Free Medical Expense Log Template for Taxes (IRS-Ready, 2025)

Tracking medical expenses throughout the year is the difference between capturing a valuable tax deduction and losing it entirely. Without a log, you’ll spend hours reconstructing expenses at tax time — and likely miss expenses that could have helped you clear the 7.5% AGI threshold. This guide gives you a free medical expense log format, explains what to track, and shows you exactly how to use it at tax time.

Why a Medical Expense Log Matters

The IRS requires that you substantiate every medical expense you deduct. That means receipts or other documentation showing the date, amount, provider, and purpose of each expense. Medical travel requires additional documentation: a log of dates, destinations, mileage, and purpose for each trip.

Beyond IRS requirements, a running log helps you:

• Know whether you’re approaching the 7.5% AGI threshold so you can plan additional qualifying expenses before year-end
• Capture small recurring expenses (pharmacy trips, co-pays) that add up significantly over 12 months
• Separate HSA-paid expenses (not deductible) from out-of-pocket expenses (deductible)
• Have a clean record if you’re ever audited

Medical Expense Log: What to Track

Your log should capture two types of entries: medical expenses (what you paid for services, medications, and equipment) and medical travel (what you spent to get to and from medical care).

Medical Expense Log Fields

Medical Travel Log Fields

The 2025 medical mileage rate will be set by the IRS in January 2025. The 2024 rate is 21 cents per mile. Update your log with the official 2025 rate once announced.

How to Use the Log at Tax Time

Step 1: Sum your total qualifying medical expenses from the expense log (excluding any amounts paid by insurance or HSA).

Step 2: Sum your total medical travel deduction: (total medical miles × mileage rate) + parking + tolls + other qualifying travel costs.

Step 3: Add both totals together for your total qualifying medical expenses for the year.

Step 4: Calculate 7.5% of your AGI (you’ll need a preliminary AGI figure).

Step 5: Subtract the 7.5% threshold from your total qualifying medical expenses. The remainder is your Schedule A medical deduction.

Example: AGI = $70,000. Threshold = $70,000 × 7.5% = $5,250. Total qualifying medical expenses = $7,800. Deduction = $7,800 − $5,250 = $2,550.

Best Apps for Tracking Medical Expenses and Mileage

If a spreadsheet feels like too much work, several apps make tracking much easier:

• MileIQ: Automatically tracks mileage using your phone’s GPS. You swipe each trip as “medical” or “personal.” Produces a year-end report perfect for tax time. Also tracks business mileage simultaneously.
• Stride: Free app designed for gig workers and freelancers. Tracks mileage, expense receipts, and estimates your deductible amounts in real time. Good for tracking both medical and business expenses together.
• Expensify: More robust expense management app. Lets you photograph receipts, categorize by expense type, and export clean reports. More than you need for most taxpayers but excellent for people with large medical expense volumes.
• Google Sheets or Excel: A simple spreadsheet using the template structure above is perfectly sufficient and free. Save receipts to a dedicated Google Drive folder organized by month.

What Receipts You Need to Keep

For each medical expense, keep documentation that shows:

• The date of service or purchase
• The name of the provider or vendor
• The amount you paid out-of-pocket (not the full charge — what you actually paid)
• The nature of the service or item

Explanation of Benefits (EOB) statements from your health insurer are useful because they show both the total charge and your patient responsibility. For prescription medications, pharmacy receipts or your year-end prescription cost summary (available from most pharmacies) work well.

Don’t Forget These Often-Missed Medical Expenses

• Health insurance premiums you pay with after-tax money (not pre-tax payroll deductions)
• All pharmacy trips — not just for prescription pick-ups, but for prescribed items like blood glucose test strips
• Dental and vision costs, which many people track separately from “medical” expenses
• Medical equipment: hearing aid batteries, CPAP supplies, wheelchair maintenance
• Mental health therapy co-pays and sessions
• Trips to physical therapy, occupational therapy, or speech therapy
• Long-term care insurance premiums (subject to age-based limits)
• Medicare Part B and D premiums (deductible for most filers)

Frequently Asked Questions

Do I need a separate log for medical mileage vs. other travel?

Not necessarily — many people combine all medical travel in one log. The important thing is that your log captures enough detail to separate medical mileage from business mileage (if you also deduct business mileage on Schedule C) since they are claimed in different places on your return. If you use a mileage app like MileIQ, you can tag each trip with a purpose category.

What if I lost receipts from earlier in the year?

Your bank and credit card statements can serve as documentation for medical expenses if you don’t have the actual receipt. Many medical providers can also provide year-end statements showing all payments made. Your pharmacy’s purchase history is typically available on their app or website. For truly unrecoverable receipts, document what you can recall with a contemporaneous note and keep any supporting evidence.

Should I track expenses even if I don’t think I’ll hit the 7.5% threshold?

Yes. You don’t know your final AGI until year-end, and a lower-than-expected AGI combined with higher-than-expected medical expenses can surprise you. Tracking costs nothing but a few minutes a month, and skipping it means losing the deduction forever — you can’t go back and reconstruct records that were never kept.

Bottom Line

A medical expense log doesn’t need to be complicated. A simple spreadsheet capturing the date, provider, amount, and purpose of each expense — plus a mileage log for every medical trip — is all the documentation you need for Schedule A. Start your log in January and update it monthly. At tax time, you’ll have everything you need in one place, and you won’t leave a potentially significant deduction on the table.

See also: Medical Travel Deduction: Mileage, Tolls, Parking & Lodging | How to Track & Deduct Medical Travel Expenses (2025 IRS Rules)