Medical expenses can reduce your taxable income, but only if you itemize deductions and meet a high threshold

You cannot get a refund directly for medical bills through the IRS. However, if your medical expenses are large enough, you can deduct them on your federal tax return, which may increase the refund you receive. The catch: you must itemize deductions instead of taking the standard deduction, and your medical costs must exceed 7.5% of your adjusted gross income (AGI) before any of them count.

For example, if your AGI is $60,000, only medical bills above $4,500 can be deducted. If your total medical expenses that year were $5,200, you could deduct $700. That deduction reduces your taxable income, which can lower the tax you owe and increase your refund—but the IRS is not paying you back for the bills themselves.

This is different from tax credits like the Child Tax Credit or Earned Income Tax Credit, which directly reduce the tax you owe and can result in a refund. Medical deductions only work if itemizing saves you more money than the standard deduction would.

Key Takeaways

  • Medical expenses reduce your taxable income only if you itemize deductions and your total medical bills exceed 7.5% of your adjusted gross income.
  • You must choose between itemizing deductions or taking the standard deduction; itemizing only makes sense if your medical costs plus other deductible expenses exceed the standard deduction amount.
  • Deductible medical expenses include doctor visits, hospital stays, prescription medications, dental work, vision care, and some travel costs to receive medical treatment.
  • Over-the-counter medications and cosmetic procedures do not count as deductible medical expenses.
  • You report medical deductions on Schedule A (Form 1040) when you file your federal tax return.

What counts as a deductible medical expense

The IRS allows you to deduct most costs related to diagnosing, treating, or preventing disease or injury. This includes doctor and dentist visits, hospital stays, surgery, prescription medications, eyeglasses and contact lenses, hearing aids, and mental health treatment. You can also deduct the cost of medical equipment like crutches, wheelchairs, or blood pressure monitors.

Insurance premiums you pay yourself—such as health insurance, dental insurance, or long-term care insurance—are deductible. If you are self-employed, you may also deduct health insurance premiums on your tax return as a business expense, which is separate from itemized deductions.

Travel to receive medical treatment can count too. If you drive to a hospital or doctor's office, you can deduct mileage at the rate the IRS sets each year (check IRS.gov for the current rate). If you fly or take a bus to a medical facility, the full cost of transportation is deductible, including lodging if an overnight stay is medically necessary.

Over-the-counter medications like aspirin or cold medicine do not count unless they treat a specific diagnosed condition and you have a prescription. Cosmetic procedures—such as teeth whitening, hair removal, or elective surgery for appearance—are not deductible, even if a doctor performs them.

When itemizing deductions makes financial sense

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 expenses (such as state and local taxes, mortgage interest, or charitable donations) add up to more than your standard deduction, itemizing saves you money.

If you are single with $60,000 in income and $5,000 in medical bills, you would need an additional $9,600 in other deductible expenses to make itemizing worthwhile. If you do not have that much in other deductions, taking the standard deduction is the better choice, and your medical bills provide no tax benefit.

Use the IRS Form 1040 instructions or a tax software program to calculate both scenarios before you file. Many people find that itemizing only makes sense in years when they have unusually high medical costs, a major home purchase with mortgage interest, or significant charitable donations.

How to report medical deductions on your tax return

If you decide to itemize, you report medical expenses on Schedule A (Form 1040), which you attach to your main tax return. On Schedule A, you list your total medical and dental expenses for the year, then subtract 7.5% of your AGI. Only the amount above that threshold is deductible.

Keep receipts and documentation for all medical expenses you claim. This includes bills from doctors and hospitals, pharmacy receipts for prescriptions, insurance statements, and mileage logs if you drove to treatment. The IRS does not require you to submit these documents with your return, but you must have them available if the IRS asks questions about your return.

If you use tax software, the program will walk you through entering medical expenses and calculate the 7.5% threshold automatically. If you file by paper or work with a tax preparer, provide them with a complete list of expenses and supporting documents.

Medical expenses you cannot deduct

The IRS does not allow deductions for cosmetic surgery, teeth whitening, gym memberships, or general wellness products. Maternity clothes, even though they are necessary during pregnancy, are not deductible. Childcare or babysitting, even if needed because of a parent's medical condition, does not count.

Medications and treatments not approved by the FDA are typically not deductible. This includes many alternative or herbal remedies, though some acupuncture and chiropractic care may may have access to if performed by a licensed practitioner to treat a diagnosed condition. When in doubt, check IRS Publication 502 (Medical and Dental Expenses) or ask a tax preparer.

If you are reimbursed by insurance or an employer health plan for a medical expense, you cannot deduct that same expense. Deduct only the amount you actually paid out of pocket after insurance reimbursement.

State tax deductions for medical expenses

Some states allow medical expense deductions on state income tax returns, while others do not. A few states—such as New York and Pennsylvania—have their own medical deduction rules that differ from federal rules. Check your state's tax agency website or ask a tax preparer whether your state allows medical deductions and what the threshold is.

If your state does allow medical deductions, you may be able to claim them even if you do not itemize on your federal return. State rules vary widely, so do not assume your federal deduction strategy applies to your state taxes.

What to do if you have large ongoing medical costs

If you have chronic illness or ongoing treatment that results in high medical bills every year, tracking expenses becomes important. Keep a folder or spreadsheet of all medical costs, including dates and amounts. This makes it easier to calculate your deduction each year and decide whether itemizing makes sense.

Some people benefit from bunching medical expenses into a single tax year if they can time elective procedures. For example, if you are considering dental work or vision correction, scheduling it in a year when you already have high medical costs may push you over the 7.5% threshold and make itemizing worthwhile.

If you have questions about whether a specific expense is deductible, consult IRS Publication 502 or speak with a tax preparer before you pay for the service. Getting clarity ahead of time prevents problems when you file.

Frequently Asked Questions

Can I deduct medical bills I paid in a previous year?

No. You can only deduct medical expenses you paid during the tax year you are filing for. If you paid a bill in December 2023 for treatment received in 2023, deduct it on your 2023 return. If you paid it in January 2024, deduct it on your 2024 return, even if the treatment happened in 2023.

Does health insurance through my employer count as a deductible medical expense?

No. Premiums deducted from your paycheck before taxes are already excluded from your taxable income, so you cannot deduct them again. You can only deduct insurance premiums you pay yourself out of pocket, such as premiums for a spouse's coverage or a policy you buy on your own.

If I use a Health Savings Account (HSA) or Flexible Spending Account (FSA), can I also deduct medical expenses?

No. Money you contribute to an HSA or FSA is already set aside tax-free for medical expenses. You cannot deduct the same expense twice. Deduct only medical costs you paid out of pocket without using an HSA or FSA.

What if my medical bills were paid by Medicaid or Medicare?

You can deduct the premiums you paid for Medicare Part B and Part D, but not the benefits you received. If Medicaid paid your medical bills, you cannot deduct those bills since you did not pay for them yourself.

Do I need to report medical deductions if I take the standard deduction?

No. If you take the standard deduction, you do not report medical expenses on your tax return at all. They provide no tax benefit in that case. You only report medical expenses if you itemize deductions on Schedule A.