You can only claim medical expenses as a tax deduction if you itemize deductions instead of taking the standard deduction, and only the amount above 7.5% of your adjusted gross income

The IRS lets you deduct medical and dental expenses, but the process has two hard limits. First, you must itemize deductions on Schedule A instead of claiming the standard deduction—most people take the standard deduction because it is larger. Second, you can only deduct the portion of your medical expenses that exceeds 7.5% of your adjusted gross income (AGI) for the tax year. If your AGI is $60,000, for example, you can only deduct medical expenses above $4,500.

This means medical deductions rarely result in a refund by themselves. They reduce your taxable income, which may lower the tax you owe. You get a refund only if your total deductions and credits exceed your total tax liability for the year. Many people find that the standard deduction is already larger than their medical expenses plus other itemized deductions combined, so they cannot claim medical expenses at all.

Key Takeaways

  • You must itemize deductions on Schedule A to claim medical expenses; most taxpayers use the standard deduction instead and cannot claim medical costs.
  • Only medical expenses above 7.5% of your adjusted gross income count toward the deduction, so you need to calculate your AGI first.
  • may be able to access expenses include doctor visits, dental work, prescription medications, medical equipment, and some travel costs to receive care.
  • You report medical deductions on Schedule A (Form 1040), filed with your tax return; you do not need receipts with your return but must keep them for IRS records.
  • If you paid medical expenses in a prior year and did not claim them, you can file an amended return using Form 1040-X within three years of the original return date.

What counts as a deductible medical expense

The IRS has a specific list of medical and dental expenses you can deduct. Deductible expenses include doctor and dentist visits, hospital stays, surgery, prescription medications, medical equipment (such as crutches, wheelchairs, or hearing aids), eyeglasses and contact lenses, and orthodontia. You can also deduct the cost of therapy, mental health treatment, and certain medical procedures not covered by insurance.

Less obvious expenses count too: mileage to and from medical appointments (you use the IRS mileage rate, not actual gas cost), lodging if you travel for medical care, and premiums you pay for health insurance if you are self-employed. You cannot deduct cosmetic surgery unless it is medically necessary to treat an injury or disease. Over-the-counter medications do not count unless they are prescribed by a doctor.

Keep receipts and invoices for every expense you plan to claim. The IRS does not require you to attach receipts to your return, but you must have them if the IRS asks to verify your deduction during an audit.

How to calculate whether you meet the 7.5% threshold

Before you spend time gathering receipts, determine whether your medical expenses will clear the 7.5% hurdle. Start with your adjusted gross income (AGI) for the tax year—this is the number on line 11 of your Form 1040. Multiply your AGI by 0.075 to find the threshold. Any medical expenses below that number do not reduce your taxable income at all.

Example: if your AGI is $50,000, the threshold is $3,750. You can only deduct medical expenses above $3,750. If you spent $4,200 on medical care, you can deduct $450 ($4,200 minus $3,750). If you spent $3,500, you cannot deduct any of it.

This calculation matters because it determines whether itemizing makes sense. Add up your medical expenses, subtract the 7.5% threshold, then add any other itemized deductions (mortgage interest, property taxes, charitable donations, state income taxes up to $10,000). If that total exceeds the standard deduction for your filing status, itemizing saves you money. If not, take the standard deduction and do not claim medical expenses.

Itemizing deductions on Schedule A

To claim medical expenses, file Schedule A (Form 1040) with your tax return. Schedule A is where you list all itemized deductions. On line 1, enter your total medical and dental expenses for the year. On line 2, enter your AGI. On line 3, multiply your AGI by 7.5% and enter that number. On line 4, subtract line 3 from line 1—this is your deductible medical expense amount. If line 1 is less than line 3, enter zero on line 4.

Transfer the amount from line 4 to the medical expenses line on your Form 1040 (the exact line number changes yearly, but the form instructions will direct you). Then complete the rest of Schedule A with your other itemized deductions: mortgage interest, property taxes, charitable donations, and state and local taxes (capped at $10,000). Add all itemized deductions and compare to the standard deduction for your filing status. Use whichever is larger.

File Schedule A and Form 1040 together with your tax return. You can file by mail or electronically through tax software or a tax professional. If you file electronically, the software will calculate the medical expense deduction for you once you enter the amounts.

Claiming medical expenses from prior years

If you paid medical expenses in a previous tax year and did not claim them, you can file an amended return. Use Form 1040-X (Amended U.S. Individual Income Tax Return) for the year in which you incurred the expenses. You must file the amended return within three years of the original return date (or within two years of paying the tax, whichever is later).

On Form 1040-X, explain in the margin that you are claiming medical deductions you did not claim on the original return. Attach a new Schedule A showing the medical expenses and the corrected itemized deduction total. Calculate the difference in tax owed and enter it on the form. If you overpaid tax, the IRS will send you a refund; if you owe more, you will receive a bill.

Mail Form 1040-X to the IRS address for your state (listed in the form instructions). Processing takes 8 to 12 weeks. You can track the status of your amended return using the IRS Where's My Amended Return tool on IRS.gov after you have filed.

When medical expenses result in a refund

A medical expense deduction reduces your taxable income, which lowers your tax bill. You receive a refund only if your total tax credits and deductions exceed the total tax you owe for the year. This happens most often when you have a large medical expense year combined with other deductions (such as mortgage interest or charitable donations) and your income is moderate.

Example: suppose your AGI is $45,000, you paid $8,000 in medical expenses, and you have $6,000 in mortgage interest. Your 7.5% threshold is $3,375, so your deductible medical expense is $4,625. Your total itemized deductions are $10,625 ($4,625 medical plus $6,000 mortgage interest). The standard deduction for a single filer in 2024 is $14,600, so you would take the standard deduction instead and receive no benefit from the medical expenses.

If the same person had $12,000 in mortgage interest instead, total itemized deductions would be $16,625, which exceeds the standard deduction. In that case, itemizing saves money and the medical deduction contributes to that savings. Whether you receive a refund depends on your total tax liability and any credits you claim.

Keeping records and handling IRS questions

The IRS does not require you to submit receipts with your tax return, but you must keep them for at least three years in case of an audit. Store receipts, invoices, bills, and proof of payment in a folder or file. If the IRS asks about your medical deduction, you will need to show documentation that you paid the expenses and that they were medically necessary.

If the IRS questions your deduction, respond promptly with the requested documents. If you cannot locate receipts, bank statements or credit card statements showing the payment can serve as backup evidence. Medical provider statements or explanation of benefits (EOB) from your insurance can also help prove you incurred the expense.

If you used a tax professional to file your return, keep a copy of your completed tax forms and all supporting documents you provided to them. This makes it easier to respond if questions arise later.

Frequently Asked Questions

Can I claim medical expenses my insurance company reimbursed me for?

No. You can only deduct medical expenses you paid out of pocket. If your insurance company reimbursed you, subtract the reimbursement from the expense before adding it to your deductible total. The IRS does not allow you to deduct the same expense twice.

What if I use a Health Savings Account or Flexible Spending Account for medical expenses?

You cannot deduct medical expenses you paid with pre-tax dollars from an HSA or FSA. These accounts already reduce your taxable income when you contribute to them, so claiming the same expenses as a deduction would be double-dipping. Only deduct expenses you paid with after-tax money.

Do I need to file Schedule A if my medical expenses are my only deduction?

Only if your medical expenses (after the 7.5% threshold) plus any other itemized deductions exceed your standard deduction. In most cases, the standard deduction is larger, so you would not benefit from itemizing. Use the calculation described in this guide to compare before you file.

Can I claim medical expenses for my spouse or dependents?

Yes, if you paid the expenses and claim them on your joint return (for a spouse) or your return (for dependents you claim). The expenses must be for medical care of you, your spouse, or your dependents. You cannot deduct medical expenses for someone else unless you are legally responsible for their care.

What happens if I claimed the standard deduction but now want to claim medical expenses instead?

File an amended return using Form 1040-X for the year you want to change. Attach a new Schedule A showing your itemized deductions including the medical expenses. You must file within three years of the original return date. The IRS will recalculate your tax and send a refund if you overpaid.