Can I deduct medical expenses on my taxes and how much?
Yes, you can deduct unreimbursed medical expenses that exceed 7.5% of your adjusted gross income (AGI) on Schedule A if you itemize deductions. Eligible costs include insurance premiums, deductibles, copays, dental, vision, prescriptions, glasses, and mileage to medical appointments (22 cents per mile in 2024). HSA and FSA contributions are tax-advantaged separately.
In This Guide:
1. Understand the 7.5% AGI Threshold
You can deduct unreimbursed medical expenses for yourself, your spouse, and dependents only to the extent they exceed 7.5% of your adjusted gross income (AGI). For example, if your AGI is $80,000, the threshold is $6,000, so only medical costs above $6,000 are deductible. The threshold dropped from 10% to 7.5% permanently under the CARES Act, benefiting seniors and middle-income families most. You must itemize deductions on Schedule A to claim it - if you take the standard deduction ($14,600 single / $29,200 married in 2024), the medical deduction provides no benefit. Run both scenarios in tax software to confirm itemizing is worth it.
- Find your AGI on Form 1040, line 11
- Multiply AGI by 7.5% to calculate your threshold
- Total all unreimbursed eligible medical expenses for the year
- Subtract the threshold to find your deductible amount
- Compare itemized vs standard deduction before committing
- The 7.5% AGI threshold is permanent - not expiring any time soon
- If you take the standard deduction, the medical write-off gives no benefit
2. Track All Eligible Medical Expenses
Eligible expenses include health insurance premiums (including COBRA and long-term care premiums up to age-based limits), deductibles, copays, prescriptions, dental work, vision care, glasses, contacts, hearing aids, medical equipment, and mileage to medical appointments (22 cents per mile in 2024). Also deductible: weight-loss programs for diagnosed conditions, smoking cessation, fertility treatments, and home modifications prescribed by a doctor. Track everything in a spreadsheet or app like Honeybee or Walnut throughout the year. Save receipts and EOB statements. Non-eligible: over-the-counter vitamins, cosmetic procedures, gym memberships, and health club dues unless prescribed for a specific condition.
- Save every medical receipt and EOB in a dedicated folder
- Track mileage to appointments at 22 cents per mile in 2024
- Include premiums, deductibles, copays, dental, and vision
- Use Honeybee or Walnut to organize receipts digitally
- Exclude vitamins, cosmetics, and gym memberships unless prescribed
- Long-term care premiums are deductible up to age-based annual limits
- IRS Publication 502 lists every eligible and ineligible medical expense
3. Combine with HSA and FSA Strategies
If you have an HSA or FSA, contributions and reimbursements are already tax-advantaged and cannot also be deducted on Schedule A - that would double-dip. Strategy: pay current medical bills with HSA or FSA funds for the triple/double tax break, then deduct only the remaining unreimbursed expenses that clear the 7.5% AGI hurdle. If you are self-employed, you can deduct 100% of health insurance premiums for yourself and family above the line (no 7.5% threshold, no itemizing required), but only if you are not eligible for an employer-subsidized plan. Keep HSA, FSA, and out-of-pocket medical spending in separate folders for clean tax records.
- Never deduct HSA- or FSA-reimbursed expenses on Schedule A
- Pay current medical bills with HSA or FSA for the tax break
- Deduct only unreimbursed expenses clearing the 7.5% AGI hurdle
- Self-employed: deduct 100% of premiums above the line
- Keep HSA, FSA, and out-of-pocket receipts in separate folders
- Self-employed health insurance deduction is above the line - no itemizing needed
- Bunching medical expenses into one tax year can help clear the 7.5% hurdle
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