Medical expenses can increase your tax refund, but only if you itemize deductions and your total medical costs exceed a threshold set by the IRS

The IRS lets you deduct medical and dental expenses on your federal tax return, but the benefit depends on how much you spent and how you file. If you take the standard deduction — which most people do — medical expenses do not reduce your taxable income at all. If you itemize deductions instead, you can subtract medical costs, but only the amount that exceeds 7.5% of your adjusted gross income (AGI). That threshold means a smaller refund or a larger tax bill unless your medical expenses were substantial.

Whether medical expenses actually increase your refund comes down to two questions: Do your total itemized deductions exceed the standard deduction for your filing status? And do your medical expenses push that total over the line? For most people, the answer is no — which is why the standard deduction exists. But if you had major medical events, paid for ongoing treatment, or had multiple family members with health costs, itemizing might work in your favor.

Key Takeaways

  • Medical expenses only reduce your taxable income if you itemize deductions instead of taking the standard deduction.
  • You can only deduct the portion of medical expenses that exceeds 7.5% of your adjusted gross income, so a $50,000 AGI requires over $3,750 in medical costs before any deduction applies.
  • Itemizing is worth considering if you had major surgery, ongoing prescriptions, dental work, vision care, or therapy in the tax year, or if you have other large deductible expenses like mortgage interest or charitable donations.
  • The standard deduction for 2024 is $14,600 for single filers and $29,200 for married filing jointly, so your total itemized deductions must exceed these amounts to benefit from medical expense deductions.
  • You will need receipts, invoices, and proof of payment for all medical expenses you claim, and some costs (cosmetic surgery, gym memberships) do not count.

What counts as a deductible medical expense

The IRS has a specific list of medical and dental costs you can deduct. These include doctor visits, hospital stays, surgery, prescription medications, dental work, vision care (glasses, contacts, eye surgery), hearing aids, mental health treatment, and physical therapy. You can also deduct the cost of medical equipment like crutches, wheelchairs, or blood pressure monitors, as well as mileage to and from medical appointments (at a rate set by the IRS each year) and health insurance premiums you paid yourself.

Expenses that do not count include cosmetic surgery (unless it is reconstructive after an injury or illness), gym memberships or fitness programs, over-the-counter vitamins or supplements (unless prescribed by a doctor), teeth whitening, and most elective procedures. Long-term care insurance premiums have limits based on your age. If you are unsure whether a specific expense qualifies, the IRS Publication 502 lists the full rules, or you can ask a tax professional.

How the 7.5% threshold works

The IRS does not let you deduct every medical dollar you spend. Instead, you can only deduct the amount that exceeds 7.5% of your adjusted gross income. Your AGI is roughly your total income minus certain deductions (like contributions to a traditional IRA). To find your threshold, multiply your AGI by 0.075.

Here is a concrete example: If your AGI is $60,000, the threshold is $4,500. If you spent $8,000 on medical expenses during the year, you can deduct $3,500 (the amount over $4,500). If you spent only $4,200, you cannot deduct any of it because it does not exceed the threshold. This threshold exists for everyone, regardless of filing status or age, though some taxpayers over 65 had a lower threshold in past years (this changed in 2021).

Itemizing versus the standard deduction

To benefit from medical expense deductions, you must itemize deductions on Schedule A of your tax return instead of taking the standard deduction. The standard deduction is a flat amount based on your filing status: for 2024, it is $14,600 for single filers, $29,200 for married filing jointly, $21,900 for head of household, and $14,600 for married filing separately. The IRS adjusts these amounts each year for inflation.

Itemizing means adding up all your deductible expenses — medical costs, mortgage interest, property taxes, charitable donations, and a few others — and using that total instead of the standard deduction. You should itemize only if your total deductions exceed the standard deduction for your filing status. For example, if you are single and your itemized deductions total $16,000, you gain $1,400 in deductions by itemizing. But if they total $12,000, the standard deduction is better, and medical expenses do not help you.

Many people with medical expenses still do not itemize because their medical costs do not exceed the 7.5% threshold, or because their other deductible expenses are small. A tax software program or tax professional can calculate both scenarios and show you which approach saves more money.

When medical expenses are most likely to increase your refund

Medical expenses are most likely to increase your refund if you had a major health event or ongoing treatment during the tax year. Examples include surgery, hospitalization, cancer treatment, fertility treatment, mental health therapy, or management of a chronic condition like diabetes. If multiple family members had medical costs, those add together on your return. If you are self-employed and pay your own health insurance premiums, those count too.

Medical expenses also become more valuable if you have other large deductible expenses in the same year. If you paid substantial mortgage interest, donated significantly to charity, or paid high state and local taxes, your total itemized deductions may already be close to or above the standard deduction. Adding medical expenses could push you over the line and make itemizing worthwhile.

Conversely, if you had no major medical events, take the standard deduction, and have no other significant deductible expenses, medical costs will not increase your refund. This is the situation for most taxpayers, which is why the standard deduction exists.

How to track and document medical expenses

If you think you might itemize, start keeping receipts and invoices for all medical expenses as they occur. The IRS does not require you to submit receipts with your return, but you must have them if the IRS asks for proof. Keep records for at least three years after you file (seven years is safer). Include the date, the provider's name, the service or item purchased, and the amount paid.

For mileage to medical appointments, keep a log with the date, destination, and miles driven, or use the standard mileage rate the IRS publishes each year. For insurance premiums, keep the statements showing what you paid. If you paid out of pocket for prescriptions, keep the receipts. If you used a health savings account (HSA) or flexible spending account (FSA), those withdrawals are already tax-free, so do not also deduct them as medical expenses.

Frequently Asked Questions

Will medical expenses increase my refund if I take the standard deduction?

No. Medical expenses only reduce your taxable income if you itemize deductions. If you take the standard deduction, medical expenses have no effect on your refund. You should only itemize if your total deductible expenses exceed the standard deduction for your filing status.

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

Yes, if you paid the expenses and they were for someone you could claim as a dependent on your return. You can also deduct medical expenses for your spouse if you file jointly. The expenses must have been paid in the tax year you are reporting them, and they count toward your 7.5% threshold regardless of who received the care.

What if my medical expenses were paid by insurance or an employer?

You cannot deduct expenses that were paid by insurance, an employer, or a government program. You can only deduct the amount you paid out of pocket. If insurance reimbursed you after you filed, you may need to file an amended return.

Do I need to file Form 1040 to deduct medical expenses?

You need to file Form 1040 or 1040-SR (for taxpayers 65 and older) and attach Schedule A to itemize deductions. You cannot itemize on the shorter 1040-EZ form, though that form is no longer available as of 2018. Tax software will guide you through this process.

Can I deduct medical expenses from previous years?

No. You can only deduct medical expenses paid in the tax year you are reporting. If you paid a large bill in December for a procedure in January of the next year, the deduction goes on next year's return, not this year's.