Yes, you may be able to claim medical expenses on your federal income tax return, but paying a large medical bill does not automatically produce a tax deduction. The IRS allows taxpayers to deduct certain unreimbursed medical and dental expenses only when they itemize deductions and their eligible expenses exceed a set percentage of adjusted gross income.
Under current federal rules for 2025 tax returns, only the portion of qualified medical expenses exceeding 7.5% of adjusted gross income, or AGI, can be deducted. The deduction is claimed on Schedule A of Form 1040.
How the 7.5% AGI Rule Works
The medical deduction is not based on your total medical spending. You must first calculate 7.5% of your AGI and subtract that amount from your eligible expenses.
Suppose your AGI is $60,000. The threshold would be $4,500. If you paid $8,000 in qualified, unreimbursed medical expenses, only $3,500 would potentially be deductible.
If your eligible expenses were $4,000, you would receive no federal medical deduction because the amount would not exceed the $4,500 threshold. The threshold applies to the combined qualified expenses of everyone whose medical costs you are permitted to include.
You Must Itemize Your Deductions
Medical expenses are generally claimed as an itemized deduction on Schedule A. You cannot separately claim this deduction while using the standard deduction.
Itemizing is usually worthwhile only when your total eligible itemized deductions—including medical expenses, qualifying taxes, mortgage interest and charitable contributions—are greater than the standard deduction available for your filing status.
Therefore, even when part of your medical expenses exceeds 7.5% of your AGI, those expenses may not reduce your taxes if taking the standard deduction still gives you a larger overall deduction.
Which Medical Expenses Can Be Claimed?
Qualified expenses generally include amounts paid for diagnosing, treating, preventing or reducing the effects of a physical or mental illness. Common deductible expenses may include:
- Payments to doctors, dentists and surgeons
- Hospital and laboratory charges
- Prescription medications and insulin
- Dental treatments, including fillings and dentures
- Mental-health treatment
- Eyeglasses, contact lenses and eye examinations
- Hearing aids and batteries
- Medical equipment, wheelchairs and crutches
- Certain nursing services
- Qualified long-term care expenses
- Health insurance premiums paid with after-tax money
- Transportation primarily required for medical care
Some nursing-home expenses may qualify when the main reason for staying in the facility is medical care. In that situation, eligible costs may include meals and lodging. When the person enters the facility mainly for personal reasons, generally only the medical-care portion qualifies.
Can You Deduct Health Insurance Premiums?
Health, dental and vision insurance premiums paid with your own after-tax money may qualify as medical expenses. Certain Medicare premiums and qualified long-term care insurance premiums may also qualify, although annual limits can apply to long-term care premiums.
You cannot deduct premiums already paid with tax-free employer benefits. You also cannot include the part of a Marketplace insurance premium covered by the Premium Tax Credit. Only the amount you actually paid may potentially qualify.
Whose Expenses Can You Include?
You can generally include qualified medical expenses paid for yourself, your spouse and your dependents. The person must usually have been your spouse or dependent either when the medical services were provided or when you paid the bill.
Special rules may allow you to include expenses paid for someone who would have qualified as your dependent except for the person’s income, joint-return status or the fact that you could be claimed by another taxpayer. These rules are especially important when adult children pay a parent’s medical or nursing-home expenses.
Medical Costs You Usually Cannot Deduct
Personal expenses that merely improve general health are normally not deductible. Common examples include:
- Toothpaste and ordinary toiletries
- Vitamins taken for general health
- Gym memberships for general fitness
- Diet food that satisfies normal nutritional needs
- Funeral or burial expenses
- Life insurance premiums
- Household help that does not provide nursing care
- Most cosmetic surgery
- Vacations recommended for rest
- Nonprescription medicines other than insulin
Cosmetic surgery may qualify when it is necessary to correct a deformity caused by a congenital condition, accident, injury or disfiguring disease. Nutritional supplements may qualify in limited circumstances when recommended to treat a specifically diagnosed medical condition.
Reimbursed Expenses Cannot Be Claimed
You can deduct only the amount you paid and were not reimbursed for. If an insurer pays $7,000 of a $10,000 hospital bill and you pay the remaining $3,000, only your $3,000 payment may be considered.
The same expense cannot receive two tax benefits. Medical bills paid or reimbursed tax-free through an HSA, FSA or HRA cannot also be claimed as an itemized medical deduction.
Special Rule for Self-Employed People
Eligible self-employed taxpayers may be able to deduct health, dental, vision and qualified long-term care insurance premiums as an adjustment to income rather than an itemized deduction. This deduction generally does not require expenses to exceed 7.5% of AGI.
However, eligibility restrictions apply. For example, you generally cannot claim the self-employed health insurance deduction for a month when you were eligible for subsidized employer coverage through your own employer or your spouse’s employer. Premiums cannot be deducted twice.
Keep Proper Records
Keep medical invoices, pharmacy receipts, insurance statements, mileage records and proof of payment. Records should show when the expense was paid, who received the treatment and how much insurance reimbursed.
Medical expenses are generally deducted in the year they are paid, even when the treatment occurred in another year. Before itemizing, calculate the 7.5% threshold and compare your total itemized deductions with your available standard deduction.
