Are Out-of-Pocket Medical Expenses Tax Deductible?

Out-of-pocket medical and dental expenses are tax deductible, but only the portion that exceeds 7.5% of your adjusted gross income, and only if you itemize deductions on Schedule A of Form 1040.¹ For someone with $80,000 in adjusted gross income, the first $6,000 of medical spending produces no deduction. Everything above that floor reduces your taxable income dollar for dollar. The deduction ends up most useful in years with unusually high healthcare costs relative to income.

How the 7.5% Floor Works

Your adjusted gross income (AGI) sits on Line 11 of Form 1040. Multiply it by 0.075 to find your floor. Only qualifying medical expenses above that number are deductible.

Say your AGI is $60,000. Your floor is $4,500. Spend $7,000 on qualifying medical care during the year and you can deduct $2,500. Spend only $4,000 and you get nothing, because you never cleared the threshold. Higher incomes make the floor harder to reach, which is why the deduction tends to help retirees, people with chronic conditions, and anyone hit by a major medical event during the year.

Itemizing or Taking the Standard Deduction

Medical expenses go on Schedule A, so claiming them means giving up the standard deduction.² Itemizing is only worthwhile if your combined itemized deductions — medical costs above the floor, state and local taxes, mortgage interest, charitable gifts — exceed the standard deduction for your filing status. For the 2026 tax year:³

Single or married filing separately: $16,100
Married filing jointly: $32,200
Head of household: $24,150

A married couple filing jointly with $28,000 in potential itemized deductions is better off with the $32,200 standard deduction. Run both calculations before committing. Keep receipts, explanation-of-benefits statements, and payment records through the year so you have the documentation ready if itemizing turns out to be the better choice.

What Counts as a Deductible Medical Expense

The IRS defines medical care broadly: anything paid for the diagnosis, cure, treatment, or prevention of disease, or for treatment affecting any part or function of the body.⁴ That reaches well beyond copays.

Eligible costs include payments to doctors, dentists, surgeons, psychologists, chiropractors, and other licensed practitioners. Hospital stays qualify, including meals and lodging during inpatient care. Prescription drugs and insulin are covered, along with X-rays and lab work. So is medical equipment: eyeglasses, contact lenses, hearing aids, wheelchairs.⁴

Transportation and Travel for Care

Getting to and from treatment creates deductible costs. You can include bus, taxi, train, and plane fares, ambulance fees, and mileage in your own vehicle. The 2026 standard medical mileage rate is 20.5 cents per mile, and parking and tolls can be added on top.⁵

Lodging while traveling for medical care is deductible up to $50 per night per person, provided the trip is primarily for care at a licensed facility. A parent staying with a sick child can claim up to $100 a night for the two of them. Meals during that travel are not part of this lodging deduction.⁴

Long-Term Care and Nursing Homes

Nursing home costs, including meals and lodging, are fully deductible when the main reason for being in the facility is medical care. If the stay is mainly personal, only the portion of the bill tied to medical or nursing services qualifies.⁴ This distinction matters in assisted living and memory care, where medical services often come bundled with room and board.

Premiums for qualified long-term care insurance count too, capped by age at year-end. For 2026:

Age 40 or under: $500
Age 41 to 50: $930
Age 51 to 60: $1,860
Age 61 to 70: $4,960
Age 71 or over: $6,200

Home Modifications

Home improvements for a medical reason can be deductible, with the size of the deduction depending on whether the change adds value to your home. If it does, you deduct only the difference between what you paid and the increase in value. A $20,000 pool prescribed for physical therapy that raises home value by $15,000 leaves you with a $5,000 medical expense.⁴

Certain accessibility modifications are treated as adding no value and are fully deductible:

Entrance or exit ramps
Widened doorways and hallways
Bathroom railings, grab bars, and support bars
Lowered kitchen cabinets and equipment
Porch lifts (elevators generally do add value)
Modified stairways, fire alarms, and electrical outlets
Grading the ground around the home for wheelchair access

Only reasonable costs for the medical purpose qualify. Upgraded materials or design features beyond the accommodation are personal expenses.

Health Insurance Premiums

Premiums you pay out of pocket for medical, dental, and vision insurance are deductible medical expenses when you itemize. That includes marketplace plans, the employee-paid portion of employer coverage, HMOs, Medicare Part B, and Medicare Part D.⁴ The income-related monthly adjustment amount (IRMAA) surcharge on Medicare premiums is deductible. Late enrollment penalties on Part B or Part D are not.

Some premiums are excluded. Life insurance, disability income policies, and policies that pay a fixed weekly amount during hospitalization do not qualify. Premiums covered by advance premium tax credits that you did not repay are also out. If you did have to repay excess advance credits, that repayment counts as a deductible medical expense.

A Separate Path for the Self-Employed

If you are self-employed, you may be able to deduct health insurance premiums without itemizing. Federal law allows an above-the-line deduction for medical, dental, vision, and qualified long-term care premiums covering you, your spouse, your dependents, and your children under age 27.⁶ You claim it on Schedule 1 (Form 1040), Line 17, using Form 7206.⁷ The deduction cannot exceed your net self-employment income and is unavailable for any month you were eligible for a subsidized plan through a spouse’s employer. Any premium you cannot claim this way can still land on Schedule A if you itemize.

Whose Medical Bills You Can Include

You can deduct medical costs you pay for yourself, your spouse, and your dependents.¹ The medical expense rules use a looser definition of “dependent” than the rest of the return: you can deduct medical costs for a person even if their gross income is too high for you to claim them as a dependent for other purposes.⁸ This often matters for elderly parents or adult children who earn some income but still rely on you financially.⁹

For divorced or separated parents, the parent who actually pays a child’s medical bill can deduct it, regardless of which parent claims the child as a dependent, as long as the child was in the custody of one or both parents for more than half the year and received more than half their support from them.⁴

What Does Not Qualify

Ineligible expenses on a return invite an audit adjustment. The main disqualified categories:

Reimbursed costs. Anything your insurer paid, your HSA or FSA covered, or an HRA reimbursed cannot be deducted. Those dollars were already tax-advantaged.¹⁰

Cosmetic procedures. Surgery aimed at appearance without treating a medical condition is excluded — face lifts, hair transplants, liposuction. Cosmetic surgery that corrects a deformity from a congenital abnormality, an accident, or a disfiguring disease is an exception.

Over-the-counter drugs and supplements. Non-prescription medications and vitamins generally do not qualify. Nutritional supplements and herbal remedies are out unless a physician diagnoses a specific condition and a medical practitioner recommends them as treatment. Insulin is always deductible, with or without a prescription.

General wellness. Gym memberships, health club dues, and fitness programs for overall well-being do not qualify, even if a doctor suggested more exercise. Weight-loss programs count only when a physician has diagnosed a specific disease the program treats, such as obesity, diabetes, or heart disease.¹¹

Funeral and burial costs. Never deductible as medical expenses.

Timing and Recordkeeping

You deduct medical expenses in the year you pay them, not the year of treatment. December surgery paid for in January belongs on the next year’s return. Credit card charges are different: the expense counts in the year you make the charge, not the year you pay the balance.⁴ Charging a large bill in December can lock in the deduction for that year while spreading the actual payment over months.

If you deduct an expense one year and receive a reimbursement for it later (a delayed insurance payment, a legal settlement), you generally report the reimbursement as income on the later return. The reportable amount is limited to the portion that actually reduced your tax originally. If the deduction did not reduce your tax because it fell below the 7.5% floor, the reimbursement is not taxable.

Keep every receipt, explanation-of-benefits statement, and pharmacy printout. The IRS can audit a return up to three years after filing, and you will need proof of what you paid, when, and for what purpose. Organized records also let you compare your running total to the 7.5% floor before year-end, so you can decide whether itemizing is worth doing before the calendar closes.

1
Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses
2
Internal Revenue Service. Instructions for Schedule A (Form 1040) (2025)
3
Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026
4
Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses
5
Internal Revenue Service. IRS Sets 2026 Business Standard Mileage Rate
6
Office of the Law Revision Counsel. 26 USC 162 – Trade or Business Expenses
7
Internal Revenue Service. Instructions for Form 7206 (2025)
8
Internal Revenue Service. Dependents
9
Internal Revenue Service. Publication 501 (2025), Dependents, Standard Deduction, and Filing Information
10
Internal Revenue Service. Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans
11
Internal Revenue Service. Frequently Asked Questions About Medical Expenses Related to Nutrition, Wellness and General Health