Medical expenses are deductible only if you itemize deductions, and only the amount above a threshold that changes each year

Most people cannot deduct medical expenses because the standard deduction is larger than what they would deduct. The standard deduction is a flat amount the IRS lets you subtract from your income without listing individual expenses — for 2024, it is $14,600 for single filers and $29,200 for married filing jointly. To deduct medical expenses at all, you must itemize deductions instead, meaning you list out specific expenses on Schedule A and add them up.

Even if you itemize, you can only deduct medical expenses that exceed a percentage of your adjusted gross income (AGI). For 2024, that threshold is 7.5 percent of your AGI. If your AGI is $60,000, you can only deduct medical expenses above $4,500. This means you need substantial medical costs in a single year to benefit from the deduction at all.

The IRS defines deductible medical expenses narrowly: they must be for diagnosis, cure, mitigation, treatment, or prevention of disease, or for treatment affecting any part or function of the body. Cosmetic procedures, vitamins, and most over-the-counter drugs do not may have access to. Prescription medications, surgery, hospital stays, dental work, vision care, and mental health treatment do may have access to.

Key Takeaways

  • You can only deduct medical expenses if you itemize deductions on Schedule A, which most taxpayers do not do because the standard deduction is larger.
  • Even when itemizing, you can deduct only the medical expenses that exceed 7.5 percent of your adjusted gross income in that tax year.
  • Deductible expenses include prescription drugs, hospital care, surgery, dental work, vision correction, and mental health treatment, but not cosmetic procedures or most over-the-counter items.
  • You must have receipts and documentation for all medical expenses you claim, and they must be for yourself, your spouse, or your dependents.

What counts as a deductible medical expense

The IRS maintains a detailed list of what qualifies. Prescription medications, insulin, and other drugs that require a prescription are deductible. Over-the-counter medications like aspirin or cold medicine are not, unless your doctor prescribes them specifically for you in writing. Vitamins and supplements are generally not deductible unless prescribed by a doctor for a specific medical condition.

Hospital bills, surgery, anesthesia, X-rays, and lab tests are all deductible. Dental work including cleanings, fillings, root canals, and orthodontia counts. Vision care — eye exams, glasses, contact lenses, and LASIK surgery — is deductible. Mental health treatment, including therapy and psychiatric care, qualifies. Physical therapy, chiropractic care, and acupuncture are deductible if performed by a licensed practitioner.

Medical equipment and supplies count: crutches, wheelchairs, hearing aids, artificial limbs, and glucose monitors are deductible. You can also deduct the cost of transportation to medical appointments, including mileage (the IRS sets a standard mileage rate for medical travel each year) or actual taxi and parking costs. Lodging during medical treatment away from home is deductible, though meals are not.

Cosmetic procedures are not deductible unless they are medically necessary — for example, reconstructive surgery after an accident or as part of cancer treatment. Teeth whitening, hair removal, and elective cosmetic surgery do not may have access to. Health club memberships and weight loss programs are not deductible, even if recommended by a doctor for weight-related health reasons.

The 7.5 percent threshold and how it works

The threshold is the barrier most people cannot clear. Your adjusted gross income (AGI) is your total income minus certain deductions like contributions to a traditional IRA or student loan interest. Once you know your AGI, multiply it by 0.075 to find the threshold. Only medical expenses above that amount can be deducted.

Example: Your AGI is $80,000. The threshold is $80,000 × 0.075 = $6,000. You spent $7,500 on medical expenses during the year. You can deduct only $7,500 − $6,000 = $1,500. If your medical expenses were $5,800, you could deduct nothing because they do not exceed the threshold.

The threshold applies to the calendar year, so you must add up all medical expenses from January 1 through December 31. If you have a large medical event in December and another in January, they fall in different tax years and may not cross the threshold in either year. Some people time elective procedures to cluster expenses in a single year to exceed the threshold.

Itemizing versus taking the standard deduction

To claim medical expenses, you must file Form 1040 with Schedule A (Itemized Deductions) instead of using the standard deduction. You add up all your itemized deductions — medical expenses, state and local taxes (capped at $10,000), mortgage interest, charitable contributions, and other may have access to expenses — and compare the total to the standard deduction. You use whichever is larger.

For most taxpayers, the standard deduction is larger. In 2024, the standard deduction for a single filer is $14,600 and for married filing jointly is $29,200. You would need more than $14,600 (or $29,200) in combined itemized deductions to benefit from itemizing at all. Medical expenses alone rarely reach that threshold unless you had a major health event or ongoing expensive treatment.

If you do itemize, you report your medical expenses on Schedule A, line 1. You subtract the 7.5 percent threshold from the total and enter the result. This amount then flows into your total itemized deductions, which reduces your taxable income.

Medical expenses for dependents and spouses

You can deduct medical expenses you paid for yourself, your spouse, and your dependents, even if they do not live with you. A dependent is someone you claim on your tax return — typically a child, but also sometimes a parent or other relative if you meet the IRS requirements for claiming them as a dependent.

The key is that you must have paid the expense. If your adult child pays their own medical bills, you cannot deduct them. If you pay for your parent's medical care and claim them as a dependent, those expenses count toward your deduction. The person receiving the care does not have to be a dependent for the entire year — if you paid medical expenses for someone who became your dependent partway through the year, those expenses still count.

Documentation and record-keeping

The IRS does not require you to attach receipts to your tax return, but you must keep them for your records in case of an audit. For each medical expense, keep the receipt or invoice showing the date, the provider's name, the service or item provided, and the amount paid. Credit card statements alone are not sufficient documentation — you need the itemized receipt from the provider.

If you paid by check or electronic transfer, keep the cancelled check or bank statement along with the receipt. For ongoing treatment like therapy or physical therapy, keep a summary showing the dates of visits and the cost of each. For prescription medications, keep the pharmacy receipt showing the prescription number, medication name, and date filled.

Organize your records by category — hospital, dental, pharmacy, vision, mental health — and keep them together. Many people use a spreadsheet to track expenses throughout the year and calculate the total before filing. This makes it easier to verify the amount you are claiming and to respond if the IRS has questions.

State tax deductions for medical expenses

Some states allow medical expense deductions on state income tax returns even when the federal deduction does not explore. A few states have lower thresholds than the federal 7.5 percent, or allow deductions without itemizing. State rules vary significantly, so check your state's tax authority website or speak with a tax professional about your state's specific rules.

If you live in a state with income tax and you itemize on your federal return, you may also be able to itemize on your state return. Some states follow federal rules closely; others have different thresholds or definitions of what qualifies. A few states with no income tax do not have this issue at all.

Frequently Asked Questions

Can I deduct health insurance premiums?

Self-employed health insurance premiums are deductible as a business expense, not as a medical expense on Schedule A. If you are an employee, premiums paid through payroll are usually deducted before taxes are calculated, so you do not deduct them again. Out-of-pocket premiums for coverage you buy yourself may be deductible on Schedule A as a medical expense.

What about over-the-counter medications like pain relievers or allergy medicine?

Over-the-counter drugs are not deductible unless a doctor prescribes them in writing for you. If your doctor writes a prescription for ibuprofen or an antihistamine, it becomes deductible. If you buy them without a prescription, they do not may have access to, even if you use them for a diagnosed condition.

Can I deduct the cost of a gym membership if my doctor recommended it for my health?

No. The IRS does not allow deductions for general health or fitness expenses, even with a doctor's recommendation. Weight loss programs and gym memberships are not deductible. However, specific medical equipment like a stationary bike prescribed as part of physical therapy for an injury may be deductible.

Do I need to report medical expenses if they are below the threshold?

No. If your medical expenses do not exceed 7.5 percent of your AGI, you cannot deduct any of them. You do not report them on your tax return. You only report the amount that exceeds the threshold.

Can I carry over medical expenses from one year to the next if I do not reach the threshold?

No. Medical expenses must be deducted in the year they were paid. If you do not exceed the threshold in 2024, you cannot move those expenses to 2025. This is why some people time elective procedures to cluster expenses in a single year.