Introduction
A root canal, a crown and a few specialist visits can add up to thousands of dollars in a single year. In 2024, Americans paid $556.6 billion out of pocket for health care, according to CMS data. The IRS lets some taxpayers recover part of that cost through a deduction.
The short answer: if you itemize, you may deduct qualifying unreimbursed medical and dental expenses that exceed 7.5% of your adjusted gross income (AGI).
Form 1040 and Schedule A are US federal tax forms. Use this guide only if you have a US filing obligation, and check separately how Australia treats the same costs.
Key Takeaways
- Only qualifying expenses you paid during the year and weren't reimbursed for count.
- You must itemize on Schedule A and can deduct only the amount above 7.5% of AGI.
- The deduction lowers taxable income. It doesn't refund your medical bills.
- Premiums, mileage, dental work and exclusions each have their own rules, covered below.
How the Medical and Dental Deduction Works on Form 1040
Schedule A calculates your itemized deductions and attaches to Form 1040 or 1040-SR. The medical section produces only the eligible amount above the AGI floor. That figure then joins your other itemized deductions.
What counts as medical care
Under IRS Publication 502, medical care covers costs for the diagnosis, cure, mitigation, treatment or prevention of disease, and costs that affect a structure or function of the body. Spending that merely benefits general health doesn't qualify.
What it is not
Keep these separate:
- A tax credit reduces tax directly. This deduction reduces income.
- Self-employed health insurance is an income adjustment with its own rules.
- HSA contributions have their own deduction.
- Amounts paid with tax-free HSA, FSA or HRA money can't be deducted again.
Who Can Claim It and How the 7.5% AGI Threshold Works
Eligibility and family expenses
You can include expenses for yourself, your spouse and your dependents. Spouse or dependent status usually needs to exist when the care is provided or when you pay. For this deduction, some usual dependency tests, such as the gross income and joint return limits, can be waived.
Special situations include:
- Divorced or separated parents: each parent may include amounts they personally pay, if the child was in their custody over half the year and the parents provided over half the support.
- Multiple support: only the designated taxpayer's own unreimbursed payments count.
- Married filing separately: each spouse generally includes what they actually paid. Joint-account payments are split equally unless shown otherwise.
- Standard deduction takers: if you don't itemize, there is no medical deduction.
Calculating the deductible amount
- Add up qualifying expenses you paid in the year.
- Subtract insurance and other reimbursements.
- Multiply your AGI by 0.075.
- Subtract that amount from your expenses. If the result is negative, enter zero.
- Enter the excess on Schedule A.
Hypothetical example only: AGI of $80,000 gives a floor of $6,000. Unreimbursed expenses of $9,500 leave a deductible amount of $3,500.
With only $5,500 of expenses, the deduction is zero.
Does itemizing pay off?
Your medical amount joins mortgage interest, state and local taxes and other itemized deductions. The total must beat your standard deduction. For 2026, per Rev. Proc. 2025-32, that is:
| Filing status | 2026 standard deduction |
|---|---|
| Single or married filing separately | $16,100 |
| Head of household | $24,150 |
| Married filing jointly | $32,200 |
Age and blindness adjustments may raise these figures.
What Medical and Dental Expenses Qualify?
Common medical costs
Payments to physicians, surgeons, dentists, hospitals and other medical practitioners qualify. So do:
- Prescriptions and insulin
- Diagnostic tests and lab fees
- Hospital care
- Eyeglasses and contact lenses needed for medical reasons
- Hearing aids, including batteries and maintenance
- Artificial limbs and wheelchairs
Dental-specific rules
Dental care that prevents or treats disease qualifies. That includes X-rays, fillings, extractions, dentures, braces and orthodontics. Teeth whitening does not.
Cosmetic surgery is generally excluded. The exception is surgery to correct a deformity from a congenital abnormality, an accident or a disfiguring disease.
For a bill that mixes both kinds of work, ask the provider for an itemized statement. Claim only the treatment portion.
Additional qualifying categories
Insurance premiums. Premiums for policies covering medical care, including eligible dental and vision coverage, can count. Medicare Part B and D premiums qualify. Premiums paid through an untaxed employer plan don't, because you never paid them with after-tax money.
Qualified long-term-care premiums are capped by age in 2026 (per person):
| Age | Limit |
|---|---|
| 40 or younger | $500 |
| 41-50 | $930 |
| 51-60 | $1,860 |
| 61-70 | $4,960 |
| Over 70 | $6,200 |
Transportation. Travel primarily for and essential to medical care qualifies. The IRS mileage rates for 2026 are 20.5 cents per mile from January to June and 23.5 cents from July to December. Parking and tolls can be added. Bus, taxi, train and ambulance fares also count.
Less obvious items:
- Nursing services (the provider does not need to be a nurse)
- Inpatient addiction treatment, including meals and lodging
- Medically required home modifications, reduced by any rise in property value
- Service animals, including food and vet care
- Weight-loss programs for a physician-diagnosed disease
Lodging for medical trips is limited to $50 per person per night. Check Publication 502 for condition-specific rules.
What Does Not Qualify and How Reimbursements Affect the Deduction
Reimbursements and tax-advantaged accounts
Include only amounts you were not reimbursed for:
- Subtract any portion paid by insurance or an employer
- Do not claim expenses covered by tax-free HSA distributions
- Exclude FSA and HRA reimbursements from the deduction
- Keep pre-tax and after-tax payments separate in your records
Personal and general-health expenses
Generally excluded:
- Vitamins and supplements (unless a practitioner recommends them to treat a diagnosed condition)
- Toiletries and ordinary personal-care items
- General wellness costs and vacations
- Non-prescription medicines, except insulin
- Funeral expenses
- Cosmetic procedures
- Illegal treatments and controlled substances
Foreign care and currency
US citizens and resident aliens abroad generally get the same deductions as those in the US. Treatment must be legal medical care, and drugs bought and used abroad must be legal in both that country and the US.
Report amounts in US dollars, converting at the exchange rate in effect when you paid.
How to Report the Deduction on Form 1040 and Keep Records
Reporting workflow
- Gather qualifying medical and dental expenses for the tax year.
- Subtract insurance, HSA, FSA or other reimbursements.
- Enter the net total on Schedule A, line 1.
- Enter AGI on line 2 and 7.5% of AGI on line 3.
- Line 4 shows the deductible excess above the AGI floor.
- Carry total itemized deductions to Form 1040, line 12e.
On the final 2025 Schedule A, the total is on line 17. The 2026 draft, not for filing, moves it to line 18. Confirm line numbers on the form you use.
Payment-year rule
You generally deduct expenses in the year you pay them, not the year of treatment. A cheque counts when mailed or delivered. A credit-card charge counts when charged, not when you pay the card. Online and phone payments count on the date your financial institution shows.
Record-keeping checklist
Keep records rather than attaching them to your return:
- Itemized provider bills and receipts
- Insurance statements and reimbursement records
- HSA and FSA records
- Prescription documentation
- Cancelled cheques or proof of payment
- Mileage, parking and lodging logs
The IRS says to keep records ordinarily three years after filing. A simple ledger helps. For each expense, record:
- Family member and provider
- Service date and payment date
- Amount paid and any reimbursement
- Medical purpose
Professional review
If your situation is cross-border or documentation-heavy, a second pair of eyes can help. VJM Global prepares Form 1040 and Form 1040-NR returns and follows IRS protocols on federal and state filings. A review can't promise a deduction or refund, but it can check that your figures are documented and correctly reported.
How to Decide Whether to Itemize and Plan for the Deduction
Compare your total itemized deductions with the standard deduction for your filing status. If you're married filing separately and your spouse itemizes, you generally must itemize too.
If itemizing beats the standard deduction, these year-round moves can improve your result:
- Track expenses all year, not at filing time.
- Bunch elective procedures into one year when treatment timing allows, so you clear the 7.5% floor.
- Don't prepay for care delivered well beyond year-end; Publication 502 generally excludes this, apart from specified lifetime-care arrangements.
- Evaluate self-employed health insurance and HSA contributions under their own rules; do not add them to the Schedule A medical total.
Before filing, check the latest Publication 502, the Schedule A instructions and current-year mileage and premium limits.
Frequently Asked Questions
Can I deduct medical expenses without itemizing?
No. This deduction requires itemizing on Schedule A. The self-employed health insurance deduction and HSA contributions follow separate rules and don't require itemizing.
How much of my medical expenses can I deduct?
Only qualifying unreimbursed expenses above 7.5% of AGI count. The deduction reduces taxable income, so your tax saving is a fraction of the expense.
Can I deduct health insurance premiums?
Yes, if they cover medical care and you paid them with after-tax money. Medicare Parts B and D and capped long-term-care premiums can qualify. Reimbursed or pre-tax amounts can't be counted.
What qualifies as a medical expense?
Costs to diagnose, treat or prevent illness, or to affect a body function. Examples include doctor visits, dental treatment, prescriptions, medical devices and eligible travel.
How do I claim medical and dental expenses on Form 1040?
Calculate the eligible amount on Schedule A, then carry total itemized deductions to Form 1040. Compare the total with your standard deduction first.
Are medical expenses deductible in the year I pay them?
Generally yes. The payment year controls, not the treatment year, and credit-card charges count when charged. Keep proof of payment.
