Learn About Deducting Medical Expenses on Taxes

Understanding Medical Expense Deductions on Your Tax Return

When you file your federal income tax return, you have the option to deduct certain expenses from your taxable income. One category of deductions involves medical and dental expenses you've paid out of your own pocket during the tax year. The Internal Revenue Service (IRS) allows taxpayers to deduct qualifying medical expenses, but there are specific rules about what counts and how much you need to spend before you can claim these deductions.

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Medical expense deductions work differently depending on whether you take the standard deduction or itemize your deductions on your tax return. Most U.S. taxpayers claim the standard deduction, which is a fixed dollar amount that reduces your taxable income. In 2024, the standard deduction ranges from $14,600 for single filers to $29,200 for married couples filing jointly. However, if your medical expenses and other deductible expenses combined exceed the standard deduction, you may benefit from itemizing instead.

The concept of medical expense deductions dates back decades in the U.S. tax code. According to IRS records, millions of Americans claim medical deductions each year, though many more could potentially benefit from understanding these rules better. The actual dollar amounts people deduct vary widely based on their health situations and income levels.

Before diving into the details of what qualifies, it's important to understand that medical expense deductions are only available to those who itemize deductions on Schedule A of their tax return. This means comparing your total itemized deductions—including medical expenses, state and local taxes, mortgage interest, and charitable contributions—against the standard deduction for your filing status. If your itemized deductions exceed the standard deduction, itemizing becomes the more beneficial choice.

Practical Takeaway: Start by determining whether itemizing deductions makes sense for your situation by calculating your total potential deductible expenses, including medical costs. You may want to consult with a tax professional or use tax preparation software to compare itemizing versus taking the standard deduction.

What Medical Expenses Can Be Deducted

The IRS maintains a detailed list of medical and dental expenses that may be deductible. These include obvious costs like doctor visits, hospital stays, and prescription medications, but also many less obvious expenses. Understanding the full range of deductible medical expenses helps you capture all the costs you may have overlooked when preparing your taxes.

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Common deductible medical expenses include:

• Payments to doctors, dentists, optometrists, and other licensed medical professionals
• Hospital fees and inpatient care charges
• Prescription medications and insulin
• Co-pays and deductibles you pay to insurance companies
• Dental work including cleanings, fillings, root canals, and orthodontia
• Vision care including eye exams, glasses, and contact lenses
• Hearing aids and related services
• Prosthetic limbs and artificial teeth
• Crutches, walkers, wheelchairs, and other medical equipment
• Guide dogs and other service animals for people with disabilities
• Fertility treatments and procedures
• Psychiatric and psychological counseling
• Substance abuse treatment programs
• Surgery and related anesthesia charges
• Medical tests and laboratory work
• Chiropractic care and acupuncture (if performed by a licensed practitioner)
• X-rays and imaging services
• Physical therapy and rehabilitation services

Beyond these standard categories, the IRS also permits deductions for certain travel expenses related to medical care. If you travel to receive medical treatment, you may deduct the cost of transportation and lodging. For example, if you drive to a hospital for cancer treatment, you can deduct your mileage at the rate set by the IRS (which was 21 cents per mile in 2024 for medical travel). If you fly to a specialized treatment center, the plane ticket may be deductible. Lodging for you and a companion during treatment may also qualify.

Importantly, over-the-counter medications generally cannot be deducted unless they were prescribed by a doctor. Vitamins and supplements are typically not deductible unless specifically prescribed as part of medical treatment. Cosmetic procedures, such as teeth whitening for appearance rather than dental health, do not count as deductible medical expenses. Weight loss programs and gym memberships are not deductible, even if your doctor recommends them for health reasons.

Practical Takeaway: Review your medical receipts and bills from the past year, and create a list organized by category. Include items you may not initially think of as medical expenses, such as transportation to treatment and lodging during medical procedures. Keep all receipts and documentation, as the IRS may request proof of these expenses if your return is examined.

The Medical Expense Threshold and How It Works

One of the most important rules about medical expense deductions is that you cannot deduct all of your medical expenses. Instead, the IRS imposes a threshold, meaning you must spend a certain amount before you can deduct anything at all. As of 2024, you can only deduct medical expenses that exceed 7.5 percent of your adjusted gross income (AGI). This threshold has remained at 7.5 percent since 2013, after it was lowered from 10 percent.

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Understanding how this threshold works is crucial for determining whether medical expense deductions will benefit you. Your adjusted gross income is the total income you report on your tax return minus certain allowable deductions, such as contributions to traditional IRAs, student loan interest, and educator expenses. You can find your AGI on your tax return from the previous year, or calculate it when preparing your current year's return.

Let's work through a practical example. Suppose you are a single filer with an AGI of $60,000. Your medical expense threshold would be $60,000 multiplied by 0.075, which equals $4,500. This means you would need to have $4,500 or more in qualifying medical expenses during the year to deduct any amount. If you had $5,200 in medical expenses, you could deduct $700 ($5,200 minus $4,500). If you had only $4,000 in medical expenses, you could deduct $0, because you did not reach the threshold.

The threshold calculation becomes more significant for higher-income taxpayers. A person with an AGI of $100,000 must reach $7,500 in medical expenses before deducting anything. A person with an AGI of $150,000 must reach $11,250. This is why medical expense deductions tend to benefit people with significant medical costs relative to their income, such as those managing chronic illnesses or recovering from major surgeries or accidents.

It's also important to note that the threshold is based on your AGI for the specific tax year in which you incurred the expenses. If you had a lower-income year, you might reach the threshold more easily. Some people strategically time major medical procedures or treatments if possible, scheduling them in a year when their income is lower, though medical decisions should never be made purely for tax reasons.

Practical Takeaway: Calculate your medical expense threshold by multiplying your AGI by 0.075. Then add up all your qualifying medical expenses for the year. Only if your expenses exceed your threshold should you plan to itemize and deduct the excess amount.

Itemizing Deductions and Medical Expenses

To claim medical expense deductions, you must itemize your deductions instead of taking the standard deduction. Itemizing means listing all your deductible expenses on Schedule A of Form 1040, which is part of your federal income tax return. This requires more detailed record-keeping than taking the standard deduction, but it can result in a larger reduction to your taxable income if your total itemized deductions exceed the standard deduction for your filing status.

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When you itemize, you combine medical expenses with other deductible items. Common categories of itemized deductions include state and local taxes (SALT), mortgage interest, charitable contributions, and casualty losses. After the 2017 Tax Cuts and Jobs Act, the standard deduction increased significantly, and some deductions became less