Medical expenses are deductible — but only the portion that exceeds a specific percentage of your income, which trips up more taxpayers than almost any other itemized category. Here is exactly how the threshold works.
The core formula
Only the amount above that 7.5% floor is deductible — the rest is simply absorbed as a normal cost of living, with no tax benefit attached.
For example, a taxpayer with $80,000 AGI and $9,000 in qualifying medical expenses would subtract $6,000 (7.5% of $80,000) from $9,000, leaving a $3,000 deductible amount — not the full $9,000 spent.
What counts as a qualifying medical expense
- Doctor, dentist, and specialist visits not covered by insurance
- Prescription medications
- Health insurance premiums not already paid pre-tax through an employer or deducted elsewhere (see the separate rules for the self-employed below)
- Certain medical travel costs, mileage to appointments, and durable medical equipment
- Long-term care costs meeting specific criteria
Purely cosmetic procedures and general health items like vitamins or gym memberships typically do not qualify unless specifically prescribed to treat a diagnosed condition.
Self-employed filers: check the other lane first
If you're self-employed, health insurance premiums often have a more favorable path available as an above-the-line deduction rather than being run through the 7.5% AGI threshold at all. See Health Insurance Premiums Deduction for the Self-Employed before assuming your premiums belong in this itemized bucket.
Why this deduction rarely wins alone
Because of the 7.5% floor, medical expenses alone rarely clear the standard deduction threshold except in years with a major medical event — surgery, a hospital stay, a serious diagnosis. It typically needs to be combined with other itemized categories like mortgage interest, SALT, and charitable giving. See the full comparison in Standard vs. Itemized Deductions: Which One Saves More Money?
Timing strategy: bunching medical expenses
Because the threshold resets every calendar year, some taxpayers deliberately schedule elective procedures, dental work, or vision correction within the same tax year rather than spreading them across two, in order to clear the 7.5% floor in one concentrated year rather than falling short in both.
Frequently asked questions
Are health insurance premiums always subject to the 7.5% threshold?
Not necessarily for the self-employed — self-employed individuals can often deduct premiums above the line instead, without the AGI threshold applying at all. See our dedicated guide for the details.
Can I deduct medical expenses paid with a credit card at year-end?
Generally, expenses are deductible in the year they were paid or charged, even if the credit card balance isn't paid off until the following year — keep documentation of the charge date.
Do over-the-counter medications qualify?
Some do, particularly if specifically prescribed; general over-the-counter items without a prescription often do not qualify under standard rules.