Quick answer

You can deduct qualified medical and dental expenses on Schedule A of Form 1040 if you itemize and your total unreimbursed expenses for the tax year exceed 7.5% of your adjusted gross income (AGI) (IRS, Topic No. 502). Eligible expenses include many common health-related costs—but not everything you buy at the pharmacy or pay for in an insurance premium. See IRS Publication 502 for full details: https://www.irs.gov/pub/irs-pdf/p502.pdf.

How the medical expense deduction works (step-by-step)

  1. Track all qualifying out-of-pocket medical costs you or your dependents pay during the calendar year.
  2. Add them together to get your total medical expenses.
  3. Compute 7.5% of your AGI. Only the amount of expenses that exceeds that 7.5% floor is deductible.
  4. Report the deductible amount on Schedule A (Itemized Deductions) of Form 1040.

Example 1 — Single filer:

  • AGI = $50,000. 7.5% of AGI = $3,750.
  • Total unreimbursed medical expenses = $6,000.
  • Deductible amount = $6,000 − $3,750 = $2,250.

Example 2 — Married filing jointly:

  • AGI = $120,000. 7.5% of AGI = $9,000.
  • Total unreimbursed medical expenses = $10,500.
  • Deductible amount = $10,500 − $9,000 = $1,500.

Note: Only taxpayers who itemize can claim these deductions. If your standard deduction is larger than your itemized total, the standard deduction is almost always the better choice.

What counts as an eligible medical expense

Under IRS rules, “medical care” includes payments for the diagnosis, cure, mitigation, treatment, or prevention of disease, and for treatments affecting any part or function of the body (IRS, Topic No. 502). Typical eligible items include:

  • Payments to doctors, dentists, surgeons, chiropractors, psychiatrists, psychologists, and other medical professionals.
  • Hospital services, inpatient care, and related facility costs.
  • Prescription medicines and insulin.
  • Medical equipment and supplies such as wheelchairs, hearing aids, and prosthetic devices.
  • Certain long-term care services and premiums (limits and rules apply; see Publication 502).
  • Costs of diagnosis and treatment, including X-rays and lab fees.
  • Transportation expenses primarily for and essential to medical care — either actual costs or the IRS standard medical mileage rate (the IRS sets this rate annually; see Publication 502 and the IRS rates page).
  • Insurance payments or premiums only to the extent they are not paid with pre-tax dollars; for many taxpayers, employer-paid health premiums and HSA-funded expenses are excluded already.

For a comprehensive list and special rules (for example, for long-term care), review IRS Publication 502: https://www.irs.gov/pub/irs-pdf/p502.pdf.

Common non-deductible or limited items

Not every health-related cost qualifies. Common exclusions include:

  • Cosmetic surgery (unless necessary to improve a deformity from a congenital abnormality, injury, or disease).
  • Over-the-counter medicines (except when prescribed by a doctor).
  • Health club memberships or general wellness products unless prescribed to treat a specific medical condition.
  • Expenses paid by your insurance, HSA distributions used for qualified medical expenses, or employer pre-tax benefits.
  • Nonessential or experimental procedures not recognized by a treating physician.

If you’re unsure about a specific item, reference Publication 502 or consult a tax professional.

Special cases and items people often miss

  • Transportation and lodging: Costs to travel to obtain medical care can be deductible when primarily for and essential to treatment. This includes parking fees and tolls; lodging may be deductible in limited circumstances. Use the IRS guidance to choose the standard mileage allowance or actual expenses.
  • Home improvements: If they’re medically necessary (for example, installing ramps or widening doorways to accommodate a wheelchair), the part of the cost that exceeds any increase in property value may be deductible.
  • Dental and vision care: Routine dental work, braces, eyeglasses, and contact lenses are generally deductible.
  • Therapy and counseling: If a licensed professional provides treatment for a diagnosable condition, those costs typically qualify.

Documentation: records you should keep

Good recordkeeping is the most reliable way to support a deduction if the IRS asks questions. Keep:

  • Itemized receipts and invoices from providers.
  • Pharmacy prescription receipts and prescribing doctor’s records where applicable.
  • Insurance statements showing payments and amounts you paid out-of-pocket.
  • Bills and canceled checks or bank/credit card statements that match medical payments.
  • Mileage logs or transportation receipts if claiming travel expenses (note purpose, date, and miles driven).
  • A summary spreadsheet that lists date, provider, type of expense, and amount.

See our guides on tracking and documenting medical expenses for practical templates and examples: “How to Track Medical Expenses to Maximize Deductions” and “How to Document Medical Expenses for Tax Purposes.” (internal links below).

Practical strategies I use with clients

In my years advising clients, these tactics commonly produce the best results:

  1. Consolidate elective but necessary medical procedures into one tax year if you’re close to the 7.5% AGI threshold. Timing can make the difference between no deduction and a meaningful one.
  2. Keep thorough, year-round records rather than trying to reconstruct expenses at tax time.
  3. Consider whether itemizing makes sense: compare total itemized deductions (including mortgage interest, state and local taxes within limits, charitable gifts, and medical costs) with the standard deduction.
  4. Coordinate claims with flexible spending accounts (FSAs) and health savings accounts (HSAs). If you’ve paid with pre-tax FSA or HSA funds, you can’t deduct those expenses again.
  5. For self-employed taxpayers: remember the self-employed health insurance deduction is an above-the-line deduction on Schedule 1 and doesn’t rely on itemizing. That deduction is different from medical expense deductions on Schedule A.

Common mistakes to avoid

  • Throwing away receipts. Small amounts add up.
  • Mixing reimbursed and unreimbursed amounts — you can only deduct unreimbursed expenses.
  • Assuming all health-related spending is deductible. Always check the rules (for example, cosmetic procedures are usually excluded).
  • Forgetting to include costs for a spouse or dependents that you actually paid for during the year.

When to consult a tax professional

If you have sizable medical bills, a recent major procedure, or complex items like home modifications or long-term care costs, consult a qualified CPA or tax advisor. In my practice, working through the details often reveals extra eligible items clients initially missed. Tax rules can change; a pro can also confirm whether the itemized approach beats the standard deduction in your situation.

Authoritative sources

Professional disclaimer

This article is for educational purposes and does not constitute personalized tax advice. Tax laws and IRS guidance can change. For advice tailored to your situation, consult a qualified tax professional or CPA.