Medical Expense Tax Deductions 2025 – What Qualifies and How to File

 

Healthcare costs can add up quickly—especially with rising premiums, deductibles, and out-of-pocket bills. But the good news is that the IRS allows you to deduct certain medical expenses when you file your federal income tax return. For 2025, understanding which expenses qualify and how to claim them could save you hundreds—or even thousands—of dollars.

This guide explains the rules for medical expense deductions in 2025, including what counts as a qualified expense, how much you can deduct, and step-by-step instructions on filing correctly.

Understanding the 2025 Medical Expense Deduction

The IRS allows taxpayers to deduct unreimbursed medical and dental expenses that exceed 7.5% of their adjusted gross income (AGI).

That means you can only deduct the portion of your total medical expenses above 7.5% of your AGI.

Example:
If your AGI is $80,000, 7.5% equals $6,000.
If you paid $9,000 in qualified medical expenses, you can deduct $3,000 on your 2025 return.

This deduction applies only if you itemize deductions using Schedule A (Form 1040) instead of taking the standard deduction.

Who Can Claim the Deduction

You can claim the deduction for expenses paid for:

·         Yourself

·         Your spouse

·         Your dependents (children or qualifying relatives)

Even if the medical services were performed in 2024 but paid in 2025, you can claim the deduction in 2025—the year you actually paid.

What Medical Expenses Qualify in 2025

The IRS defines a medical expense as any payment for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any structure or function of the body.

Here’s a breakdown of what’s deductible in 2025:

✅ Common Deductible Medical Expenses

1. Doctor and Hospital Bills

·         Payments to physicians, surgeons, dentists, chiropractors, psychiatrists, psychologists, and other qualified medical practitioners.

·         Hospital and clinic fees for treatment, lab tests, and nursing services.

2. Prescription Medications & Insulin

·         Prescribed drugs and insulin are fully deductible.

·         Over-the-counter (OTC) medications are only deductible if prescribed by a doctor.

3. Health Insurance Premiums

·         Premiums for medical, dental, and long-term care insurance.

·         Premiums paid with after-tax income (not employer contributions).

·         Medicare Part B, Part D, and Medicare Advantage (Part C) premiums also qualify.

4. Medical Equipment & Supplies

·         Eyeglasses, contact lenses, hearing aids, braces, wheelchairs, crutches, breast pumps, and other prescribed equipment.

5. Travel & Lodging for Medical Care

·         Transportation to and from medical appointments (car mileage at 21¢ per mile in 2025).

·         Bus, taxi, airfare, or train tickets to receive treatment.

·         Up to $50 per night per person for lodging if travel is primarily for medical care (not including meals).

6. Dental & Vision Care

·         Cleanings, braces, fillings, dentures, eye exams, and corrective surgeries like LASIK.

7. Preventive Care & Screenings

·         Vaccinations, blood tests, mammograms, and other preventive exams.

8. Long-Term Care Services

·         Nursing home, assisted living, or in-home care—if primarily for medical reasons.

Expenses You Can’t Deduct in 2025

Certain healthcare costs don’t qualify under IRS rules, including:

🚫 Cosmetic surgery (unless necessary for medical reconstruction)
🚫 Health club memberships or gym fees
🚫 Vitamins or supplements (unless prescribed)
🚫 Over-the-counter pain relievers or cold medicine without a prescription
🚫 Funeral expenses
🚫 Nonprescription nicotine patches or gum (unless prescribed)
🚫 Childbirth classes or babysitting while at doctor’s appointments

How to Calculate Your Deduction

To figure out how much you can deduct:

1.      Add up all qualified medical expenses for you, your spouse, and dependents.

2.      Subtract any reimbursements from insurance or employer programs (like HSA or FSA).

3.      Determine your AGI from your tax return.

4.      Multiply AGI by 7.5% (0.075).

5.      Subtract that number from your total qualified expenses.

The result is the amount you can deduct on Schedule A.

Example:

·         AGI: $70,000

·         Medical expenses: $9,000

·         7.5% threshold: $5,250

·         Deductible amount: $3,750

How to File for Medical Expense Deductions (Step-by-Step)

Step 1: Choose to Itemize

You must use Schedule A (Form 1040) and itemize deductions instead of taking the standard deduction.

Step 2: Gather Receipts & Documentation

Collect proof of payment such as invoices, insurance statements, pharmacy receipts, and travel logs.

Step 3: Enter Your Total Expenses

List the total unreimbursed medical expenses on line 1 of Schedule A.

Step 4: Apply the 7.5% Rule

Subtract 7.5% of your AGI to find your deductible total.

Step 5: Attach Schedule A to Form 1040

Submit both when filing your 2025 return, either electronically or by mail.

Using HSAs & FSAs for Medical Expenses

If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), you can use those pre-tax funds to pay for qualified medical expenses. However:

·         You can’t double-dip—expenses paid with HSA/FSA money can’t also be claimed as tax deductions.

·         HSA contributions are already tax-deductible, even if you don’t itemize.

·         In 2025, contribution limits are:

o    HSA: $4,300 (individual) / $8,650 (family)

o    FSA: $3,150 per year

Medical Deductions for Self-Employed Individuals

Self-employed taxpayers get additional advantages:

·         You can deduct 100% of your health insurance premiums (for yourself, your spouse, and dependents) above the line on your 1040—meaning you don’t need to itemize.

·         You can also deduct qualified long-term care premiums up to IRS limits based on your age.

This deduction directly reduces taxable income, offering one of the most valuable healthcare tax breaks available.

Recordkeeping Tips

The IRS may request verification of your deductions, so keep:

·         Copies of invoices, canceled checks, or credit card statements.

·         Doctor or hospital statements showing dates and purposes of treatment.

·         Mileage logs or travel receipts for transportation to medical appointments.

·         Insurance Explanation of Benefits (EOBs) for all claims and reimbursements.

Keep these records for at least three years after filing your return.

Should You Itemize or Take the Standard Deduction?

For 2025, the standard deduction is projected to be around:

·         $14,600 for single filers

·         $29,200 for married couples filing jointly

You’ll benefit from itemizing only if your total deductions (including mortgage interest, property taxes, charitable donations, and medical expenses) exceed your standard deduction.

Final Thoughts

Medical expenses can take a significant bite out of your income—but the IRS medical deduction can help offset some of that burden. In 2025, any unreimbursed, qualified medical expenses over 7.5% of your AGI may reduce your taxable income, especially if you itemize deductions.

Keep good records, know which costs qualify, and consider consulting a tax professional if you’re unsure how to calculate or claim your deduction. With careful planning, you can turn healthcare spending into meaningful tax savings this filing season.