Medical bills are deductible only if you itemize deductions and your total medical expenses exceed a threshold set by the IRS

Most people cannot deduct medical bills because the IRS requires two conditions: you must itemize deductions instead of taking the standard deduction, and your medical expenses must exceed 7.5% of your adjusted gross income (AGI) for the year. If your AGI is $60,000 and your medical bills total $3,000, you cannot deduct any of them because $3,000 is only 5% of your income. If your medical bills total $5,000, you can deduct only $500 — the amount above the 7.5% threshold.

The threshold of 7.5% applies to all taxpayers regardless of age or income. This means high-income earners need much larger medical bills to cross the threshold than lower-income earners do. A person earning $40,000 needs $3,000 in medical expenses to start deducting; a person earning $100,000 needs $7,500.

Whether itemizing makes sense depends on your total deductions. If your standard deduction is $13,850 (single filer in 2023) and your itemized deductions total $12,000, you take the standard deduction and get no benefit from your medical expenses. You must choose one method or the other; you cannot use both.

Key Takeaways

  • Medical expenses are deductible only if you itemize deductions and your total medical bills exceed 7.5% of your adjusted gross income for the year.
  • The 7.5% threshold means most taxpayers cannot deduct medical expenses unless they have a major health event or ongoing treatment that costs thousands of dollars.
  • You must compare your itemized deductions (including medical expenses) to your standard deduction to determine which method saves you more in taxes.
  • Deductible medical expenses include insurance premiums, hospital bills, prescription drugs, dental work, and vision care, but not cosmetic procedures or over-the-counter medications.
  • You report medical deductions on Schedule A (Form 1040) only if you itemize; most taxpayers use the standard deduction instead.

What counts as a deductible medical expense

The IRS allows you to deduct costs you paid for diagnosis, cure, mitigation, treatment, or prevention of disease, plus costs for treatments affecting any part of your body or mind. This includes hospital stays, surgery, prescription medications, dental work, vision care, mental health treatment, and physical therapy. You can also deduct health insurance premiums you paid yourself, including COBRA continuation coverage and long-term care insurance premiums (with limits).

Expenses that do not count include cosmetic surgery (unless it corrects an injury or birth defect), over-the-counter medications like aspirin or cold medicine, vitamins and supplements, gym memberships, weight-loss programs, and teeth whitening. Maternity clothes and general health items do not may have access to either. If you are unsure whether a specific expense counts, Publication 502 from the IRS lists hundreds of items with rulings.

You can deduct only the portion of expenses you paid out of your own pocket. If your insurance covered part of a bill, you deduct only what you paid. If your employer paid for health insurance, you cannot deduct that amount — it was already excluded from your taxable income.

How to calculate whether you can deduct medical expenses

Start by finding your adjusted gross income (AGI) on your tax return or your most recent pay stub estimate. Multiply your AGI by 0.075 (7.5%). This is your threshold — the amount of medical expenses you must exceed before any deduction applies.

Next, gather receipts and bills for all medical expenses you paid during the tax year. Include insurance premiums, copays, deductibles, prescription costs, dental bills, vision care, therapy sessions, and travel to medical appointments (at the standard mileage rate). Add these up to get your total medical expenses.

Subtract the threshold from your total. If the result is zero or negative, you have no deductible medical expenses. If the result is positive, that amount is your potential deduction — but only if itemizing deductions gives you a larger tax benefit than the standard deduction.

To decide whether to itemize, add up all your itemized deductions: medical expenses (after subtracting the threshold), state and local taxes (capped at $10,000), mortgage interest, charitable donations, and other deductible items. Compare this total to your standard deduction for your filing status. Use whichever is larger.

Standard deduction versus itemizing

The standard deduction for 2023 is $13,850 for single filers, $20,800 for heads of household, and $27,700 for married filing jointly. These amounts increase slightly each year. Most taxpayers use the standard deduction because it is simpler and often larger than their itemized deductions.

You should itemize only if your total itemized deductions exceed your standard deduction. If you have significant medical expenses, large charitable donations, high state and local taxes, or substantial mortgage interest, itemizing may save you money. If your itemized deductions fall short, the standard deduction is your better choice.

Some taxpayers alternate between itemizing and using the standard deduction from year to year, depending on whether they had a major medical event or other large deductible expenses that year. If you had $8,000 in medical bills in 2023 but expect none in 2024, you might itemize in 2023 and use the standard deduction in 2024.

Where to report medical deductions on your tax return

Medical expenses appear on Schedule A (Form 1040), which is the form you use to report all itemized deductions. You complete Schedule A only if you choose to itemize instead of taking the standard deduction. The medical expense section asks for your total medical and dental expenses, your AGI, and calculates the threshold for you.

You do not need to attach receipts to your return, but you must keep them for your records in case the IRS asks questions. The IRS can request documentation for up to three years after you file (or longer if they suspect underreporting).

If you use tax software like TurboTax, H&R Block, or TaxAct, the program walks you through Schedule A and calculates whether itemizing or the standard deduction saves you more money. If you work with a tax professional, bring your medical bills and receipts to your appointment so they can include them in your return.

Medical expenses paid in different years

You deduct medical expenses only in the year you paid them, not the year you received the treatment or the year the bill was dated. If you had surgery in December 2023 but did not pay the bill until January 2024, the expense counts toward your 2024 deduction, not 2023. This timing matters when you are deciding whether to itemize in a particular year.

Some people use this timing strategically. If you expect large medical bills in the coming year, you might defer paying bills from the current year until next year so you can bunch your medical expenses into one tax year and exceed the 7.5% threshold more easily. Conversely, if you paid a large bill in December and expect few expenses next year, paying it this year might help you itemize this year instead of next year.

If you received a refund or insurance reimbursement for a medical expense you deducted in a previous year, you must report that reimbursement as income in the year you receive it — but only if the deduction reduced your taxes in the prior year. This rule prevents you from deducting the same expense twice.

Medical expenses for dependents and spouses

You can deduct medical expenses you paid for yourself, your spouse, and your dependents, even if they did not live with you the entire year. If you paid your adult child's medical bills, you can include those expenses in your deduction. If you paid your parent's medical bills and they may have access to as your dependent, those expenses count too.

The key requirement is that you actually paid the bill. If your dependent paid their own medical expenses, you cannot deduct them. If you reimbursed your dependent after they paid, you can deduct the amount you reimbursed in the year you paid it.

Frequently Asked Questions

Can I deduct medical expenses if I take the standard deduction?

No. Medical expenses are only deductible if you itemize deductions on Schedule A. If you use the standard deduction, you cannot deduct any medical expenses. You must choose one method or the other for your entire return.

What if my medical bills are very high due to a major illness or surgery?

High medical bills make itemizing more likely to save you money. If your bills exceed 7.5% of your AGI and your total itemized deductions exceed your standard deduction, you can deduct the amount above the 7.5% threshold. Some people with chronic conditions or major health events find that itemizing saves them hundreds of dollars in taxes.

Can I deduct health insurance premiums I pay myself?

Yes, if you itemize. Self-employed health insurance premiums are also deductible as a business expense on Schedule C, which is a separate route that does not require itemizing. If you are an employee and pay premiums out of pocket, they count as medical expenses subject to the 7.5% threshold.

Do I need receipts to deduct medical expenses?

You do not attach receipts to your return, but you must keep them for your records. The IRS can request documentation if they question your deduction. Statements from your doctor, hospital, pharmacy, or insurance company all count as proof of payment.

What if I paid medical bills for someone who is not my dependent?

You cannot deduct medical expenses for someone unless they are your spouse or your dependent for tax purposes. If you paid bills for an adult child who does not meet the dependent test, or for a friend or relative, those expenses do not may have access to for the deduction.