Medicare premiums go on one of two lines of your federal return. If you itemize, enter them on Schedule A (Form 1040), Line 1, as part of your medical and dental expenses.1Internal Revenue Service. Instructions for Schedule A Form 1040 If you’re self-employed, enter them on Schedule 1 (Form 1040), Line 17, as the self-employed health insurance deduction.2Internal Revenue Service. 2025 Instructions for Form 7206 The Schedule 1 route is the better deal when you qualify, because it reduces adjusted gross income directly and doesn’t require you to itemize.
Schedule A, Line 1 (Itemized Deduction)
Total your Medicare premiums for the year and include them with your other medical and dental expenses on Schedule A, Line 1. Schedule A then does the math: your AGI goes on Line 2, 7.5% of AGI on Line 3, and only the amount of medical expenses above that floor carries down to Line 4 as your actual deduction.3Office of the Law Revision Counsel. 26 USC 213 – Medical Dental Etc Expenses The Schedule A total flows to Form 1040, Line 12.4Internal Revenue Service. 2025 Schedule A Form 1040
A quick example. AGI of $50,000 puts your floor at $3,750. Say your Part B premiums for the year came to $2,434.80, plus $1,800 in Medigap and $600 in Part D. Your medical total is $4,834.80, but only $1,084.80 of it actually deducts.
Check the Standard Deduction First
Itemizing only helps if your total itemized deductions beat the standard deduction. For 2026, the standard deduction is $16,100 for single filers and $32,200 for married couples filing jointly, with an added amount for filers age 65 or older.5Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026 Medicare premiums by themselves rarely clear that bar. You’ll need to combine them with state and local taxes, mortgage interest, and charitable contributions. Run both numbers before you commit.
Schedule 1, Line 17 (Self-Employed Health Insurance Deduction)
If you have self-employment income, you can deduct Medicare premiums above the line on Schedule 1, Line 17, instead of burying them in Schedule A. There’s no 7.5% floor, and you can still take the standard deduction on top.2Internal Revenue Service. 2025 Instructions for Form 7206 You calculate the deduction on Form 7206 and transfer the result to Schedule 1.
The deduction is capped at your net self-employment earnings from the business under which the coverage is established.6Office of the Law Revision Counsel. 26 USC 162 – Trade or Business Expenses If the business netted $10,000 and your Medicare premiums came to $3,000, the full $3,000 deducts. If the business netted $1,500, your deduction stops at $1,500.
Who Counts as Self-Employed Here
The deduction is available to sole proprietors filing Schedule C, partners with net earnings on Schedule K-1, farmers filing Schedule F, and more-than-2% shareholders of S corporations whose premiums are included in their W-2 wages.2Internal Revenue Service. 2025 Instructions for Form 7206 For the S-corp path, the corporation must pay or reimburse the premiums and report them in Box 1 of your W-2 (but not Boxes 3 or 5). No W-2 reporting, no deduction.
The Employer Plan Disqualifier
You cannot take this deduction for any month you were eligible to participate in a subsidized health plan through any employer, including your spouse’s.6Office of the Law Revision Counsel. 26 USC 162 – Trade or Business Expenses Eligibility is the test, not enrollment. If your spouse’s employer offers a plan you could join, those months are out even if you never signed up.2Internal Revenue Service. 2025 Instructions for Form 7206
No Double-Dipping, but You Can Split
Premiums you deduct on Schedule 1 cannot also appear in your medical expenses on Schedule A.6Office of the Law Revision Counsel. 26 USC 162 – Trade or Business Expenses If some months qualified for the self-employed deduction and others didn’t, you can split the year: qualifying months on Schedule 1, the rest on Schedule A.
Which Premiums You Can Include
Every Medicare premium you pay out of pocket counts as a deductible medical expense: Part B, Part D, Medicare Advantage, and Medigap. Voluntary Part A premiums (paid by people who didn’t qualify for premium-free Part A) are deductible as well.7Internal Revenue Service. Publication 502 – Medical and Dental Expenses Higher-income beneficiaries can include the Income-Related Monthly Adjustment Amount (IRMAA), which the Social Security Administration reports as part of your total Medicare premium.8Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles Late enrollment penalties are folded into the monthly premium amount you actually pay; the IRS has not published separate guidance splitting them out.
Where to Find the Numbers
If your premiums are withheld from your Social Security check, the SSA-1099 you receive each January is your source document. Box 3 shows gross benefits paid, and the description column next to it breaks out the specific amounts withheld for Part B, Medicare Advantage, prescription drug coverage, and IRMAA.9Social Security Administration. GN 05002.010 – Social Security Benefit Statement Box 3 Benefits Paid That breakdown is what feeds your deduction total.
If you pay Medicare directly, save the quarterly premium bills and your bank records or payment confirmations.10Medicare.gov. How to Pay Part A and Part B Premiums For Medicare Advantage or standalone Part D coverage paid to a private insurer, keep the annual premium statement; those amounts won’t show up on the SSA-1099 unless you asked to have them withheld. Form 1095-B is proof of coverage and generally doesn’t list premium amounts, so don’t rely on it for the deduction math.11Internal Revenue Service. Questions and Answers about Health Care Information Forms for Individuals
Paying Premiums with an HSA Instead
Once you turn 65, you can withdraw HSA funds tax-free to pay Medicare Part B, Part D, and Medicare Advantage premiums.12Internal Revenue Service. Publication 969 – Health Savings Accounts and Other Tax-Favored Health Plans Medigap premiums are the exception; they don’t qualify for tax-free HSA withdrawals even though they are deductible on Schedule A. You can’t contribute new money to an HSA after enrolling in any part of Medicare, but you can keep spending down the existing balance.13Congress.gov. Health Savings Accounts HSAs and Medicare Premiums covered by a tax-free HSA distribution cannot also be deducted on Schedule A or Schedule 1.14Internal Revenue Service. Topic No 502 Medical and Dental Expenses The tax benefit applies once.