IRS Publication 502 is the definitive list of what counts as a deductible medical expense — and it’s surprisingly generous. This master guide explains how Pub 502 works, what’s on (and off) the list, and links to our detailed guides for every major category.
What Publication 502 Is
Publication 502 defines medical expenses as the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, plus treatments affecting any structure or function of the body. If an expense fits that definition and isn’t reimbursed by insurance, it can count toward your medical expense deduction — subject to the 7.5% AGI threshold on Schedule A. Run your numbers through the free medical deduction calculator to see if you clear it.
The Big Categories Pub 502 Allows
- Vision: prescription eyeglasses, contact lenses and supplies, LASIK, and eye exams.
- Hearing: hearing aids, batteries, and cochlear implants.
- Dental: cleanings, fillings, braces and orthodontics — but not teeth whitening.
- Mental health: therapy and counseling, psychiatric care, and substance abuse treatment.
- Prescriptions: prescription drugs and insulin (OTC drugs don’t qualify).
- Travel for care: 21¢/mile, parking, tolls, airfare, and limited lodging.
- Long-term care: nursing homes and assisted living and LTC insurance premiums (age-based limits).
- Equipment: wheelchairs, CPAP machines, and home medical equipment.
- Family: expenses you pay for dependents and qualifying relatives count too.
For the full alphabetical rundown, see the complete IRS-approved medical expense list.
What Pub 502 Excludes
Cosmetic procedures (unless treating disease, injury, or a congenital condition — see the cosmetic surgery rules), general health items like vitamins and gym memberships, nonprescription drugs, funeral costs, and anything reimbursed by insurance or paid with pre-tax dollars.
The 7.5% Threshold — and the HSA Alternative
Only expenses above 7.5% of your adjusted gross income are deductible, and only if you itemize. Many filers do better paying medical costs through an HSA or FSA — tax-free from the first dollar with no threshold. Compare in our HSA vs medical deduction guide, and see seven strategies to maximize the deduction if you’re close to the line.
Publication 502 FAQ
Does Publication 502 cover eyeglasses and contact lenses?
Yes — explicitly. Glasses, contacts, exams, and even contact lens supplies like saline and enzyme cleaner qualify as medical expenses.
Is there a Publication 502 for 2025?
The IRS updates Pub 502 annually — the edition covering 2025 returns applies to expenses paid during 2025. The core definition of medical care rarely changes; dollar figures like the LTC premium limits and the medical mileage rate (21¢ for 2025) update each year.
Are health insurance premiums deductible under Pub 502?
Premiums you pay with after-tax dollars count, including Medicare premiums. Self-employed filers may deduct 100% of premiums above the line instead — see the self-employed medical guide.
Where do I claim Pub 502 expenses?
Schedule A, Line 1, if you itemize. Total your unreimbursed expenses, subtract 7.5% of AGI, and the rest is deductible. If you take the standard deduction, see your remaining options.
Educational purposes only — not tax advice. Source: IRS Publication 502. Consult a CPA for your specific situation.
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