Yes. Medicare Part B and Part D premiums are tax deductible as qualified medical expenses under federal law. How you claim the deduction depends on your situation: most retirees have to itemize on Schedule A and clear a 7.5% income floor before any benefit kicks in, while self-employed taxpayers can deduct the premiums above the line without any floor at all.1Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses2Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses
Which Medicare Costs Count
Federal law names Part B premiums directly in the statute governing the medical expense deduction.1Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses Part D isn’t named in the statute, but IRS Publication 502 confirms that prescription drug plan premiums also qualify.2Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses
Several related costs qualify too:
- IRMAA surcharges on Part B and Part D, because they are part of your total Medicare premium.3Social Security Administration (SSA). POMS HI 01101.031 – How IRMAA Is Calculated and How IRMAA Affects the Total Medicare Premium
- Medicare Advantage (Part C) premiums, under the same rules that cover other health insurance.
- Medigap premiums for supplemental coverage.
- Part A premiums, if you pay one because you didn’t earn 40 quarters of Social Security credits.4Centers for Medicare & Medicaid Services. Original Medicare (Part A and B) Eligibility and Enrollment
Premiums deducted from your Social Security check count the same as premiums you write a check for. The Social Security Administration reports them on Form SSA-1099 each January.5Social Security Administration. Get Your Social Security Benefit Statement (SSA-1099)
How Most Retirees Claim the Deduction
If you aren’t self-employed, Medicare premiums come off your taxes only through itemized deductions on Schedule A of Form 1040.6Internal Revenue Service. Instructions for Schedule A (Form 1040) (2025) That path has two hurdles, and both have to be cleared.
The 7.5% AGI Floor
Only medical expenses that exceed 7.5% of your adjusted gross income are deductible.2Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses If your AGI is $60,000, the first $4,500 of medical spending produces no deduction at all. Only the dollars above $4,500 go onto Schedule A.
The good news is you don’t count premiums alone. Everything qualifying goes into one pile: Medicare premiums, Medigap or Advantage premiums, unreimbursed doctor and dental bills, prescription copays, vision care, hearing aids, long-term care expenses. The whole pile is measured against the floor.
The Standard Deduction Hurdle
Even after clearing the floor, itemizing only pays off if your total itemized deductions across every category beat the standard deduction. For 2026, the standard deduction is $16,100 for single filers and $32,200 for joint filers, with additional amounts for taxpayers 65 and older.7Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026 A joint filer needs more than $32,200 in combined medical, state and local tax, mortgage interest, and charitable deductions before itemizing is worth doing.
This is where most deduction hopes end. The standard Part B premium for 2026 is $202.90 per month, or about $2,434.80 per year.8Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles A married couple both on Medicare pays close to $4,870 in Part B alone, plus Part D and any surcharges. That sounds like a lot, but a couple with $70,000 in AGI has to spend over $5,250 before any medical expense counts, and whatever clears that floor still has to combine with their other deductions to beat $32,200. Unless the year included major surgery, extensive dental work, or heavy ongoing treatment, the standard deduction wins.
Who Comes Out Ahead
Itemizing tends to work for people with large unreimbursed medical costs, substantial state and local tax or mortgage deductions already pushing them past the standard deduction, or high-income filers paying IRMAA. At the top IRMAA bracket, the total Part B premium reaches $689.90 per month in 2026, with another $91.00 added to Part D.8Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles A high-income couple can pay $15,000 or more in combined Medicare premiums, which makes clearing the floor more realistic, though the same high income also lifts the floor itself.
Keep Your Records
Premiums withheld from Social Security show up on your SSA-1099. If you pay CMS or a Part D insurer directly, hold onto bank statements and payment confirmations. The IRS doesn’t ask you to file this paperwork with your return, but you need it if a question comes up later.2Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses
The Self-Employed Route
If you have self-employment income, the rules shift in your favor. You can deduct Medicare Part B and Part D premiums on Schedule 1 of Form 1040 as a self-employed health insurance deduction, which reduces your adjusted gross income directly.9Internal Revenue Service. Instructions for Form 7206 (2025) – Self-Employed Health Insurance Deduction No 7.5% floor. No requirement to itemize. You can take the standard deduction and still claim this one.
The deduction covers premiums for you, your spouse, and your dependents. IRMAA surcharges count. You compute the amount on Form 7206 and carry it to Schedule 1.10Internal Revenue Service. About Form 7206, Self-Employed Health Insurance Deduction
Two Conditions
First, you need enough net self-employment profit. The deduction can’t exceed your net earnings from the business, after subtracting half of your self-employment tax.11Internal Revenue Service. Self-Employed Health Insurance Deduction Case Study A break-even or loss year means no deduction here, though you can still move those premiums to Schedule A if you itemize.
Second, neither you nor your spouse can be eligible for subsidized coverage through an employer. Eligibility is enough to disqualify you, even if you never signed up. If your spouse’s job offers a plan that would cover you, the deduction is unavailable for the months that coverage was available.
S-Corporation Shareholders
More-than-2% S-corp shareholders qualify, but only if the paperwork is right. The corporation has to pay the premiums directly or reimburse you, and the premium amount has to appear in Box 1 of your W-2 as wages (not in Boxes 3 and 5, so no payroll tax applies).12Internal Revenue Service. S Corporation Compensation and Medical Insurance Issues You then take the above-the-line deduction on your personal return, which cancels out the W-2 inclusion. Miss any step and the deduction disappears. Partners and sole proprietors reporting on Schedule C or Schedule F qualify under the same statute.13Office of the Law Revision Counsel. 26 USC 162 – Trade or Business Expenses
Using an HSA Instead
If you funded a Health Savings Account during your working years, you can pay Medicare Part A, Part B, and Part D premiums with those dollars tax-free after age 65.14Internal Revenue Service. Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans It isn’t a deduction in the technical sense, but the result is similar: the money was never taxed going in and isn’t taxed coming out.
Medigap premiums are the exception. The IRS specifically excludes supplemental Medicare policies from the list of qualified HSA expenses at any age. You can still withdraw for Medigap, but you’ll owe income tax on the distribution.
Two practical limits. Once you enroll in any part of Medicare, your HSA contribution limit drops to zero, and that applies to any months of retroactive coverage too. If you expect your Medicare start date to be backdated, plan your final contributions accordingly. And you can’t deduct a premium on Schedule A that you already paid from your HSA, because that would be claiming the same expense twice.
What You Can’t Deduct
A few costs sit outside the rule, and knowing them keeps you from counting dollars that won’t produce a benefit.
Premiums paid with pre-tax dollars don’t qualify a second time. If a Flexible Spending Arrangement or any employer arrangement with pre-tax payroll deductions covered the premium, the tax break was already taken at the front end.
Late enrollment penalties for Part B or Part D are generally not treated as deductible, since the penalty portion is a surcharge for delayed enrollment rather than a cost of insurance. If you’re carrying a penalty, a tax preparer can tell you what portion of your bill still qualifies.
Premiums paid by someone else aren’t your deduction. A retiree health plan from a former employer that covers your Medicare premiums, or any reimbursement you receive, removes those amounts from your deductible total.
Strategies That Can Push You Over the Floor
If you’re close to clearing the 7.5% threshold, two moves sometimes help.
For married couples where one spouse has heavy medical costs and lower income, filing separately gives each spouse an independent AGI and a correspondingly lower floor for the medical-heavy spouse. The tradeoff is real: separate filing cuts off access to several credits and can land both spouses in worse brackets. Work the numbers both ways before you commit.
Bunching elective medical costs into a single year is the other lever. Dental work, new glasses, or planned procedures scheduled alongside a year of heavy premiums can lift your total enough to clear the floor. The strategy only matters for itemizers; the self-employed deduction has no floor to beat.