Can Medical Expenses Be Deducted on Your Taxes?

You can deduct medical expenses on your taxes, but only the portion that exceeds 7.5% of your adjusted gross income, and only if you itemize deductions on Schedule A instead of taking the standard deduction.¹ Most people with routine healthcare costs never clear that floor. But if you had a major surgery, a chronic condition, expensive prescriptions, long-term care premiums, or a family member whose bills you paid, the deduction can be worth real money. Here’s how it works and what to check before you count on it.

The 7.5% AGI Floor

Add up your qualifying medical expenses for the year. Then multiply your AGI by 0.075. Subtract the second number from the first. Whatever is left is the amount you can potentially deduct. Anything at or below the floor does not produce a deduction.¹

An example. If your AGI is $60,000, your floor is $4,500. Spend $6,000 in qualifying costs and your deduction is $1,500. Spend $4,000 and your deduction is zero. That’s why $5,000 in real bills often translates into only a few hundred dollars of tax benefit. It also explains why timing matters: bunching payments into one high-cost year can turn nothing into something.

You Have to Itemize for It to Matter

Medical expenses only produce a tax benefit if the total of all your itemized deductions exceeds your standard deduction. For 2026, the standard deduction is $16,100 for single filers, $32,200 for married filing jointly, and $24,150 for head of household.² Filers 65 or older get an additional standard amount on top.

A married couple would need more than $32,200 in total itemized deductions (medical above the floor, state and local taxes, mortgage interest, charitable gifts) before itemizing pays off. The math works most often for filers who already itemize because of a mortgage or large charitable giving, or for anyone who had a very high-cost medical year.

What Counts as a Qualifying Expense

The IRS defines medical care broadly. Payments to doctors, surgeons, dentists, chiropractors, and other licensed practitioners qualify when they’re for diagnosis, treatment, or prevention of disease. Hospital stays, lab work, and nursing services count as long as nothing reimbursed you. Eye exams, prescription glasses, and contact lenses are included.³

Prescription drugs and insulin are deductible. Over-the-counter medicines are not, even on a doctor’s recommendation, unless they’re actually prescribed. Vitamins and supplements are excluded unless a physician prescribes them for a specific diagnosed condition.³

Equipment qualifies: hearing aids, wheelchairs, crutches, prosthetics. So does travel to and from medical care. Bus, taxi, train, and plane fares for medical trips are deductible, and if you drive yourself, you can either track actual gas and oil or use the standard medical mileage rate.³

Insurance Premiums

Health insurance premiums count as medical expenses, but only if you paid them with after-tax dollars. Most employer plans pull premiums from your paycheck pre-tax, which already gave you a tax break; you can’t claim them again on Schedule A.³ This is the single most common mistake people make on medical deductions.

Medicare premiums do qualify. That includes Part A, Part B, Part D, Medicare Advantage, and Medigap.³ Even if your Part B premium is withheld from your Social Security check, the full amount still counts.

Long-term care insurance premiums are partially deductible, capped by age. For 2026:

Age 40 or under: $500
Ages 41–50: $930
Ages 51–60: $1,860
Ages 61–70: $4,960
Age 71 and older: $6,200

Anything you paid above the age cap can’t be included, and whatever falls within the cap still has to run through the 7.5% floor with everything else.

Life insurance premiums, disability income policies, and policies that pay a flat weekly amount during hospitalization are never deductible as medical expenses.³

What Doesn’t Qualify

Cosmetic surgery is out. Any procedure aimed at improving appearance that doesn’t treat illness, correct a congenital deformity, or repair damage from an accident or disfiguring disease is nondeductible.¹ Face lifts, hair transplants, teeth whitening, and liposuction all fall on the wrong side.

Gym memberships and health club dues don’t qualify, even with a doctor’s note, unless the fees are specifically for a physician-prescribed weight-loss program treating a diagnosed condition. Dancing and swimming lessons a doctor recommended for general fitness are also out.³

Other exclusions that catch filers off guard: marijuana (a federally controlled substance even in states where it’s legal), funeral expenses, maternity clothes, babysitting so you can attend appointments, and household help a doctor recommended.³

HSAs, FSAs, and No Double-Dipping

You can’t deduct an expense on Schedule A if you paid it with tax-free money from an HSA, FSA, or HRA.³ Those accounts already delivered a tax benefit up front.

The rule reaches further than most people expect. If you paid a bill out of pocket, then took an HSA distribution later to reimburse yourself, that expense is off the table for Schedule A too.⁴ Any portion covered by a tax-free distribution is gone from your deductible pool.

In a heavy medical year, it’s worth thinking through which expenses to route through your HSA and which to pay with regular after-tax dollars so you preserve the option to itemize.

Whose Expenses You Can Include

You can include bills you paid for your spouse and for anyone who qualifies as your dependent.¹ The person must have been your dependent either when the services were provided or when you paid.

For a qualifying relative, you generally need to have provided more than half of their support for the year.³ They must also be a U.S. citizen or national, or a resident of the U.S., Canada, or Mexico; legally adopted children who live with you as household members are exempt from the citizenship rule.⁵

This is often valuable for adult children paying medical bills for aging parents. If you cover more than half of a parent’s support and the other dependency tests are met, their bills fold into your deduction calculation alongside your own.

When the Expense Counts

Medical expenses go on the return for the year you paid them, not the year you received care.³ Surgery in December 2025 that you finish paying off in February 2026 belongs on your 2026 return.

The payment date depends on how you paid. For a check, it’s the date you mailed or delivered it. For an online or phone payment, it’s the date on your bank statement. For a credit card, it’s the date of the charge, not the date you paid the credit card bill.³

The credit card rule is the one to remember. A $5,000 procedure charged in December counts for that year even if you pay the statement in January. If you’re close to clearing the 7.5% floor, timing a large charge before December 31 can convert a nondeductible year into a deductible one.

Home Modifications for Medical Reasons

Structural changes and special equipment installed for medical reasons can count as medical expenses. The question is whether the improvement increases your home’s value.³

If it does, you subtract the value increase from what you spent. Only the remainder qualifies. Spend $8,000 on an elevator, get an appraisal showing the home’s value went up by $4,400, and $3,600 is your medical expense. If the value increase matches or exceeds what you spent, nothing is deductible.

Many disability-related modifications don’t typically raise home value and can be included in full: entrance ramps, grab bars and railings, widened doorways, modified cabinets, porch lifts, modified stairways.³ Elevators are the exception; they usually do add value, so plan on an appraisal. Only reasonable costs for the medical accommodation itself qualify. Aesthetic upgrades layered on top are personal expenses.

Ongoing maintenance of a medically necessary improvement stays deductible in later years, even if the original installation didn’t fully qualify.³

Reporting on Schedule A

Medical and dental expenses go on the first four lines of Schedule A (Form 1040):⁶

Line 1: total qualifying expenses after subtracting insurance reimbursements.
Line 2: your AGI from Form 1040.
Line 3: line 2 multiplied by 0.075.
Line 4: line 1 minus line 3. Zero or negative means no medical deduction.

The line 4 amount flows into the rest of Schedule A with your other itemized deductions.

Records to Keep

The IRS can ask you to substantiate every dollar. Keep receipts and bills from providers and pharmacies. Save explanation-of-benefits statements showing what your insurer did and didn’t cover. If you’re claiming medical mileage, keep a log with date, destination, purpose, and miles for each trip.

For insurance premiums, keep records showing what you paid and whether it came from pre-tax or after-tax income. For home improvements, hold onto the contractor’s invoice and any appraisal establishing the value before and after. There’s no dedicated IRS form for this recordkeeping. You just need enough paper to rebuild your deduction if the IRS asks.

1
Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses
2
Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026, Including Amendments From the One, Big, Beautiful Bill
3
Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses
4
Internal Revenue Service. Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans
5
Internal Revenue Service. Publication 501 (2025), Dependents, Standard Deduction, and Filing Information
6
Internal Revenue Service. 2025 Schedule A (Form 1040) Itemized Deductions