The short answer
You can deduct unreimbursed medical and dental expenses only to the extent they exceed 7.5% of your AGI, and only if you itemize on Schedule A instead of taking the standard deduction. The expenses can be for you, your spouse, and your dependents — but a dependent generally must be a U.S. citizen or national, or a resident of the U.S., Canada, or Mexico.
How the 7.5% floor works
| Example | |
|---|---|
| AGI | $80,000 |
| 7.5% floor | $6,000 |
| Unreimbursed medical and dental expenses paid | $9,500 |
| Amount on Schedule A | $3,500 |
| Does it help? | Only if your total itemized deductions are more than your standard deduction |
What counts and what does not
| Generally counts | Generally does not count |
|---|---|
| Payments to doctors, dentists, and other medical practitioners; hospital care | Cosmetic surgery, unless needed for a deformity from a congenital abnormality, accident, or disfiguring disease |
| Prescription drugs and insulin | Non-prescription drugs (other than insulin) |
| Medical insurance premiums paid with after-tax money | Premiums paid by pre-tax salary reduction |
| Qualified long-term care premiums, up to an age-based limit | Gym, health club, or spa dues (even for general health) |
| Transportation primarily for and essential to medical care | Expenses reimbursed by insurance, an HRA, or a pre-tax FSA, or paid with tax-free HSA money |
Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and for the purpose of affecting any part or function of the body. Publication 502 lists many specific items.
2025 and 2026 amounts
| Item | 2025 | 2026 |
|---|---|---|
| Medical mileage rate | 21 cents per mile | 20.5 cents (January 1 – June 30); 23.5 cents (July 1 – December 31) |
| Long-term care premium limit — age 40 or under | $480 | $500 |
| Age 41 to 50 | $900 | $930 |
| Age 51 to 60 | $1,800 | $1,860 |
| Age 61 to 70 | $4,810 | $4,960 |
| Age 71 or over | $6,020 | $6,200 |
The 2025 figures are from Publication 502 (2025). The 2026 long-term care limits are from Rev. Proc. 2025-32, and the 2026 mileage rates are from the IRS standard mileage rates page. Parking fees and tolls can be added to either the mileage rate or actual car expenses.
Whose expenses you can include
- You and your spouse.
- Your dependents — a qualifying child or qualifying relative who was your dependent either when the care was given or when you paid.
- Citizenship or residency: the person must be a U.S. citizen or national, or a resident of the United States, Canada, or Mexico. An adopted child who lived with a U.S. citizen or national as a member of the household for the year is an exception.
- Gross income test: to be a qualifying relative in general, a person's gross income must be less than $5,200 for 2025 ($5,300 for 2026, under Rev. Proc. 2025-32).
- Special rule for the medical deduction: you can still include expenses for someone who would have been your dependent except that their gross income was at or above that amount, they filed a joint return, or you (or your spouse) could be claimed as someone else's dependent. The person must still meet the other dependency tests, such as the relationship or household, support, and citizenship or residency tests.
- Divorced or separated parents: a child can be treated as the dependent of both parents for this deduction, if certain custody and support conditions are met.
- Multiple support agreements: if siblings share a parent's support under such an agreement, only the person treated as claiming the parent can include medical expenses, and only the amount they paid and were not repaid for.
Example: a parent visiting from abroad
Lin's mother is a citizen and resident of Taiwan and visits the U.S. for three months in 2025. Lin pays $12,000 for her hospital care. Because Lin's mother is not a U.S. citizen, national, or resident of the U.S., Canada, or Mexico, she does not meet the citizenship or residency requirement, so Lin generally cannot include the $12,000 — even though Lin paid it. If Lin's mother had become a U.S. resident for tax purposes, the result could be different; see claiming a parent as a dependent.
Keep bills, receipts, insurance statements showing what was reimbursed, and a mileage log for medical trips. Only expenses you actually paid, and that were not reimbursed, count.