep receipts, invoices, and proof of payment for all claimed expenses in case the IRS requests documentation.

Expenses the IRS allows you to deduct

Doctor, dentist, and mental health visits count, including the cost of the visit itself and any tests or procedures performed during it. Prescription medications and insulin are deductible. Over-the-counter medications such as aspirin, cold medicine, or antacids are not, unless prescribed by a doctor.

Medical equipment and supplies are deductible if prescribed by a doctor: eyeglasses, hearing aids, crutches, wheelchairs, blood pressure monitors, glucose monitors, and similar items. The cost of replacing or repairing them counts too. Dental work including cleanings, fillings, root canals, crowns, and orthodontia (braces) is deductible.

Health insurance premiums you paid yourself are deductible if you are self-employed or unemployed. If your employer deducted premiums from your paycheck, those are already pre-tax and do not count again. Long-term care insurance premiums are deductible up to an annual limit that depends on your age; the IRS publishes the limit each year.

Hospital and surgical center bills, including room and board during inpatient treatment, are deductible. Therapy and rehabilitation services, including physical therapy and substance abuse treatment, count. The cost of travel to and from medical appointments—mileage at the IRS rate, parking, and tolls—is deductible, but not meals or lodging unless you are traveling for inpatient care.

Expenses you cannot deduct

Cosmetic procedures such as teeth whitening, Botox, facelifts, and hair removal are not deductible unless they are reconstructive after an accident, burn, or disease. Elective surgery for appearance alone does not may have access to. Gym memberships and general wellness programs are not deductible, even if recommended by your doctor for health reasons.

Over-the-counter medications and supplements are not deductible unless prescribed. Vitamins, herbal remedies, and nutritional supplements do not count. Expenses reimbursed by insurance, an employer health plan, or a health savings account (HSA) cannot be deducted again; you deduct only the amount you paid out of pocket.

Maternity clothes, childcare, and babysitting are not medical expenses. Cosmetic dentistry such as teeth whitening or veneers is not deductible unless it is part of treatment for a disease or injury. Expenses for a spouse or dependent you do not claim on your return do not count.

How to document and report medical expenses

Keep receipts, invoices, and statements from every provider and pharmacy. The receipt should show the date, the provider's name, what service or item was provided, and the amount you paid. If you paid by check or credit card, the bank or card statement serves as proof of payment. For mileage, keep a log with the date, destination, and miles driven.

Add up all deductible expenses for the tax year. Subtract 7.5% of your AGI from this total. The remainder is the amount you can deduct. For example, if your AGI is $50,000 and your medical expenses total $6,000, you subtract $3,750 (7.5% of $50,000), leaving $2,250 deductible.

Report this amount on Schedule A, line 1. You must also complete Form 1040 to calculate your AGI. If your total itemized deductions (medical plus other allowed deductions) do not exceed the standard deduction for your filing status, you will not benefit from itemizing, and your medical expenses will not reduce your tax.

When you should itemize instead of taking the standard deduction

The standard deduction for 2024 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 (mortgage interest, property taxes, charitable donations, state and local taxes up to $10,000) total more than your standard deduction, itemizing saves you money.

High medical expenses in a single year can push you over the standard deduction threshold. If you had a major surgery, hospitalization, or ongoing treatment, add up all related costs. If you also own a home with a mortgage and pay property taxes, you may have enough itemized deductions to benefit from itemizing.

Use the IRS Interactive Tax Assistant or a tax software program to compare your standard deduction against your itemized deductions. If itemizing saves you money, report your medical expenses on Schedule A. If not, take the standard deduction and do not report medical expenses.

Medical expenses for dependents and spouses

You can deduct medical expenses you paid for your spouse, even if you file separately (though filing jointly usually saves more money). You can deduct expenses for a dependent you claim on your return, even if the dependent had income of their own. The dependent must be a child, parent, or other relative you support.

If you paid medical expenses for someone who was your dependent for part of the year but not the whole year, you can deduct only the expenses paid while they were your dependent. If you and your ex-spouse share custody and alternate claiming a child, only the parent who claims the child that year can deduct that child's medical expenses.

Frequently Asked Questions

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

No. Premiums deducted from your paycheck are already pre-tax, meaning they reduce your taxable income before you file. You cannot deduct them again on your tax return. Only premiums you paid out of pocket—such as COBRA coverage or insurance you bought yourself—are deductible.

Are prescription glasses and contacts deductible?

Yes. The cost of eyeglasses, contact lenses, and eye exams to determine your prescription are deductible medical expenses. Frames and lens coatings count too. However, the total must still exceed 7.5% of your AGI, and you must itemize deductions to claim them.

Can I deduct therapy or counseling sessions?

Yes. Mental health treatment, including therapy, counseling, and psychiatric visits, is deductible. Medications prescribed for mental health conditions are also deductible. These expenses count toward your medical expense threshold just like any other medical cost.

What if I paid medical bills for my adult child?

You can deduct medical expenses you paid for an adult child only if you claim them as a dependent on your return. If your child files their own return and is not your dependent, you cannot deduct their medical expenses, even if you paid the bills.

Do I need to report which provider I paid each medical expense to?

No. You report only the total deductible amount on Schedule A. However, you must keep receipts and documentation for each expense in case the IRS requests them during an audit. The IRS does not require you to list each provider on your return.