Can You Deduct Medical Expenses? Here Are the Rules

Healthcare and related costs can add up fast. If you pay out-of-pocket for medical or dental care, and meet certain thresholds, you may be able to deduct part of those expenses on your federal tax return. This guide covers the rules, what qualifies, how to calculate deductions, and practical tips to help you determine whether itemizing makes sense.

Who Can Deduct?

You can deduct unreimbursed medical and dental expenses for yourself, your spouse, and your dependents. To claim medical deductions, you must itemize deductions on Schedule A (Form 1040).

Only the portion of your total medical expenses that exceed 7.5% of your adjusted gross income (AGI) is deductible. Under IRS rules, medical care generally includes amounts paid for the diagnosis, cure, mitigation, treatment or prevention of disease, or for the purpose of affecting any structure or function of the body.

What Qualifies as a Deductible Medical Expense

Qualifying expenses are broad and include many common and sometimes lesser-known categories. Examples include:

• Doctor and dentist visits, surgeries, hospital stays and related treatments
• Prescription medications and medical devices
• Dental and vision care
• Mental health services
• Travel for medical care, including mileage, parking, bus or taxi fares if the travel is primarily for, and essential to, receiving medical treatment
• Other qualifying expenses under IRS guidelines, including those outlined in IRS Publication 502

Note: Expenses that are reimbursed by insurance, a Health Savings Account (HSA), Flexible Spending Account (FSA) or another plan are not deductible.

Standard Deduction Amounts for 2025 and 2026

Your tax advisor can help determine whether it makes more sense for you to itemize or claim the standard deduction. For some taxpayers, it may be advantageous to bunch itemizable deductions in alternating years and then take the standard deduction in between.

How to Calculate the Deduction

1. Add up all qualifying out-of-pocket medical and dental expenses paid during the tax year.
2. Compute 7.5% of your AGI.
3. Subtract that 7.5%-of-AGI threshold from your total medical expenses. Only the excess amount is deductible.
4. Include the deductible portion on Schedule A, but only if your total itemized deductions exceed the standard deduction for your filing status.

Example: If your AGI is $50,000, 7.5% is $3,750. If your total eligible medical expenses are $10,000, you could deduct $6,250, provided you itemize.

Why the AGI Threshold Matters

The threshold for deducting medical expenses has changed over time. While it was temporarily raised to 10% of AGI, legislation restored the 7.5%-of-AGI floor and made it permanent beginning in 2021. Even so, it can still be difficult for taxpayers to qualify for a deduction.

Because of that threshold and the requirement to itemize, many taxpayers will not benefit from the medical-expense deduction in typical years. However, for those who have unusually high costs due to illness, injury, chronic conditions or major treatments, the deduction can offer meaningful relief.

Tips to Maximize Deduction

• Keep meticulous records. Save receipts, bills and statements for doctor visits, prescription medications, dental and vision care, medical devices and travel for medical care.
• Include expenses for dependents. You may deduct qualifying costs for your spouse, dependents and certain other eligible family members under IRS rules.
• Check reimbursement and benefit sources. If costs were reimbursed through insurance, an HSA, an FSA or another health plan, they can’t be counted toward the deduction.
• Weigh itemizing vs. the standard deduction. Because the deduction applies only to expenses beyond 7.5% of AGI and only if you itemize, compare your full itemized deductions against the standard deduction for your filing status.
• Consider timing. If you anticipate exceeding the 7.5% threshold, you might try to cluster predictable medical expenses into one tax year, if medically appropriate.

Eligible Expenses

For itemized deduction purposes, medical care includes procedures and care for the diagnosis, cure, mitigation, treatment or prevention of disease, or for the purpose of affecting any structure or function of the body. Care that is merely beneficial to general health is not medical care.

A wide range of medical costs may qualify. Examples include:

• Acupuncture
• Artificial teeth
• Chiropractic services
• Dental care
• Diagnostic devices
• Eyeglasses
• Hearing aids
• Laboratory fees
• Long-term care services
• Meals while staying in a hospital or similar facility
• Medicare insurance premiums
• Nursing home expenses
• Optometrist services
• Psychiatric care
• Stop-smoking programs
• Weight-loss programs, if part of treatment for a specific disease or condition such as obesity
• Wheelchairs
• X-rays

For a complete list, see IRS Publication 502, "Medical and Dental Expenses.

A portion of the fees paid to enter and reside in a continuing care retirement community can also qualify as medical expenses for itemized deduction purposes. These fees can be substantial, so they may help push you over the percentage-of-AGI deduction threshold. IRS Publication 502 provides a more complete list of eligible expenses.

7 Deductible Medical Expenses You Might Have Missed

Some deductible medical expenses are commonly overlooked. Here are seven that may deserve a second look:

1. Transportation. The deductible amount is not limited to the actual cost of services provided by a physician, dentist or hospital. You may also deduct the cost of getting to and from treatment, even if similar treatment is available nearby. If you travel by car, you may deduct actual vehicle expenses or use the applicable standard mileage rate, plus related tolls and parking fees.
2. Lodging. You may be able to deduct the cost of staying at a hotel while receiving medical care away from home, as long as the accommodations are not lavish or extravagant. The deductible amount for lodging is generally limited to $50 per day per person. If a companion must travel with the patient, that person’s lodging may also qualify, subject to the same limit.
3. Medical expenses for dependents and certain relatives. You can deduct expenses incurred by your spouse and children, but you may also be able to write off costs attributable to the care or treatment of another qualifying family member.
4. Nursing care. If a family member needs home nursing services, the cost may qualify as a medical expense. The deductible amount generally includes only the portion attributable to medical care if the caregiver also provides household services.
5. Long-term care insurance. Out-of-pocket health insurance premiums may qualify, and certain premiums for qualified long-term care insurance can also be deductible, subject to age-based limits. These expenses may also include qualified premiums paid for certain relatives.
6. Home improvements for medical purposes. Normally, home improvements are nondeductible personal expenses, but some improvements made for medical reasons may qualify. In general, you may deduct the cost to the extent it exceeds the increase in the value of your home. Related operating and maintenance costs may also qualify.
7. Healthcare-related tuition costs. In limited situations, a portion of tuition related to healthcare coverage may qualify as a medical expense if those charges are specifically stated or can be clearly identified.

These often-missed categories can make a meaningful difference for taxpayers who are close to the AGI threshold or already planning to itemize.

Who Benefits Most and When It’s Worth Doing

The medical-expense deduction tends to benefit taxpayers who:

• Incur high out-of-pocket medical or dental costs, particularly for major treatments, surgeries or chronic conditions
• Have relatively low to moderate AGI, since the 7.5%-of-AGI threshold is lower in absolute dollar terms
• Have other itemizable deductions, making itemizing more attractive than taking the standard deduction

For many others, the combination of the AGI threshold and the relatively high standard deduction means the benefit is limited. Still, for those with substantial medically necessary expenses, the deduction remains valuable and is often overlooked.

For More Information

Did you spend enough on medical care to qualify for this tax break this year? If so, your Porte Brown tax advisor can help you compile a comprehensive list of eligible expenses and discuss strategies to maximize your itemized deduction for medical expenses. IRS Publication 502 is also a useful starting point for determining what medical and dental expenses may qualify.