Medical expense deduction

Add up the medical and dental bills you paid during the year for yourself, your spouse, and your dependents. Subtract 7.5% of your adjusted gross income (AGI). What is left is your deduction. Everything below that line is lost.

The deduction goes on Schedule A with your other itemized deductions: state and local taxes, mortgage interest, and charitable gifts. It only helps if the whole Schedule A total beats your standard deduction.

Head of household gets $24,150. If you are 65 or older, the standard deduction rises by another $2,050 (single or head of household) or $1,650 per spouse (married), which raises the bar for itemizing.

The IRS list is long. The common items:

• Doctor, hospital, lab, and clinic bills, including copays and deductibles
• Prescription drugs and insulin
• Dental work, eye exams, glasses, contacts, and hearing aids
• Mental health care and physical therapy
• Health insurance premiums you paid with after-tax money, including Medicare Part B and Part D. Premiums taken out of your paycheck before tax do not count.
• Long-term care insurance premiums, up to an age-based limit
• Mileage to and from appointments at the IRS medical rate, plus parking and tolls

Not deductible:

• Cosmetic surgery, unless it corrects a deformity from a birth defect, an injury, or a disfiguring disease
• Over-the-counter drugs, vitamins, and supplements without a prescription
• Gym memberships and general wellness costs
• Anything your insurance reimbursed. A reimbursement that arrives in a later year for a bill you already deducted is income in that year.
• Anything paid from an HSA or FSA. That money was already tax-free going in.

If you are self-employed, your health insurance premiums usually go on Schedule 1 as an above-the-line deduction instead. No floor applies there.

If you have a high-deductible plan, an HSA is usually the better route. Contributions are deductible with no floor, up to $4,400 self-only or $8,750 for a family in 2026.

You deduct expenses in the year you pay them, not the year of the treatment. A credit card charge counts when you charge it, not when you pay off the card.

If a large bill is coming, pay it in the same year as any elective dental or vision work. Bills bunched into one year are more likely to clear the floor than the same bills split across two.

Example: AGI $80,000, single, $9,000 of unreimbursed medical bills paid in 2026. The floor is 7.5% of $80,000, or $6,000. The deduction is $9,000 minus $6,000, or $3,000.

That $3,000 goes on Schedule A. If your other itemized deductions already exceed the $16,100 standard deduction, it saves about $660 at the 22% rate. If they do not, some or all of it is used up just reaching the standard deduction.

• Schedule A, line 1: total medical and dental expenses you paid.
• Lines 2 to 4: AGI from Form 1040 line 11b, then 7.5% of it, then line 1 minus line 3. Line 4 is your deduction.
• Records: keep receipts and insurance statements for three years. You do not send them in.

Tax software does the subtraction once you enter the total. Enter the full amount you paid, not the amount above the floor.