Allowable Medical Expense Deductions

The IRS defines qualifying medical expenses as those related to the “diagnosis, cure, mitigation, treatment, or prevention of a disease or condition affecting any part or function of the body.” To be tax deductible, a medical expense generally must be legal and meet IRS conditions, which include:

Any medical services from physicians, surgeons, dentists, and other medical professionals related to the diagnosis, cure, mitigation, treatment, or prevention of diseaseAny costs for medications prescribed by a medical professionalAny costs for medical devices, equipment, and supplies prescribed by a medical professional, such as eyeglassesExpenses associated with transportation to and from medical careLong-term care servicesInsurance for medical care or long-term care

Expenses that are merely beneficial to general health, such as vitamins, aren’t covered. 

You can deduct the cost of transportation to and from a health care facility or treatment if the trip is primarily for medical care and is essential. The following expenses can be included in the cost of medical-related transportation:

Bus, taxi, train, and plane fares Ambulance serviceTransportation expenses of a parent who has to go with their child who needs medical careTransportation expenses of a nurse who travels with the patient and provides care because the patient can’t travel aloneTransportation expenses for regular visits to see a dependent who is mentally ill, as long as the visits are recommended as a part of treatment

Who Can Receive Treatment?

You can deduct medical expenses paid for yourself, your spouse, and your dependents. You might also be able to deduct expenses for someone you don’t actually claim as your dependent, but you could have done so except for any of the following circumstances:

You didn’t claim your child as a dependent because of the rules for children of divorced or separated parents. You didn’t claim an individual as a dependent on your return because that person earned $4,300 or more in gross income as of 2021, or because they filed a joint return. You or your spouse (if married filing jointly) can’t be claimed as a dependent on someone else’s return. 

The Deduction and Your AGI Threshold

You can calculate the 7.5% rule by tallying up all your medical expenses for the year, then subtracting the amount equal to 7.5% of your AGI. For example, if your AGI is $65,000, your threshold would be $4,875, or 7.5% of $65,000. You can find your AGI on Form 1040. If you spent $10,000 on qualified medical expenses, then you could deduct $5,125—the balance over that $4,875 threshold.

You Must Itemize to Claim the Deduction

You must itemize your deductions to claim medical expenses. This means you must complete and file Schedule A with your tax return. It could be worth your while if you’re eligible to claim several other itemized deductions as well, so they all add up to more than the year’s standard deduction. The deduction amount for tax year 2022 ranges from $12,950 to $25,900, and $13,850-$27,700 in tax year 2023. You’d pay taxes on more income than you have to if you don’t claim the standard deduction and if you don’t have itemized deductions that total more than the applicable standard deduction amount. If you choose to itemize, you can deduct your medical expenses starting on Line 1 of Schedule A. Complete Lines 2 and 3 to calculate your threshold limitation on medical expenses. Lastly, Line 4 shows how much you can deduct.

Pre-Tax Expenses Aren’t Deductible

Only medical expenses that aren’t reimbursed by your insurance can be included in the medical expense deduction. For example, say you have a prescription medication that costs $50, and your insurance company pays $20. You pay $30. With the medical expense deduction, you can only deduct the $30.  Similarly, any medical expenses paid from a flexible spending account, a health savings account (HSA), or a health reimbursement arrangement aren’t included in the itemized deduction for medical expenses. These accounts already provide a tax advantage, and you can’t double dip. 

Special Rules for Some Health Insurance

You can deduct premiums for health, dental, and vision care insurance, but only if the premiums are paid with after-tax dollars. Those who have group insurance through their employers usually pay these premiums with pretax dollars.  You can deduct Medicare Part A premiums, but only if you aren’t covered under Social Security and are voluntarily enrolled in Medicare Part A. Medicare Part B and Part D premiums are deductible, too.