Which Medical Expenses You Can Deduct on Your Taxes

What counts as a medical expense deduction

You can deduct medical and dental expenses you paid out of your own pocket during the tax year, but only if they exceed 7.5% of your adjusted gross income (AGI). That threshold means most people cannot deduct medical expenses unless they had unusually high costs or a low income that year. The IRS has a specific list of what counts, and it is narrower than you might expect — health insurance premiums, prescription medications, and visits to doctors, dentists, and therapists all may have access to, but over-the-counter pain relievers, vitamins, and cosmetic procedures do not.

The expenses must be for you, your spouse, or a dependent you claim on your return. You cannot deduct medical costs for an adult child you do not claim, even if you paid the bills. You also cannot deduct expenses that were reimbursed by insurance or an employer health plan — only the amounts you actually paid yourself count.

Key Takeaways

• Medical expenses are deductible only if they exceed 7.5% of your adjusted gross income, which means most households cannot use this deduction.
• may have access to expenses include doctor and dentist visits, prescription medications, mental health treatment, medical equipment, and health insurance premiums you paid yourself.
• Over-the-counter medications (except insulin), vitamins, cosmetic procedures, and gym memberships do not count, even if they improve your health.
• You must itemize deductions on your tax return to claim medical expenses — you cannot use the standard deduction and claim them at the same time.
• Keep receipts, invoices, and insurance statements for every medical expense you plan to deduct, because the IRS asks for proof.

Medical services and treatments that may have access to

Doctor visits, hospital stays, surgery, and emergency room care all count. Mental health treatment — therapy, counseling, and psychiatric care — qualifies whether you see a therapist, psychologist, or psychiatrist. Dental work including cleanings, fillings, root canals, and orthodontia counts. Physical therapy, occupational therapy, and speech therapy are deductible. Chiropractic care, acupuncture, and other alternative treatments count if they treat a specific medical condition, not general wellness.

Prescription medications are deductible, including birth control pills prescribed by a doctor. Insulin is the only over-the-counter medication that counts — other OTC drugs like aspirin, cold medicine, and antacids do not, even if a doctor recommends them. Medical equipment such as crutches, wheelchairs, hearing aids, glasses, and contact lenses counts. Home modifications made for medical reasons — a wheelchair ramp, grab bars, or a walk-in shower installed because of a disability or injury — are deductible, though you may need documentation that a doctor recommended the change.

Expenses that do not may have access to

Cosmetic procedures are never deductible, even if they make you feel better. That includes teeth whitening, Botox, hair transplants, and elective plastic surgery. Gym memberships and fitness classes do not count, even if a doctor says exercise would help your condition. Vitamins and dietary supplements are not deductible unless prescribed by a doctor for a specific medical deficiency. Weight loss programs and diet foods do not count unless a doctor prescribed them to treat obesity as a medical condition, and even then the documentation burden is high.

Health insurance premiums you paid through an employer payroll deduction are already pre-tax and cannot be deducted again. If you are self-employed and paid premiums yourself, you may be able to deduct them as a business expense rather than a medical expense — that is a different calculation and often more valuable. Expenses for a spouse or dependent you do not claim on your return do not count. Cosmetic dentistry like veneers or teeth whitening does not may have access to, though medically necessary dental work does.

How the 7.5% threshold works

Before you can deduct any medical expenses, your total medical costs for the year must exceed 7.5% of your adjusted gross income. If your AGI is $60,000, you can only deduct medical expenses above $4,500. If your total medical costs were $5,200, you can deduct only $700 — the amount over the threshold. If your costs were $4,200, you cannot deduct anything.

This threshold changes the math for most households. A family with moderate income and normal health care costs will not reach 7.5% of their income. You reach it only in years when you had major medical events — a surgery, a hospitalization, an extended course of treatment, or multiple family members with significant health needs. Even then, you must itemize deductions on your tax return to claim the deduction, and itemizing only makes sense if your total itemized deductions (medical expenses plus mortgage interest, state taxes, charitable donations, and other deductible items) exceed the standard deduction for your filing status.

Itemizing versus the standard deduction

You cannot claim medical expense deductions and use the standard deduction in the same year — you must choose one or the other. For 2024, the standard deduction is $14,600 for single filers and $29,200 for married couples filing jointly. If your medical expenses plus other deductible items (mortgage interest, property taxes, state income taxes, charitable donations) add up to less than the standard deduction, you will get a larger tax break by taking the standard deduction and skipping the medical deduction entirely.

Work with a tax preparer or use tax software to calculate both scenarios and see which gives you a bigger deduction. Some years you will benefit from itemizing; other years the standard deduction will be better. If you are close to the threshold, timing matters — you might bunch medical expenses into one year by scheduling elective procedures and paying outstanding bills before December 31, which can push you over the threshold and make itemizing worthwhile.

What records you need to keep

The IRS requires documentation for every medical expense you deduct. Keep receipts from doctors, dentists, hospitals, and pharmacies. If you paid by credit card or check, your statement serves as proof of payment. For insurance reimbursements, keep the explanation of benefits (EOB) showing what the insurance paid and what you paid out of pocket — you can only deduct your portion. For medical equipment or home modifications, keep the invoice showing what was purchased and receipts proving you paid for it.

If a doctor recommended a home modification or alternative treatment, keep a copy of that recommendation in writing. For mental health treatment, you do not need to disclose the diagnosis or details of therapy — just the date, provider name, and amount paid. Organize receipts by category (doctor visits, prescriptions, equipment, insurance premiums) and add them up by category. The IRS does not require you to attach receipts to your return, but you must have them available if the IRS asks.

Special situations: Self-employed and business owners

If you are self-employed, health insurance premiums you paid yourself may be deductible as a business expense on Schedule C, which is often more valuable than claiming them as a medical expense. You cannot claim the same premium both ways. Talk to a tax preparer about which route gives you the bigger deduction. Medical expenses related to your business — a home office modification for a disability, equipment needed to work — may also be deductible as business expenses rather than personal medical expenses.

If you have employees, you cannot deduct your own health insurance premiums as a business expense if your business provides health insurance to employees and you are covered under that plan. The rules are complex and depend on your business structure (sole proprietor, S-corp, LLC, partnership). A tax preparer who knows your business can tell you which expenses go where and which route saves you the most money.

Frequently Asked Questions

Can I deduct my health insurance premiums?

It depends. If you paid premiums through an employer payroll deduction, they are already pre-tax and you cannot deduct them again. If you are self-employed and paid premiums yourself, you may deduct them as a business expense on Schedule C, which is usually better than claiming them as a medical expense. If you are unemployed and paid premiums out of pocket, they count toward your medical expense deduction, but only if your total medical costs exceed 7.5% of your AGI.

Does my dependent child's medical expenses count?

Only if you claim them as a dependent on your tax return. You must provide more than half their financial support for the year and meet other IRS tests. If your adult child is independent and files their own return, their medical expenses belong on their return, not yours — even if you paid the bills. If you claim them as a dependent, their medical expenses count toward your 7.5% threshold.

What if I paid medical bills in one year but the insurance reimbursed me in a different year?

Deduct the expense in the year you paid it, not when you were reimbursed. If the insurance reimbursement comes in a later year, you may need to amend your earlier return to reduce the deduction. Keep the EOB showing the reimbursement date so you can match it to the original expense.

Can I deduct a therapy dog or emotional support animal?

A service dog trained to perform specific tasks for a disability (guiding a blind person, alerting to seizures) is deductible. An emotional support animal or therapy pet is not deductible, even if a therapist recommends it. The IRS distinguishes between animals trained to perform work and animals that provide comfort through their presence.

What if my medical expenses were much higher this year — should I deduct them?

Calculate whether your medical expenses plus other deductible items exceed your standard deduction. If they do, itemizing will save you money. If you are close to the threshold, consider timing — you might bunch elective procedures and pay outstanding bills before year-end to push yourself over the limit. A tax preparer can run the numbers and show you the difference between itemizing and taking the standard deduction.