You can reduce your federal income tax through a medical expense deduction, but only if your out-of-pocket medical costs exceed 7.5% of your adjusted gross income and you itemize deductions instead of taking the standard deduction

The IRS allows you to deduct unreimbursed medical and dental expenses on Schedule A (Itemized Deductions) on Form 1040. However, there is a floor: you can only deduct the amount of medical expenses that exceeds 7.5% of your adjusted gross income (AGI) for the 2024 tax year. This means if your AGI is $50,000, you can only deduct medical expenses above $3,750. You must also choose to itemize deductions rather than claim the standard deduction, which means the medical deduction is only worth taking if your total itemized deductions exceed the standard deduction for your filing status.

This is not a refund in the sense of money coming back to you automatically. It is a deduction that reduces your taxable income, which may lower the tax you owe or increase a refund you would otherwise receive. The actual benefit depends on your tax bracket and total tax situation. Many people with medical expenses do not see any tax benefit because their expenses fall below the 7.5% threshold or because the standard deduction is larger than their itemized deductions combined.

Key Takeaways

  • Medical expenses must exceed 7.5% of your adjusted gross income before any amount becomes deductible on your federal return.
  • You must itemize deductions on Schedule A to claim medical expenses; the standard deduction is usually larger and does not allow medical deductions.
  • may be able to access expenses include doctor visits, dental work, prescription medications, medical equipment, and some travel costs to receive care, but not cosmetic procedures or over-the-counter drugs.
  • State tax returns may have different rules and thresholds, so check your state's tax instructions separately.
  • You cannot deduct expenses that were reimbursed by insurance, an employer health plan, or a health savings account.

What medical expenses the IRS allows you to deduct

The IRS publishes a list of deductible medical expenses in Publication 502. may be able to access expenses include doctor and dentist fees, hospital stays, prescription medications, medical equipment (wheelchairs, crutches, hearing aids), vision care and eyeglasses, mental health treatment, and certain travel costs to receive medical care. You can also deduct premiums you pay for health insurance if you are self-employed, and long-term care insurance premiums up to an age-based limit.

Expenses that do not may have access to include cosmetic surgery (unless it is reconstructive after an injury or illness), over-the-counter medications and vitamins, gym memberships, general wellness programs, and teeth whitening. Maternity clothes, even if purchased during pregnancy, are not deductible. If you are unsure whether a specific expense qualifies, Publication 502 contains a detailed table, or you can ask a tax professional.

How to calculate whether the deduction is worth taking

Before you gather receipts, do a quick calculation to see if itemizing makes sense. Add up all your medical expenses for the year. Multiply your AGI by 0.075 (7.5%). Subtract that number from your total medical expenses. If the result is zero or negative, you have no deductible medical expenses. If it is positive, that is the amount you can deduct—but only if your total itemized deductions (medical plus charitable donations, mortgage interest, state and local taxes, and other deductible items) exceed the standard deduction for your filing status in 2024 ($14,600 for single filers, $29,200 for married filing jointly).

Example: Your AGI is $60,000 and you had $7,000 in medical expenses. The threshold is $60,000 × 0.075 = $4,500. You can deduct $7,000 − $4,500 = $2,500 in medical expenses. But if your other itemized deductions total only $10,000, your total itemized deductions are $12,500, which is less than the $14,600 standard deduction for a single filer. In that case, you would claim the standard deduction instead and receive no benefit from the medical expenses. Tax software will perform this comparison automatically when you enter your information.

How to report medical expenses on your tax return

You report medical expenses on Schedule A (Form 1040), which is part of your federal tax return. On line 1 of Schedule A, enter your total medical and dental expenses for the year. On line 2, enter 7.5% of your AGI (the IRS provides a worksheet to calculate this). On line 3, subtract line 2 from line 1. If the result is positive, that is your deductible medical expense amount, which flows to your total itemized deductions.

You do not need to attach receipts to your return, but you must keep them for your records in case the IRS requests documentation. Keep receipts, invoices, insurance statements showing what you paid out of pocket, and any other proof of payment for at least three years after you file. If you use tax preparation software or work with a tax professional, they will guide you through entering this information correctly.

State tax returns and medical expense deductions

Some states allow medical expense deductions on state income tax returns, but the rules vary widely. A few states follow the federal 7.5% threshold, some use a higher threshold (such as 10%), and some do not allow the deduction at all. Check your state's tax instructions or contact your state tax department to learn whether medical expenses reduce your state tax liability.

If your state does allow the deduction, you will report it on your state return using a similar method to the federal return. Some states that do not allow a medical deduction on the state level may offer other tax breaks for health-related expenses, such as credits for health insurance premiums or long-term care costs, so it is worth checking your state's specific rules even if the standard medical deduction is not available.

Medical expenses you cannot deduct

You cannot deduct any medical expense that was paid by insurance, an employer health plan, Medicare, Medicaid, or a health savings account (HSA) or flexible spending account (FSA). If your insurance covered part of a bill and you paid the rest, you can only deduct the amount you paid out of pocket. Similarly, if you received a reimbursement from an employer or a personal injury settlement for medical costs, that reimbursed amount is not deductible.

If you use an HSA or FSA, those accounts already provide a tax benefit (contributions are made with pre-tax dollars), so the IRS does not allow you to deduct the same expenses again on your tax return. This is an important rule to remember if you have both an HSA and significant out-of-pocket medical costs. The IRS treats this as double-dipping and will disallow the deduction if you claim it.

When to consider working with a tax professional

If you have substantial medical expenses, own a business, or have a complex tax situation, a tax professional can help you determine whether itemizing is worth it and ensure you claim all may be able to access expenses. They can also advise you on timing—for example, if you are close to the threshold, you might defer elective procedures to the following year to bunch expenses and cross the threshold in one year rather than spreading them across two.

If you file your own return using tax software, most programs will calculate the medical expense deduction for you once you enter the expenses and your AGI. The software will also compare itemizing to the standard deduction and recommend the option that results in lower tax. This built-in comparison takes the guesswork out of deciding whether to itemize.

Frequently Asked Questions

Can I deduct health insurance premiums I pay myself?

If you are self-employed, you can deduct health insurance premiums as a business expense on Schedule C, which is separate from medical expense deductions. If you are an employee, you cannot deduct premiums you pay out of pocket unless you are receiving unemployment benefits, in which case you may be able to deduct premiums paid during that period. Check IRS Publication 502 for details on your specific situation.

What if I paid medical expenses in one year but received reimbursement the next year?

Deduct the expenses in the year you paid them, not the year you were reimbursed. If you receive reimbursement in a later year, you cannot deduct those expenses in that later year. If the reimbursement arrives before you file your return for the year you paid the expenses, reduce your deduction by the reimbursement amount.

Can I deduct medical expenses for my adult child or parent?

You can deduct medical expenses you paid on behalf of someone else only if that person was your dependent for the entire year. The dependent must meet IRS tests for relationship, citizenship, income, and support. If your adult child or parent does not meet the dependent test, you cannot deduct their medical expenses even if you paid them.

Does the medical expense deduction apply to dental work and vision care?

Yes. Dental work, orthodontia, eyeglasses, contact lenses, and eye exams are all deductible medical expenses, subject to the 7.5% threshold. Cosmetic dental work (such as teeth whitening or veneers) is not deductible unless it is reconstructive due to injury or disease.

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

High medical expenses in a single year make it more likely you will exceed the 7.5% threshold and benefit from itemizing. Keep all receipts and statements from hospitals, doctors, pharmacies, and medical suppliers. If you had a major event, consider whether you can bunch other deductible expenses (charitable donations, mortgage interest) into the same year to maximize your itemized deduction.