Copays for medical and dental care are tax deductible, but only under two conditions: you itemize deductions on Schedule A rather than taking the standard deduction, and your total unreimbursed medical costs for the year exceed 7.5% of your adjusted gross income (AGI).1Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses Copays paid with tax-advantaged funds like an HSA or FSA don’t qualify, and insurance reimbursements have to be subtracted. For most people with routine healthcare spending, copays alone won’t clear the threshold, but they add to the total that does.
How the 7.5% AGI Floor Works
Only the portion of your unreimbursed medical spending that exceeds 7.5% of your AGI is deductible.1Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses AGI is the figure on your return after adjustments like student loan interest and retirement contributions, but before your standard or itemized deduction.
Say your AGI is $50,000. Multiply by 0.075 and your floor is $3,750. If you paid $4,500 in copays, prescriptions, and other qualified costs during the year, $750 is deductible. Everything below the floor still matters, because those dollars are what get you to the threshold in the first place.
Which Copays Qualify
The IRS defines deductible medical care broadly, covering costs to diagnose, treat, or prevent disease and treatments that affect any part or function of the body.2Internal Revenue Service. Topic No. 502, Medical and Dental Expenses Copays that fit inside that definition include:
- Primary care, urgent care, and specialist visits.
- Dental work, including cleanings, fillings, extractions, braces, dentures, and X-rays.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses
- Vision care such as eye exams, glasses, contacts, and corrective surgery.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses
- Prescription medications, plus insulin even when not prescribed.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses
- Therapy and psychiatric care for a diagnosed mental illness.4Internal Revenue Service. Frequently Asked Questions About Medical Expenses Related to Nutrition, Wellness and General Health
- Long-term care services for a chronically ill person under a licensed practitioner’s plan of care.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses
Over-the-counter medications don’t count unless a doctor prescribes them. Insulin is the exception. Cosmetic procedures — face lifts, hair transplants, liposuction — are excluded when they primarily improve appearance without treating disease, though reconstructive surgery after an accident, disease, or for a congenital abnormality generally qualifies.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses
Copays Paid With HSA or FSA Funds Don’t Count
If you paid a copay using money from a Health Savings Account, Flexible Spending Arrangement, or Archer MSA, you cannot also deduct that copay on Schedule A.5Internal Revenue Service. Publication 969 – Health Savings Accounts and Other Tax-Favored Health Plans Those dollars were already tax-advantaged going into the account. Only copays paid with after-tax money — a personal checking account, debit card, or credit card — go into your Schedule A total. If you split a bill between your HSA and personal funds, count only the personal portion. Anything your insurer later reimbursed comes out of the total too.
Is Itemizing Actually Worth It?
You can only deduct medical expenses if you itemize instead of taking the standard deduction.2Internal Revenue Service. Topic No. 502, Medical and Dental Expenses That decision is all-or-nothing: your combined itemized deductions — medical costs above the 7.5% floor, mortgage interest, state and local taxes, charitable contributions, and others — need to beat the standard deduction for your filing status.
For the 2026 tax year:6Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026, Including Amendments From the One, Big, Beautiful Bill
- Single or married filing separately: $16,100
- Married filing jointly: $32,200
- Head of household: $24,150
Those figures are high enough that many taxpayers come out ahead with the standard deduction even after a rough year of medical bills. The copay deduction tends to pay off when you already have significant itemized deductions from other categories and the medical piece pushes the total meaningfully past the standard amount.
Copays You Paid for Family Members
Copays you paid for your spouse or a dependent count too.1Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses For a relative who isn’t your spouse or child, the person generally has to meet the IRS “qualifying relative” tests, which include your having provided more than half of their financial support during the year.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses
Divorced and separated parents have a specific rule. Either parent can deduct copays they personally paid for the child, as long as the child was in the custody of one or both parents for more than half the year and the parents together provided more than half of the child’s support.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses Each parent deducts only what they actually paid.
When a Copay Counts: The Timing Rule
The expense belongs to the year you paid it, not the year you got care or received the bill. A copay charged to a credit card counts in the year you made the charge, not the year you paid off the balance.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses For a check, the payment date is the day you mailed or delivered it. For an online or phone payment, use the date your bank recorded.
If you’re near the 7.5% threshold in December, moving a January appointment forward and paying for it before year-end can be the difference between deducting nothing and deducting something. Prepayments for care you’ll receive in a future year, though, generally aren’t deductible until you actually receive the care.
Other Costs That Stack With Your Copays
Copays are only part of the total. Transportation to and from medical appointments also counts, including bus fare, ambulance charges, parking, and mileage when you drive yourself. For 2026, the IRS medical mileage rate is 20.5 cents per mile, or you can track actual gas and oil costs instead.7Internal Revenue Service. IRS Sets 2026 Business Standard Mileage Rate at 72.5 Cents per Mile, Up 2.5 Cents These amounts join your copays, prescriptions, and other qualified spending when you test the 7.5% threshold.
How to Claim the Deduction
You file Form 1040 with Schedule A attached.8Internal Revenue Service. 2025 Instructions for Schedule A (Form 1040) Enter your total unreimbursed medical costs on Line 1 of the medical and dental section. The form then computes 7.5% of your AGI, subtracts it, and gives you the deductible amount.
Keep the documentation that backs up your Line 1 figure: receipts, explanation-of-benefits statements, pharmacy year-end summaries, and provider records that show the date of service, the provider, and what you paid out of pocket after insurance. If the number you enter doesn’t line up with what your records support, expect follow-up from the IRS.