Medical expenses can create meaningful tax deductions, but the rules are narrower than many taxpayers expect. For 2025, individuals who itemize deductions may deduct only the portion of qualifying medical and dental expenses that exceeds 7.5% of adjusted gross income (AGI).
That threshold is the starting point, not the whole rule. To claim the deduction correctly, you need to know:
- which expenses qualify as “medical care,”
- whose expenses you can count,
- how reimbursements affect the deduction,
- where to report the deduction, and
- what common expenses are specifically excluded.
This post walks through the federal rules for claiming medical expense deductions on a 2025 return.
1. The basic rule: only expenses above 7.5% of AGI are deductible
Internal Revenue Code allows a deduction for medical care expenses paid during the taxable year, not compensated by insurance or otherwise, for the taxpayer, spouse, or certain dependents, to the extent the expenses exceed 7.5% of AGI.
The same threshold is reflected in IRS guidance for 2025.
Example
If your AGI is $100,000 and you have $10,000 of qualifying unreimbursed medical expenses, only $2,500 is deductible:
- 7.5% of AGI = $7,500
- qualifying expenses = $10,000
- deductible amount = $2,500.
2. You must itemize to claim the deduction
Medical expenses are claimed as an itemized deduction on Schedule A (Form 1040).
If you take the standard deduction instead of itemizing, you generally do not get a separate medical expense deduction.
This means the medical deduction is most useful when:
- your total itemized deductions exceed your standard deduction, and
- your unreimbursed medical expenses are high enough to clear the 7.5% AGI floor.
3. What counts as “medical care”
Defines medical care broadly. It includes amounts paid:
- for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any structure or function of the body,
- for transportation primarily for and essential to medical care,
- for qualified long-term care services, and
- for insurance covering qualifying medical care, including certain Medicare premiums and qualified long-term care insurance premiums, subject to limits.
IRS Publication 502 applies that definition to many common expenses.
Common deductible medical expenses include:
- doctor, dentist, surgeon, chiropractor, psychologist, and similar practitioner fees;
- hospital care, clinic costs, lab fees, X-rays, and diagnostic testing;
- prescription medicines and insulin;
- eyeglasses, contact lenses, hearing aids, wheelchairs, crutches, and similar medical aids;
- surgery to correct defective vision, such as laser eye surgery;
- ambulance service and certain transportation costs to obtain medical care;
- health insurance premiums, including Medicare Part B and Part D premiums, and in some cases Medicare Part A premiums;
- qualified long-term care services and limited qualified long-term care insurance premiums;
- smoking cessation programs and prescription drugs to alleviate nicotine withdrawal;
- weight-loss program costs if undertaken to treat a specific disease diagnosed by a physician;
- breast pumps and lactation supplies;
- personal protective equipment such as masks and sanitizer when purchased primarily to prevent the spread of COVID-19.
4. Transportation and lodging can qualify, but only under narrow rules
Includes transportation primarily for and essential to medical care.
Publication 502 explains that deductible transportation can include:
- bus, taxi, train, plane, or ambulance fares,
- mileage for use of your own car for medical travel,
- parking fees and tolls.
Also allows certain lodging away from home to be treated as medical care if:
- the lodging is primarily for and essential to medical care,
- the care is provided by a physician in a licensed hospital or equivalent facility,
- the lodging is not lavish or extravagant, and
- there is no significant element of personal pleasure, recreation, or vacation.
The deductible lodging amount is capped at $50 per night per individual.
5. Some expenses are specifically excluded
Not every health-related expense is deductible. excludes cosmetic surgery and similar procedures unless necessary to correct a deformity arising from a congenital abnormality, accident or trauma, or disfiguring disease.
Publication 502 also identifies many nondeductible items, including:
- general health expenses,
- vitamins and nutritional supplements taken for general wellness,
- nonprescription drugs other than insulin,
- maternity clothes,
- funeral expenses,
- household help that is not medical or nursing care,
- health club dues,
- teeth whitening,
- illegal drugs or illegal treatments,
- most cosmetic procedures.
The key distinction is whether the expense is primarily for medical care rather than general health, appearance, or personal convenience.
6. Whose expenses can you include
Allows expenses for the taxpayer, spouse, and a dependent as defined under, with certain modifications.
Publication 502 explains that you can generally include expenses you paid for:
- yourself,
- your spouse,
- your dependents,
- certain individuals who would have been your dependents except for gross income, joint return, or dependency-status limitations.
Contains a special rule for children of divorced or separated parents: a child to whom applies is treated as a dependent of both parents for purposes of.
That means a parent may be able to count medical expenses paid for the child even if that parent does not claim the child as a dependent for other tax purposes, assuming the statutory conditions are met
7. Timing matters: deduct expenses in the year paid
Allows a deduction for expenses paid during the taxable year.
Publication 502 emphasizes that you generally deduct medical expenses in the year you actually pay them, not necessarily the year the services were provided.
Examples:
- if you pay by check, the payment date is general.ly when you mail or deliver the check;
- if you charge the expense to a credit card, the expense is generally treated as paid in the year charged, not when the credit card bill is later paid.
8. Reimbursements reduce the deduction
Allows only expenses “not compensated for by insurance or otherwise”.
So if insurance, an HRA, Medicare, or another source reimburses you, you generally must reduce your deductible medical expenses by the reimbursed amount.
This includes:
- direct insurance reimbursements,
- employer health reimbursement arrangements,
- premium tax credit amounts that paid health insurance premiums.
Publication 502 also explains that if you receive a reimbursement in a later year for expenses you deducted in an earlier year, some or all of the reimbursement may have to be included in income under the tax benefit rule.
9. Health insurance premiums often qualify, but not always
Medical expenses include insurance premiums for medical care under.
Publication 502 confirms that deductible premiums may include:
- medical and dental insurance,
- Medicare Part B,
- Medicare Part D,
- certain Medicare Part A premiums,
- qualified long-term care insurance premiums, subject to age-based limits.
But there are important exclusions. You generally cannot deduct:
- premiums paid through pretax salary reduction under an employer plan,
- premiums already deducted elsewhere,
- premiums paid with tax-free retirement plan distributions by certain retired public safety officers,
- life insurance or income protection policies.
10. Long-term care has special rules
Includes qualified long-term care services, and includes premiums for qualified long-term care insurance contracts, but only up to the “eligible long-term care premiums” limit.
The Code provides age-based statutory dollar limits, indexed for inflation. Publication 502 gives the 2025 age-based limits as:
- age 40 or under — $480,
- age 41 to 50 — $900,
- age 51 to 60 — $1,800,
- age 61 to 70 — $4,810,
- age 71 or over — $6,020.
Also disallows certain payments to relatives for qualified long-term care services unless the services are provided by a licensed professional, and also disallows certain related-party entity payments.
11. Cosmetic surgery is usually nondeductible
Is one of the most important limitation rules. It says medical care does not include cosmetic surgery or similar procedures unless necessary to ameliorate a deformity arising from:
- a congenital abnormality,
- a personal injury from accident or trauma, or
- disfiguring disease.
Publication 502 applies this rule to procedures such as face lifts, hair transplants, hair removal, and liposuction, which are generally nondeductible unless they fit the statutory exception.
12. Medicines are deductible only if prescribed, unless insulin
limits deductions for medicine and drugs. An amount paid for medicine or a drug is taken into account only if it is:
- a prescribed drug, or
- insulin
defines a prescribed drug as one that requires a physician’s prescription.
That means over-the-counter medicines generally are not deductible unless they fall within the insulin exception.
13. Medical expenses for decedents have a special rule
Provides a special rule for decedents. Medical expenses for the taxpayer that are paid out of the estate during the 1-year period beginning the day after death are treated as paid by the taxpayer at the time incurred.
But this rule does not apply if the amount is allowed as an estate tax deduction under, unless a statement and waiver are filed as required .
Publication 502 explains how a survivor or personal representative may elect this treatment on the decedent’s final return.
14. Child and dependent care expenses are not medical expenses if claimed as a credit
States that any expense allowed as a credit under is not treated as an expense paid for medical care.
That means you cannot double count the same expense as both:
- a medical expense deduction, and
- a child and dependent care credit expense.
Publication 503 similarly notes that some expenses for care of individuals unable to care for themselves may qualify either as medical expenses or as dependent care expenses, but not both.
15. How to claim the deduction on your 2025 return
To claim the deduction:
- total your qualifying unreimbursed medical and dental expenses for 2025,
- reduce them by reimbursements,
- subtract 7.5% of AGI,
- report the deductible amount on Schedule A (Form 1040).
The Schedule A instructions specifically state that you can deduct only the part of medical and dental expenses that exceeds 7.5% of AGI.
16. Recordkeeping matters
Publication 502 stresses that you should keep records of medical and dental expenses to support the deduction.
Useful records include:
- receipts,
- invoices,
- canceled checks,
- credit card statements,
- insurance reimbursement statements,
- mileage logs for medical travel,
- practitioner statements where needed.
This is especially important for:
- capital improvements claimed as medical expenses,
- long-term care expenses,
- transportation and lodging,
- later reimbursements,
- expenses for dependents or decedents.
17. Common mistakes to avoid
Based on the sources, common errors include:
- trying to deduct expenses while taking the standard deduction;
- forgetting the 7.5% AGI floor;
- including reimbursed expenses;
- deducting over-the-counter medicines that are not prescribed;
- deducting cosmetic procedures that do not meet the statutory exception;
- deducting general wellness expenses like gym dues or vitamins;
- double counting dependent care expenses as medical expenses.
Bottom line
For 2025, medical expense deductions remain available, but only for taxpayers who itemize and only for qualifying unreimbursed expenses above 7.5% of AGI. The governing rule is, and the practical details are fleshed out in Schedule A instructions and Publication 502.
