Medical expenses are one of the most misunderstood itemized deductions, mostly because of the threshold you need to clear before any of it counts, and because the IRS’s definition of “medical care” is broader than most people assume. Here’s the complete list of what qualifies, what doesn’t, and how the math actually works for 2026.
The 7.5% AGI Threshold
You can only deduct the portion of your medical expenses that exceeds 7.5% of your adjusted gross income, and only if you itemize instead of taking the standard deduction. If your AGI is $60,000, the first $4,500 (7.5%) of medical expenses doesn’t count toward the deduction — only costs above that floor do. Spend $10,000 on qualifying medical care with a $60,000 AGI, and you can deduct $5,500. This is a hard floor with no exceptions for age or filing status; it applies the same whether you’re 25 or 85.
Because itemizing only helps once your total itemized deductions (medical, state and local taxes up to the SALT cap, mortgage interest, and charitable giving) exceed your standard deduction, a lot of people who clear the 7.5% floor still don’t see any tax benefit unless their other itemized deductions add up too. Run the numbers before assuming a big medical year automatically means a bigger refund.
The Complete List: What Qualifies
Medical and dental care
- Payments to doctors, dentists, surgeons, chiropractors, podiatrists, and other licensed practitioners
- Hospital and nursing home care primarily for medical treatment (not custodial care alone)
- Dental treatment: cleanings, fillings, crowns, braces, implants, and dentures
- Vision care: eye exams, prescription glasses, contacts, and LASIK
- Mental health treatment, including therapy, psychiatric care, and counseling for a diagnosed condition
- Substance abuse treatment programs
- Acupuncture and other treatments a licensed practitioner provides
Prescriptions, equipment, and supplies
- Prescription medications and insulin
- Medical equipment: wheelchairs, crutches, hearing aids, and batteries for them
- Contact lens supplies and prescription eyewear
- Home modifications for medical necessity (ramps, grab bars) — to the extent the cost exceeds any increase in home value
Travel for medical care
- Mileage to and from medical appointments, at the IRS medical mileage rate — 20.5¢/mile for miles driven January–June 2026, and 23.5¢/mile for miles driven July–December 2026
- Parking and tolls for medical visits
- Bus, taxi, train, or plane fare primarily for and essential to medical care
- Lodging (not meals) up to $50/night per person while traveling away from home primarily for medical care, subject to IRS limits
Insurance premiums
- Health insurance premiums you pay yourself, if not already pre-tax through payroll or deducted elsewhere (self-employed health insurance is generally an above-the-line deduction instead — don’t double-claim it here)
- Medicare Part B, Part D, and Medigap premiums
- Qualified long-term care insurance premiums, up to these 2026 age-based limits:
| Age at End of Year | 2026 Maximum Deductible Premium |
|---|---|
| 40 or younger | $500 |
| 41–50 | $930 |
| 51–60 | $1,860 |
| 61–70 | $4,960 |
| Over 70 | $6,200 |
Only tax-qualified long-term care policies count — most hybrid life-insurance-with-LTC-rider or “linked benefit” policies don’t meet the federal definition and aren’t deductible here.
What Generally Doesn’t Qualify
- Cosmetic procedures that aren’t medically necessary (elective cosmetic surgery, teeth whitening)
- Over-the-counter medications and supplements without a prescription (with the exception of insulin)
- General health items: vitamins, gym memberships, and toothpaste, even if a doctor “recommends” them for general health
- Funeral and burial expenses
- Non-prescription eyeglasses or sunglasses without a prescription
- Health savings account (HSA) contributions themselves (those are a separate above-the-line deduction, not a medical expense deduction)
- Expenses reimbursed by insurance or paid through a pre-tax FSA/HSA — you can’t deduct what you were already reimbursed for or paid with pre-tax dollars
Frequently Asked Questions
Can I deduct medical expenses for my spouse or dependents?
Yes. You can include qualifying medical expenses you paid for yourself, your spouse, and anyone who was your dependent either when the expense was paid or when the service was provided.
Do I need to itemize every receipt separately on my return?
No — you report one total on Schedule A. But keep every receipt and statement in case the IRS asks for substantiation; a bank or credit card statement alone usually isn’t enough to prove an expense was medical in nature.
What if my total medical expenses don’t clear the 7.5% threshold?
Then there’s nothing to deduct that year on Schedule A. Some people in this position instead route predictable medical costs through an HSA or FSA if their employer offers one, which reduces taxable income without needing to clear the 7.5% floor or itemize at all.
For educational purposes only. Not tax advice. Threshold and category rules sourced from IRS Publication 502. Long-term care premium limits and mileage rates are 2026 IRS figures. Consult a licensed CPA for guidance specific to your situation.