Medical Tax Deduction: The 7.5% Floor, What Qualifies, and How to Claim

The medical tax deduction lets you subtract unreimbursed medical and dental expenses from your taxable income, but only the portion that exceeds 7.5 percent of your adjusted gross income, and only if you itemize on Schedule A instead of taking the standard deduction. That two-part test is why many people with real medical bills still get no tax benefit. When the math does work out, though — usually after a surgery, a serious diagnosis, or a year of heavy caregiving — the deduction can meaningfully cut what you owe.

The 7.5 Percent Floor

Under Internal Revenue Code Section 213, you deduct only the medical expenses that exceed 7.5 percent of your adjusted gross income (AGI).¹ Everything under that threshold does nothing for your taxes. If your AGI is $80,000, you need more than $6,000 in qualifying expenses before a single dollar counts. Only what sits above $6,000 reduces your taxable income.

Because the threshold moves with your income, the deduction rewards years when medical costs concentrate. If you have any choice about when to pay for an elective procedure or a major out-of-pocket bill, bunching costs into one tax year often produces a bigger deduction than spreading them across two.

You Have To Itemize

Medical expenses go on Schedule A, so the deduction is only useful if your total itemized deductions beat your standard deduction. For the 2026 tax year, the standard deduction is $16,100 for single filers, $32,200 for married couples filing jointly, and $24,150 for heads of household.²

Medical costs alone rarely push a household over that line. Combined with mortgage interest, state and local taxes, and charitable contributions, they often can. Add up the full Schedule A picture before assuming it isn’t worth the effort.

Whose Expenses You Can Include

You can deduct medical costs you pay for yourself, your spouse, and your dependents.³ The definition of “dependent” is looser here than for other tax purposes: the statute waives the gross income test and the joint return test that normally apply.¹ That means you may be able to deduct medical bills you pay for a parent even if that parent earned too much to be claimed as a dependent elsewhere on your return. You still have to provide more than half of their support for the year.

What Qualifies

The IRS defines medical care broadly: costs to diagnose, treat, or prevent a disease, or that affect a structure or function of the body.⁴ Under that umbrella, deductible expenses include:

Payments to doctors, surgeons, dentists, chiropractors, psychologists, psychiatrists, and other licensed practitioners.³
Prescription drugs and insulin. Non-prescription medications generally do not qualify.³
Medical equipment such as wheelchairs, crutches, and oxygen equipment.⁴
Eyeglasses, contact lenses, and hearing aids.³
Health insurance premiums you paid with after-tax dollars. Premiums pulled from your paycheck pre-tax don’t count, because you already got the tax break on that money.⁴
Transportation for medical care: bus and train fare, ambulance charges, tolls, parking, and out-of-pocket car costs. Instead of tracking gas, you can use the IRS medical mileage rate of 20.5 cents per mile for 2026.⁵
Tuition at a school designed for children with physical or mental disabilities, if a doctor recommends the school and its specialized resources are the main reason for attendance. Meals and lodging at the school can be included.

Home Modifications

Home improvements you make for medical reasons can qualify, with a twist. If the modification raises your property value, you deduct only the part of the cost that exceeds the increase in value. Install a $25,000 therapeutic pool that adds $10,000 to your home’s value, and $15,000 is deductible.⁴

Many accessibility changes don’t affect home value at all, so the full cost qualifies. The IRS specifically lists entrance ramps, widened doorways and hallways, bathroom grab bars and support rails, modified kitchen cabinets, porch lifts, and adjusted electrical outlets.⁴ Only reasonable costs count; aesthetic upgrades beyond what’s medically necessary don’t.

Long-Term Care

When medical care is the main reason someone is in a nursing home or similar facility, the entire cost — including meals and lodging — is deductible.⁴ If the placement is primarily for personal reasons, only the medical and nursing portion of the bill counts.

Qualified long-term care insurance premiums are also deductible, but capped by age. For 2026, the ceilings run from $500 for people 40 and under to $6,200 for people 71 and older. Anything you paid above the cap for your age bracket is not deductible.

What You Cannot Deduct

The IRS separates treatment for a specific condition from general wellness spending. On the wrong side of that line:

Cosmetic procedures, unless the surgery corrects a deformity from a birth defect, accident, or disfiguring disease.⁴
Vitamins, supplements, and over-the-counter medications, even when a doctor recommends them. The expense has to treat a specific diagnosed condition.⁶
Personal care items like toothpaste and toiletries, and non-prescription nicotine patches or gum.³
Gym memberships and health club dues. Weight-loss program costs can qualify, but only when a physician has diagnosed a specific disease such as obesity or hypertension and prescribed the program as treatment.⁴
Funeral and burial expenses.³

Medical Marijuana

This area shifted in 2026. The Department of Justice moved FDA-approved marijuana products and state-licensed medical marijuana into Schedule III of the Controlled Substances Act.⁷ Previously, the IRS disallowed deductions because Schedule I status meant purchases violated federal law.⁴ With rescheduling, that legal barrier is gone. Deductible drug costs under Section 213 typically require a physician’s prescription rather than a recommendation, which matters because many state programs issue recommendations. The IRS has not yet issued detailed guidance on how the rescheduling affects individual tax deductions.

No Double-Dipping with HSAs and FSAs

Expenses you paid using a Health Savings Account, Flexible Spending Account, Health Reimbursement Arrangement, or Archer MSA cannot be deducted on Schedule A.⁶ Those dollars already got a tax break going in.

Only expenses you paid with after-tax money, and that insurance or a tax-advantaged account did not reimburse, count toward the 7.5 percent floor. If you routinely pay medical bills from an HSA, those costs are already off the deduction ledger.

A Better Option for the Self-Employed

If you’re self-employed, look at Section 162(l) before Schedule A. It gives you an above-the-line deduction for health insurance premiums that reduces your AGI directly, without itemizing and without the 7.5 percent floor.⁸

Two limits apply. The deduction can’t exceed the net earnings from the business that sponsors the plan. And you can’t claim it for any month you were eligible to join a subsidized employer health plan, including one through your spouse’s job.⁸ Premiums you deduct under 162(l) can’t also go on Schedule A.

Timing Rules

You deduct medical expenses in the year you pay them, not the year of the service or the billing date.⁴ A December 2025 surgery you settle in January 2026 belongs on your 2026 return. That flexibility is useful when you’re near the 7.5 percent threshold and can choose whether to pay a bill in December or January.

Credit card charges count on the swipe date, not when you pay the card. Charge a bill on December 30 and it counts for that year, even though the statement arrives in January.⁴ For checks, the payment date is generally the day you mail or deliver it.

How To Claim It

Report medical and dental expenses on Schedule A (Form 1040). Line 1 takes your total qualifying costs, reduced by any insurance reimbursements or other payouts. The form then subtracts 7.5 percent of your AGI. What’s left combines with your other itemized deductions, and the total flows to your 1040 to reduce taxable income.⁹

Records To Keep

Hold onto receipts, invoices, Explanation of Benefits statements, and pharmacy records for everything you claim. For mileage, keep a log with dates, destinations, purposes, and miles. Vague totals without backup don’t survive an IRS request for documentation.

Keep the records for at least three years after you file, the standard window the IRS has to audit or assess more tax.¹⁰ The window extends to six years if you underreport income by more than 25 percent, and there is no time limit at all in cases of fraud.

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
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Internal Revenue Service. Topic No. 502, Medical and Dental Expenses
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Internal Revenue Service. Publication 502 – Medical and Dental Expenses
5
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. Frequently Asked Questions About Medical Expenses Related to Nutrition, Wellness and General Health
7
Department of Justice. Justice Department Places FDA-Approved Marijuana Products and Products Containing Marijuana in Schedule III
8
Office of the Law Revision Counsel. 26 US Code 162 – Trade or Business Expenses
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Internal Revenue Service. Instructions for Schedule A (Form 1040)
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Internal Revenue Service. How Long Should I Keep Records