The IRS medical expense deduction lets you write off unreimbursed costs you paid to diagnose, treat, prevent, or manage a disease, or to address something affecting how your body works, but only the portion that exceeds 7.5% of your adjusted gross income counts.1Internal Revenue Service. Topic No. 502, Medical and Dental Expenses You claim it on Schedule A of Form 1040, which means you have to itemize. With the 2026 standard deduction set at $16,100 for single filers and $32,200 for married couples filing jointly, itemizing pays off only when your medical bills, combined with your other itemized deductions, clear those numbers.2Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026
How the 7.5% AGI Floor Works
Only the medical spending above 7.5% of your AGI is deductible. If your AGI is $80,000, the floor is $6,000. Spend $10,000 on qualifying costs and you deduct $4,000. Spend $5,500 and you deduct nothing, because you never crossed the line.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses
This math is why the deduction tends to help people with a single expensive year — a surgery, hearing aids, major dental work — and rarely helps people with steady, moderate costs. If you can see a large bill coming, bunching other elective medical spending into the same calendar year gets more of it above the floor.
What Counts as Medical Care
Internal Revenue Code Section 213(d) defines medical care as amounts paid to diagnose, treat, prevent, or manage disease, plus anything that affects a structure or function of the body.4Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses The controlling test is whether the primary purpose of the expense is medical. A hot tub bought for relaxation fails; one prescribed by a physician for a diagnosed joint condition can pass. Vitamins taken because you feel like it don’t qualify; vitamins prescribed to treat a diagnosed deficiency can.
When an expense sits on the boundary between personal comfort and medical treatment, a physician’s letter explaining medical necessity is what separates a defensible deduction from a problem.
Practitioners and Services That Qualify
Services from licensed physicians, surgeons, and dentists sit at the core of most deductions: exams, surgery, lab work, specialized treatment. The IRS also allows deductions for care from chiropractors, podiatrists, psychologists, psychiatrists, and occupational therapists, provided the practitioner is legally authorized to provide the service where they practice.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses Nursing care qualifies even at home, as long as the services are the kind a nurse normally performs. Inpatient hospital care, including meals and lodging during treatment, is standard.
Mental Health Care
Therapy sessions, inpatient substance abuse treatment, and smoking-cessation programs are deductible when treating a diagnosed condition. The provider doesn’t have to be a psychiatrist; licensed psychologists, clinical social workers, and other qualified mental health professionals count.
Special Education
If a doctor recommends tutoring for a child whose learning disability stems from a mental or physical impairment, the fees qualify, provided the tutor is specially trained. Tuition, meals, and lodging at a school providing special education can also qualify, but only if overcoming the disability is the primary reason for enrollment and ordinary academic instruction is incidental.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses Boarding school for behavioral issues alone does not qualify unless medical care is a principal reason for attending.
Nursing Home Care
Nursing home costs are fully deductible when the main reason for being there is medical care, and in that case meals and lodging count too. If the main reason is personal — the person needs a place to live — only the portion directly tied to medical or nursing care qualifies.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses
Prescriptions, Insulin, and Supplies
Prescription drugs are deductible. Over-the-counter drugs are not, unless a doctor writes a prescription. IRC Section 213(b) is explicit: a medicine counts only if prescribed or if it is insulin.4Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses Insulin is the one exception you can deduct without a prescription.
One boundary worth flagging: the rule allowing OTC medicines and menstrual care products to be reimbursed from HSAs and FSAs without a prescription applies to those accounts, not to the Schedule A deduction. If you’re itemizing, OTC drugs still need a prescription.
You can also deduct medical supplies and diagnostic equipment: bandages, blood sugar test kits, contact lenses, and similar items with a documented medical purpose.
Devices, Equipment, and Home Modifications
Hearing aids, eyeglasses, contact lenses, artificial limbs, wheelchairs, and prosthetic devices all qualify, and so does the ongoing cost of operating and maintaining them, such as batteries or the electricity to charge a powered wheelchair.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses A specialized item like a hospital bed can be deductible with a doctor’s prescription for a specific condition. A standard mattress bought for general comfort cannot.
Home modifications for medical reasons follow their own math. The deductible amount is the cost of the improvement minus any increase in the home’s value. Spend $20,000 installing an elevator that raises your home’s value by $8,000, and you deduct $12,000. If the improvement adds no value, the full cost counts.
Certain disability-related modifications generally add no value at all, so the full cost is usually deductible. Publication 502 lists these examples:
- Entrance and exit ramps
- Widened doorways and hallways
- Railings and support bars in bathrooms and along stairways
- Modified kitchen cabinets and counters
- Grading or landscaping for wheelchair access
Operating and maintaining the modification remains a deductible medical expense afterward, as long as the primary reason is still medical care. For larger projects, budget for an appraisal before and after the work if you need to prove the improvement didn’t add value.
Travel and Lodging for Medical Care
Getting to care is itself deductible. Bus fares, plane tickets, ambulance charges, and the cost of driving your own car all count when the trip is primarily for medical treatment. The 2026 standard medical mileage rate is 20.5 cents per mile, and you can add parking and tolls on top.5Internal Revenue Service. Notice 26-10, 2026 Standard Mileage Rates
Lodging qualifies when the travel is primarily for medical care at a licensed hospital or facility run by a physician, capped at $50 per night per person. A parent traveling with a sick child can deduct up to $100 per night. No deduction is allowed if the travel has any significant recreational element, so a stay near a medical facility in a resort town where you also spend days on the beach will not survive scrutiny.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses
Health Insurance Premiums
Premiums you pay with after-tax dollars are deductible medical expenses. This covers medical, dental, and vision insurance, along with Medicare Part B, Part D, and Medigap. If your employer takes premiums out of your paycheck pre-tax — the most common arrangement — those dollars are already excluded from your taxable income and can’t be deducted again.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses
Some premiums never qualify, regardless of how you pay them:
- Life insurance
- Policies covering lost wages or lost earning capacity
- Policies paying a fixed amount per week during hospitalization
Long-Term Care Insurance Limits
Premiums for tax-qualified long-term care insurance are deductible, but only up to an age-based annual limit. For 2026:
- Age 40 or younger: $500
- Age 41–50: $930
- Age 51–60: $1,860
- Age 61–70: $4,960
- Over 70: $6,200
Age is determined as of the last day of the tax year, not when you paid the premium. Most hybrid life-insurance policies with a long-term care rider do not qualify.
Reimbursed Costs and HSA Interaction
Any expense reimbursed by insurance, an HRA, HSA, FSA, or Archer MSA is off the table for Schedule A. Only unreimbursed costs count, whether the insurer paid you, the provider, or the patient.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses You also can’t pay a bill from your HSA and then use an equivalent amount of personal funds to claim the deduction — the IRS blocks that workaround directly.
In a year where you expect to clear the 7.5% floor, paying out of pocket and letting the HSA continue growing tax-free can be the better move.
Whose Expenses You Can Deduct
You can deduct medical costs you paid for yourself, your spouse, and your dependents. The IRS also lets you deduct expenses for a person who would have been your dependent except that they earned too much, filed a joint return, or could be claimed on someone else’s return.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses This matters most for aging parents whose Social Security income exceeds the dependent threshold but who still rely on you.
The qualifying relationship must exist either when the services were provided or when the bills were paid. For children of divorced or separated parents, each parent can deduct the medical costs they actually paid, regardless of who claims the child as a dependent.
When siblings share the cost of supporting a parent, only one can claim the parent as a dependent that year, with the others signing Form 2120 to waive their claim. Each signer must have contributed more than 10% of the parent’s support.6Internal Revenue Service. About Form 2120, Multiple Support Declaration Only the sibling claiming the dependent can deduct medical expenses they paid for that parent. The siblings who waived cannot, even if they wrote the checks.
What Does Not Qualify
The IRS separates treating a condition from maintaining general health. Common items on the wrong side of that line include:
- Gym memberships and health club dues, even with a doctor’s recommendation. A separate fee for a weight-loss program can qualify if a physician has diagnosed a specific disease like obesity or hypertension.
- Cosmetic surgery, unless it corrects a deformity from a congenital abnormality, an injury, or a disfiguring disease.
- Toothpaste, multivitamins taken for general wellness, and similar toiletries.
- Normal food costs on a prescribed diet. Only special food that doesn’t meet normal nutritional needs and is prescribed to treat an illness qualifies, and only for the amount exceeding the cost of a normal diet.
- Substances illegal under federal law, even if legal in your state.3Internal Revenue Service. Publication 502 – Medical and Dental Expenses
Weight-loss programs are the gray area that catches people off guard. With a physician’s diagnosis of obesity, heart disease, or hypertension and a prescribed program as treatment, fees and meeting costs are deductible. General weight-loss efforts without a diagnosis are not.
Records to Keep
Keep receipts, explanations of benefits, prescription records, and physician letters for at least three years after filing the return that claimed the deduction. That’s the general statute of limitations for IRS assessments, and it stretches to six years if you significantly underreport income.7Internal Revenue Service. How Long Should I Keep Records
Mischaracterizing personal expenses as medical, or inflating amounts, can trigger a 20% accuracy-related penalty on the underpaid tax when the IRS finds negligence, a substantial understatement, or intentional disregard of the rules.8Office of the Law Revision Counsel. 26 USC 6662 – Imposition of Accuracy-Related Penalty on Underpayments A log connecting each expense to a specific condition and practitioner is the simplest protection if the agency asks.