How to Itemize Medical Expenses on Your Tax Return

To itemize medical expenses on your tax return, you list qualifying medical and dental costs on Schedule A (Form 1040), subtract 7.5% of your adjusted gross income, and deduct whatever remains, provided your total itemized deductions across all categories beat the standard deduction for your filing status. Two thresholds have to fall in your favor before the effort pays off: your medical spending has to clear the AGI floor, and your itemized total has to exceed the standard deduction. When both happen, the paperwork is straightforward.

The 7.5% AGI Floor

You can deduct only the portion of qualifying medical and dental expenses that exceeds 7.5% of your adjusted gross income.¹ Your AGI is the number on Form 1040 after above-the-line adjustments like retirement contributions and student loan interest, but before any itemized or standard deduction.

A quick example. With an AGI of $60,000, multiply by 0.075 to get a $4,500 floor. If you spent $7,000 on qualifying care, $2,500 is deductible. Spend $4,000, and nothing is deductible because you never cleared the floor. The higher your income, the more you need to spend before a single dollar counts.

Will Itemizing Beat the Standard Deduction

Itemizing only helps if your total itemized deductions exceed the standard deduction for your filing status. For 2026, the standard deduction amounts are:²

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

Medical expenses on their own rarely clear these numbers. Combined with mortgage interest, state and local taxes (capped at $10,000), and charitable contributions, the itemized total can pull ahead. Run it both ways before you commit. If your itemized figure falls short, the standard deduction gives you a bigger break with far less paperwork.

What Counts as a Qualifying Expense

Federal law defines deductible medical care as amounts paid to diagnose, treat, prevent, or alleviate a physical or mental condition.³ In practical terms, that covers:

Fees paid to physicians, surgeons, dentists, psychiatrists, psychologists, and other licensed practitioners
Prescription drugs and insulin (over-the-counter medications generally don’t count unless prescribed)
Lab tests, X-rays, MRIs, and similar diagnostic work
Inpatient and outpatient mental health treatment, including substance abuse programs
Prescription eyeglasses, contact lenses, hearing aids, prosthetics, wheelchairs, and crutches
Health insurance premiums paid with after-tax dollars, including dental and vision coverage

If you’re self-employed and pay your own health insurance premiums, those are usually better claimed as an adjustment to income on Schedule 1, because that reduces your AGI directly. Any premium amount you can’t deduct there can still be included in your Schedule A medical total.⁴

Travel and Lodging for Care

Transportation to get medical care qualifies. You can track actual gas and parking costs or use the IRS medical mileage rate, which for 2026 is 20.5 cents per mile.⁵ Bus, train, and plane fares to reach a medical facility also count.⁶

When treatment requires an overnight stay away from home, lodging is deductible up to $50 per night per person. A parent or companion traveling with the patient adds another $50, so a parent with a child could claim $100 per night. Meals during the trip aren’t deductible, the lodging can’t be lavish, and the trip can’t have any real vacation element.⁶

Home Modifications for a Medical Reason

Modifications made to your home for a medical reason can count. Improvements that don’t increase your home’s value are fully deductible. The IRS lists modifications that generally don’t add value:⁶

Entrance and exit ramps
Widened doorways and hallways
Bathroom railings, support bars, and grab bars
Lowered cabinets and modified fixtures
Porch lifts and stairway modifications
Modified fire alarms and warning systems

When an improvement does raise your home’s value, you deduct only the difference. Spend $15,000 on a therapeutic pool that increases the home’s value by $10,000, and $5,000 is a deductible medical expense. Operating and maintaining medically necessary equipment is also deductible, even when the original installation wasn’t fully deductible.

Long-Term Care Premiums

Premiums for qualified long-term care insurance are deductible, but capped by your age at the end of the tax year. 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 and older: $6,200

These premiums still pass through the 7.5% AGI filter along with everything else on Schedule A.⁶ Nursing home costs are fully deductible when the primary reason for the stay is medical care and the resident is certified chronically ill by a physician; if the stay is primarily custodial, only the medical portion counts.

What Doesn’t Qualify

Cosmetic procedures are generally not deductible. The narrow exception is a procedure that corrects a deformity from a congenital abnormality, an accidental injury, or a disfiguring disease.³ Teeth whitening, liposuction, and elective facelifts don’t qualify. Also excluded: gym memberships (unless prescribed for a specific condition), nonprescription vitamins and supplements, and funeral costs. General wellness spending that isn’t tied to a diagnosed condition doesn’t count no matter how healthy it is.

Whose Expenses You Can Include

You can deduct qualifying medical expenses you paid for yourself, your spouse, and anyone who qualifies as your dependent.¹ For divorced or separated parents, a child is treated as a dependent of both parents for medical expense purposes regardless of who claims the child on their return, so each parent can deduct the expenses they personally paid.⁷

Timing and Reimbursements

Medical expenses are deducted in the year you pay them, not when the service happened or the bill arrived. Surgery in December paid off in January belongs on next year’s return. Credit card charges count in the year you swipe, not when the statement is paid.⁶

Only unreimbursed expenses count. If insurance covers part of a bill, deduct only your out-of-pocket share.¹ Watch the HSA, FSA, and HRA rule: any expense paid or reimbursed through one of those accounts cannot also be claimed on Schedule A. The IRS treats that as double-dipping. If you’re planning to itemize, it can pay to run some medical costs through the account and others through your after-tax dollars, depending on which route saves more.

Filling Out Schedule A

The medical expense calculation takes the first four lines of Schedule A (Form 1040):

Line 1: total qualifying medical and dental expenses paid during the year
Line 2: your AGI from Form 1040
Line 3: Line 2 multiplied by 0.075 (the floor)
Line 4: Line 1 minus Line 3, or zero if Line 3 is larger

The Line 4 figure then combines with your other itemized deductions further down the form. Tax software does this automatically. If you’re working the form by hand, confirm that the AGI on Line 2 matches your 1040 exactly; a wrong AGI throws off the whole deduction.⁶

Records to Keep

You don’t send documentation with the return, but you need it if the IRS asks. For each expense, keep the receipt, canceled check, or credit card statement showing the date and amount. Explanation of Benefits statements from your insurer document what insurance covered and what you paid yourself. If you use the mileage rate, keep a log with dates, destinations, and miles driven.

Hold these records for at least three years from the date you filed the return, or two years from the date you paid the tax, whichever is later.⁸

1
Internal Revenue Service. Topic No. 502, Medical and Dental Expenses
2
Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026
3
Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses
4
Internal Revenue Service. Instructions for Form 7206
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Internal Revenue Service. IRS Sets 2026 Business Standard Mileage Rate at 72.5 Cents Per Mile, Up 2.5 Cents
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Internal Revenue Service. Publication 502 – Medical and Dental Expenses
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Internal Revenue Service. IRS Courseware – Medical Expenses
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Internal Revenue Service. How Long Should I Keep Records