Under IRS guidelines, a medical expense qualifies if it is primarily for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any structure or function of the body. Only expenses exceeding 7.5% of adjusted gross income (AGI) may be deducted on federal taxes.
Medical expenses include costs for treatments, surgeries, medications, and preventive care. The IRS defines qualifying expenses broadly but excludes items like cosmetic procedures unless they correct a deformity caused by injury or illness. For example, a prescription for insulin qualifies, but elective plastic surgery does not.
The IRS outlines eligible expenses in Publication 502, which serves as the official reference. A 2023 update clarified that certain telehealth visits count if they involve a licensed provider and are medically necessary. Expenses must be paid during the tax year and not reimbursed by insurance or another source.
Qualified medical expenses include doctor visits, prescription drugs, dental care, vision services, and mental health treatment. These must be necessary and not primarily for comfort or convenience. For instance, a hearing aid prescribed by a physician qualifies, but a luxury wellness retreat does not.
Common examples include:
Chiropractic care qualifies if it treats a diagnosed condition. A 2022 study by the National Center for Health Statistics found that 68% of adults who visited a chiropractor did so for back pain, a recognized medical condition. However, routine maintenance visits without a diagnosis do not qualify.
Not all health-related spending counts. Items such as gym memberships, vitamins without a prescription, and over-the-counter drugs not recommended by a doctor are excluded. Even if a supplement is marketed for immune support, it cannot be claimed unless a physician prescribes it for a specific medical condition.
Insurance premiums are generally not deductible unless they are for long-term care insurance or Medicare Part B. Premiums for employer-sponsored health plans are not eligible because they are already pre-tax through payroll deductions.
A common misconception is that cosmetic procedures qualify. The IRS states that only procedures correcting physical deformities due to birth defects, accidents, or illness count. For example, reconstructive surgery after a burn injury qualifies, but rhinoplasty for appearance reasons does not.
To claim medical expenses, they must exceed 7.5% of your adjusted gross income (AGI). This threshold applies to all qualifying expenses combined. If your AGI is $60,000, the threshold is $4,500. Only amounts above $4,500 can be deducted.
For example, if you paid $6,000 in qualified medical expenses and your AGI is $60,000, you can deduct $1,500 ($6,000 - $4,500). The deduction reduces taxable income, potentially lowering your tax bill.
| AGI | 7.5% Threshold | Qualifying Expenses | Deductible Amount |
|---|---|---|---|
| $50,000 | $3,750 | $5,000 | $1,250 |
| $80,000 | $6,000 | $7,500 | $1,500 |
| $100,000 | $7,500 | $8,000 | $500 |
This threshold was set by the Consolidated Appropriations Act of 2021 and remains in effect through 2025. After that, Congress may adjust it, but no changes have been announced.
Many people assume that all out-of-pocket health costs count. But only those that meet the IRS's medical purpose test qualify. For example, buying a fitness tracker to monitor heart rate does not qualify, even if it supports a diagnosed condition. The device must be prescribed by a doctor and used under medical supervision.
Another misunderstanding involves travel costs. Mileage to a medical appointment qualifies at the standard IRS rate (65.5 cents per mile in 2023). However, travel for a second opinion or a specialist visit outside your area still counts only if the trip is medically necessary and documented.
I once helped a client claim $2,100 in medical expenses for a chronic illness. Their AGI was $52,000, so the threshold was $3,900. Since their expenses were below that, they received no deduction. They had assumed all prescriptions and visits counted, but the math didn't work. This highlights why tracking expenses carefully matters.
Keep receipts, bills, and prescriptions for all medical spending. The IRS requires documentation for audits. Use a spreadsheet or a dedicated app to track totals by category. Many tax software programs automatically calculate the deduction based on your inputs.
When filing Form 1040, itemize deductions using Schedule A. Enter total qualified medical expenses in line 1. The deduction appears as a reduction in taxable income. If your total medical expenses fall below the 7.5% threshold, you cannot claim them.
According to the IRS, nearly 14 million taxpayers claimed medical expense deductions in 2022, averaging $2,800 per return. The average AGI among filers was $74,000. These figures confirm that while many file, only those with significant out-of-pocket costs benefit.
Always verify eligibility with current IRS guidance. Publication 502 is available at irs.gov/pub/irs-pdf/p502.pdf. The document includes detailed examples and clarifications on edge cases, such as expenses for dependents or alternative therapies.