What Medical Expenses Are Tax Deductible? The 7.5% AGI Floor Rule

Medical expenses that are tax deductible on your federal return include unreimbursed costs for doctors, hospitals, dentists, vision care, mental health treatment, prescription drugs, health insurance premiums paid with after-tax dollars, long-term care, medical transportation, certain home modifications, and service animals — for you, your spouse, and your dependents. The catch: you can only deduct the portion of those costs that exceeds 7.5% of your adjusted gross income, and only if you itemize on Schedule A instead of taking the standard deduction.¹

The 7.5% AGI Floor and Whether Itemizing Is Worth It

Only medical spending above 7.5% of your AGI counts. If your AGI is $60,000, the first $4,500 of medical costs is not deductible. Spend $7,000 on qualifying care, and $2,500 is what you can actually deduct.¹

Your AGI sits on line 11 of Form 1040.² But clearing the 7.5% floor is only half the test. The medical deduction lives on Schedule A, which means it only helps you if your total itemized deductions — medical, state and local taxes, mortgage interest, charitable gifts — beat the standard deduction for your filing status.

For tax year 2026, the standard deduction is $16,100 for single filers, $24,150 for heads of household, and $32,200 for joint filers.³ Taxpayers 65 or older get an additional $6,000 per person for tax years 2025 through 2028; a married couple where both spouses are 65 or older has a combined standard deduction of $44,200.⁴ If your itemized total doesn’t exceed those thresholds, the medical deduction won’t do anything for you this year.

Whose Expenses You Can Include

You can deduct qualifying costs paid for yourself, your spouse, and your dependents. A spouse’s expenses qualify as long as you were married either when the services were provided or when you paid the bill.⁵ That means you can still deduct earlier treatment costs for a spouse who has since died.

Dependents include qualifying children and qualifying relatives you support for more than half the year. Even someone who earns too much to be your dependent for other tax purposes can have their medical expenses deducted by you, so long as you provide more than half their support. For children of divorced or separated parents, each parent can deduct the medical costs they personally pay, provided the child is in the custody of one or both parents for more than half the year and receives more than half of their support from the parents combined.⁵

Timing follows the payment, not the service. Expenses are deductible in the year you pay them, even if the treatment happened years earlier. Paying off several years of accumulated bills in one year piles all of it into that year’s deduction.

What Counts as a Qualifying Medical Expense

The IRS defines medical care broadly: amounts paid for the diagnosis, treatment, or prevention of disease, or for treatments affecting any part or function of the body.⁵ The main categories:

Doctor and hospital costs: office visits, surgeries, lab work, X-rays, routine physicals, specialist consultations.
Dental care: cleanings, fillings, braces, crowns, extractions, dentures.
Vision care: eye exams, prescription glasses, contact lenses, laser eye surgery.
Mental health: sessions with psychologists or psychiatrists, and inpatient treatment for substance abuse or other mental health conditions.
Prescription drugs and insulin. Insulin qualifies even without a prescription; everything else must be prescribed.⁵
Medical equipment: hearing aids, wheelchairs, crutches, prosthetic limbs, oxygen equipment.
Service animals: the cost of buying, training, and maintaining a guide dog or other service animal for a visual, hearing, or physical disability.⁶

Transportation to Medical Care

Travel primarily to get medical care is deductible. You can claim actual gas and oil costs, or use the IRS standard medical mileage rate of 20.5 cents per mile for 2026.⁷ Parking and tolls on medical trips count. Traveling to another city for treatment? Bus, taxi, train, and plane fare are deductible, and so is lodging (up to a limit) if you stay overnight. Meals on those trips are not.

Special Education

Tuition at a special school can qualify as a medical expense when the primary reason for enrollment is to overcome a learning disability caused by a mental or physical impairment, with regular education incidental to the specialized instruction. Fees for a tutor recommended by a doctor for a child with learning disabilities also qualify. Sending a child with behavioral problems to a structured school does not count if medical care is not the main reason for enrollment.⁵

Health Insurance Premiums

Premiums you pay with after-tax dollars are deductible medical expenses. That includes private medical, dental, and vision policies, plus Medicare Part B and Part D.⁵ Premiums your employer takes out of your paycheck on a pre-tax basis do not qualify — that money was never in your taxable income to begin with, so there is nothing left to deduct.

Life insurance, disability income insurance, and policies that pay a fixed amount per week of hospitalization are not deductible. Only insurance that specifically covers medical care counts.

If you are self-employed, health insurance premiums for you, your spouse, dependents, and children under age 27 are usually claimed as an above-the-line deduction on Schedule 1, not on Schedule A. The deduction cannot exceed your net self-employment income from the business that established the plan, and you cannot claim it for any month you were eligible for an employer-subsidized plan. You cannot deduct the same premiums both above the line and on Schedule A.⁸

Home Modifications for Medical Reasons

Modify your home for a medical need — wheelchair ramp, wider doorways, grab bars, lowered cabinets — and the cost can qualify.⁵ How much is deductible depends on whether the improvement raises your home’s value. If it does, you subtract the increase in value from the cost, and only the difference is a medical expense. If it does not, the full cost is deductible.

Certain accessibility features typically do not add home value, so the full cost is deductible: entrance ramps, bathroom railings and support bars, widened hallways or doorways, porch lifts, modified fire alarms, grading the ground around entrances, and modified door hardware.⁵ Elevators usually do add value, so only part of the cost qualifies. Aesthetic upgrades tacked onto a medical modification are excluded.

Long-Term Care

Qualified long-term care services — help with daily activities like bathing, dressing, or eating required because of a chronic illness or disability — are deductible as medical expenses. The full cost of qualifying care counts.

Premiums for qualified long-term care insurance are also deductible, but capped by age at year-end. For 2026:

Age 40 or younger: $500
Age 41 to 50: $930
Age 51 to 60: $1,860
Age 61 to 70: $4,960
Over age 70: $6,200

The capped premium amount joins your other medical expenses in clearing the 7.5% AGI floor.

What Does Not Qualify

Plenty of health-related spending is off-limits:

Cosmetic procedures, unless they correct a deformity from a birth defect, injury, or disfiguring disease.⁹
Over-the-counter drugs and supplements. Only insulin and prescribed medications count.⁵
Gym memberships, health clubs, spas, and general fitness programs, unless prescribed by a doctor as part of treatment for a specific diagnosed condition.
Funeral and burial costs.
Anything already reimbursed by insurance or another source.

You Cannot Double-Dip With HSA or FSA Money

Medical expenses paid with tax-free money from a Health Savings Account or Flexible Spending Account cannot also be deducted on Schedule A. You get the tax break through the account or through the deduction, never both.¹⁰⁵

Costs beyond what the HSA or FSA covers still count toward the 7.5% floor. If you had $10,000 in medical expenses and your HSA paid $4,000, the remaining $6,000 is what you start with on Schedule A.

How to Claim the Deduction on Schedule A

The medical expense deduction is reported on Schedule A, filed with Form 1040.¹¹ The calculation runs:

Line 1: total unreimbursed medical and dental expenses for the year.
Line 2: your AGI from Form 1040, line 11.
Line 3: your AGI times 0.075. This is the non-deductible floor.
Line 4: line 1 minus line 3. A positive number is your deductible amount.

That line 4 figure joins the rest of your itemized deductions. If the combined total does not beat the standard deduction for your filing status, take the standard deduction instead.

Records to Keep

Hold onto receipts, explanation-of-benefits statements from your insurer, and canceled checks or credit card statements showing what you paid. If you claim medical mileage, keep a log with the date, destination, purpose, and miles for each trip. These records back you up if the IRS questions the deduction.

The IRS generally has three years from your filing date to audit a return, so keep medical expense records at least that long.¹² If you file late, the three-year clock starts on the actual filing date, not the original due date.

1
Office of the Law Revision Counsel. 26 USC 213 Medical, Dental, Etc., Expenses
2
Internal Revenue Service. Adjusted Gross Income
3
Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026, Including Amendments From the One, Big, Beautiful Bill
4
Internal Revenue Service. 2026 Filing Season Updates and Resources for Seniors
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Internal Revenue Service. Publication 502, Medical and Dental Expenses
6
Internal Revenue Service. Fact Sheet – Service Animals for Taxpayers With Disabilities
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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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Office of the Law Revision Counsel. 26 USC 162 – Trade or Business Expenses
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Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses
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Internal Revenue Service. Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans
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Internal Revenue Service. About Schedule A (Form 1040), Itemized Deductions
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Internal Revenue Service. How Long Should I Keep Records?