Are Medicare premiums tax deductible in 2026? Yes, in most cases they are, because the IRS treats premiums for insurance covering medical care as a qualified medical expense. How you claim the deduction, and whether it actually lowers your tax, depends on whether you itemize on Schedule A or qualify for the self-employed health insurance deduction.
Yes. Medicare premiums are tax deductible in 2026 as a qualified medical expense under IRC 213(d), which covers amounts paid for insurance covering medical care. Retirees generally claim them on Schedule A above a 7.5% of adjusted gross income floor, while self-employed people deduct them above the line on Schedule 1. The 2026 standard Part B premium is $202.90 per month.
Are Medicare premiums tax deductible in 2026?
Are Medicare premiums tax deductible in 2026? Yes, in most cases. The IRS treats Medicare Part B, Part D, Medicare Advantage (Part C), Medigap, and any voluntary Part A premium as amounts paid for insurance covering medical care under IRC 213(d) (Source: Cornell LII, IRC 213). You claim them either by itemizing on Schedule A or, if you are self-employed, above the line on Schedule 1.
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There are two separate paths, and each has its own rules. The itemized path on Schedule A is open to any taxpayer but applies only above a 7.5% of adjusted gross income floor. The self-employed path on Schedule 1 has no floor but is limited to people with business earned income. Most retirees use the first path.
The standard Medicare Part B premium is $202.90 per month in 2026, up from $185.00 in 2025 (Source: CMS, 2026 fact sheet). Deducting a premium is a separate question from how much you pay for it, since income-related surcharges are set by a two-year income lookback. A Roth conversion strategy can raise that income figure in the year you convert, so timing matters for both the deduction math and the premium itself.
How do you deduct Medicare premiums if you itemize?
If you are not self-employed, you deduct Medicare premiums by itemizing on Schedule A (Form 1040), and only the portion of total medical costs above 7.5% of your adjusted gross income counts (Source: IRS Publication 502). This 7.5% floor is permanent, not temporary (IRC 213(a)). Some older articles still cite a 10% floor, which is outdated for 2026.
Worked example: with $75,000 of adjusted gross income, the first 7.5% ($5,625) of medical costs is not deductible. If total qualifying medical expenses, including Medicare premiums, reach $8,625, the deductible amount is $3,000. Only what you actually pay out of pocket counts; amounts reimbursed by insurance do not (Source: IRS Publication 502).
Qualifying medical costs on Schedule A include far more than premiums: dental work, hearing aids, vision care, long-term-care services, and mileage to appointments all count toward the same 7.5% threshold. Combining a high-cost medical year with the premium deduction is often what pushes a retiree over the floor.
Does the 2026 standard deduction make itemizing worth it for retirees?
It depends on your total deductions. Itemizing helps only when your itemized deductions beat your standard deduction, which for 2026 is $16,100 for single filers and $32,200 for married couples filing jointly, plus an extra $2,050 (single) or $1,650 per spouse for taxpayers age 65 or older (Source: IRS, Rev. Proc. 2025-32). That hurdle is high before Medicare premiums even enter the calculation.
The One, Big, Beautiful Bill Act (Public Law 119-21, signed July 4, 2025) adds a temporary senior deduction of $6,000 per eligible person age 65 or older for tax years 2025 through 2028. It phases out above modified adjusted gross income of $75,000 ($150,000 for joint filers) (Source: IRS, One Big Beautiful Bill Act deductions for seniors). Because this bonus deduction is available whether or not you itemize, it widens the gap that itemized deductions must clear, so the Schedule A medical deduction now tends to pay off only in years with large medical, dental, or long-term-care bills.
Which parts of Medicare can you deduct?
Most Medicare premiums qualify: Part B, Part D, a voluntary Part A premium, Medicare Advantage (Part C), and Medigap are each treated as insurance covering medical care under IRC 213(d) (Source: IRS Publication 502). Premium-free Part A earned through payroll taxes is not deductible, and the Medicare payroll tax itself is not deductible. Premiums stay deductible even when they are withheld automatically from your Social Security benefit.
| Coverage | Deductible as a medical expense? | Note for 2026 |
|---|---|---|
| Part B (medical insurance) | Yes | Standard premium $202.90/mo in 2026 ($185.00 in 2025); IRMAA surcharge above $109,000 single or $218,000 joint MAGI is also deductible |
| Part D (prescription drugs) | Yes | Voluntary drug coverage premiums qualify, including any Part D IRMAA surcharge |
| Part A (voluntary) | Yes, only if you pay a premium | $311/mo reduced or $565/mo full in 2026; premium-free Part A is not deductible |
| Part C (Medicare Advantage) | Generally yes | Treated as insurance covering medical care under IRC 213(d) |
| Medigap (Supplement) | Generally yes | Deductible on Schedule A; excluded from tax-free HSA payment |
The income-related surcharge known as IRMAA is fully deductible on the same basis as the base premium, because it is still an amount paid for the same insurance. Voluntary Part A applies only to the roughly 1% of beneficiaries who did not earn enough Medicare-covered quarters (Source: CMS, 2026 fact sheet).
Can self-employed retirees deduct Medicare premiums without itemizing?
Yes. Self-employed retirees can deduct Medicare premiums above the line on Schedule 1 (Form 1040), line 17, using Form 7206, without itemizing and without the 7.5% adjusted gross income floor (Source: IRS Instructions for Form 7206, 2025). Two limits apply under IRC 162(l): the deduction cannot exceed your net business earned income, and it is barred for any month subsidized employer coverage was available.
Form 7206 now carries the calculation that previously appeared in IRS Publication 535, which has been discontinued (Source: IRS Instructions for Form 7206, 2025). The instructions confirm that Medicare premiums you voluntarily pay to obtain insurance in your name that is similar to qualifying private health insurance can be used to figure the deduction. A policy under this rule may also cover your spouse, dependents, and any child who was under age 27 at the end of the year.
The earned-income cap means the deduction cannot create or increase a business loss; it is limited to your net profit from the trade or business. The employer-coverage bar applies on a month-by-month basis, so eligibility for a subsidized plan through your own or a spouse’s job in a given month removes that month from the calculation (Source: Cornell LII, IRC 162(l)).
How does the more-than-2% S-corporation shareholder rule work?
For a more-than-2% S-corporation shareholder, the S-corporation must generally pay or reimburse the Medicare premiums and include them in Box 1 wages on the shareholder’s Form W-2 before the shareholder can claim the above-the-line deduction (Source: IRS Notice 2008-1; IRS, S Corporation Compensation and Medical Insurance Issues). The deduction works whether the corporation buys the policy in its own name or reimburses one the shareholder bought, provided the premium appears in W-2 wages. Reporting for entity owners is fact-specific, so many owners confirm the arrangement with a tax professional.
Are Medicare Advantage premiums tax deductible?
Yes. Medicare Advantage (Part C) premiums are tax deductible in 2026 because the IRS treats a Part C plan as insurance covering medical care under IRC 213(d). Retirees who itemize include them on Schedule A above the 7.5% of adjusted gross income floor, and self-employed people may deduct them above the line on Schedule 1 using Form 7206 (Source: IRS Publication 502).
Medicare Advantage bundles Part A, Part B, and usually Part D coverage into one private plan. Because the premium you pay for that plan buys insurance covering medical care, it qualifies on the same basis as a standalone Part B or Medigap premium. Any separate Part D or supplemental premium you pay alongside a Part C plan is deductible on the same terms.
Can you pay Medicare premiums from an HSA, and what about retired public safety officers?
Two extra rules matter. Health Savings Account funds may be used tax-free to pay Medicare premiums once you reach age 65, except premiums for a Medigap policy (Source: IRS Publication 969). Separately, eligible retired public safety officers may exclude up to $3,000 per year of distributions used for health or long-term-care premiums, but cannot also deduct the same amount on Schedule A (Source: IRS Publication 575).
Once you enroll in any part of Medicare, you can no longer make new HSA contributions, but existing balances remain usable. After age 65 those balances may pay Part B, Part D, Part A, and Medicare Advantage premiums tax-free; Publication 969 specifically excludes Medigap premiums from that treatment (Source: IRS Publication 969, 2025).
The public safety officer exclusion is capped at the smaller of the premiums paid or $3,000 per year, and the tax code does not allow a double benefit, so an amount excluded this way cannot also appear as a Schedule A medical deduction (Source: IRS Publication 575, 2025). Long-term-care insurance premiums also count as medical care under IRC 213(d)(10), subject to age-based caps that range from $500 (age 40 or under) to $6,200 (over age 70) for 2026 (Source: Rev. Proc. 2025-32).
Itemized vs self-employed: which deduction path applies to you?
The two routes differ in eligibility and mechanics. The Schedule A itemized deduction is open to any taxpayer with medical costs but requires itemizing and applies only above 7.5% of adjusted gross income. The self-employed deduction on Schedule 1 has no AGI floor and needs no itemizing, but is limited to those with business earned income and is barred when subsidized employer coverage is available (Source: IRS Publication 502; IRC 162(l)).
| Feature | Schedule A (itemized) | Self-employed (Schedule 1) |
|---|---|---|
| Where reported | Schedule A, Form 1040 | Schedule 1, line 17 (via Form 7206) |
| Must itemize? | Yes | No |
| 7.5% AGI floor? | Yes | No |
| Who qualifies | Any taxpayer with medical costs | Self-employed with earned income |
| Amount limit | Costs above 7.5% of AGI | Up to net business earned income |
| Employer-plan bar? | No | Yes, if subsidized coverage available |
Neither deduction applies until it is reported on the return. Retirement-tax moves change the inputs on both paths: a Roth conversion raises your adjusted gross income for the year, which lifts the 7.5% medical floor and can affect the net investment income tax. Coordinating conversions with required minimum distributions is one reason many retirees model the deduction year by year, and our guide on how much to convert to a Roth walks through the tradeoffs.
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Frequently asked questions
Can you deduct Medicare premiums on your taxes?
Yes, in most cases. Medicare premiums qualify as a medical expense under IRC 213(d) (Source: Cornell LII). Retirees who itemize claim them on Schedule A, subject to the 7.5% of adjusted gross income floor. Self-employed taxpayers may instead deduct them above the line on Schedule 1, line 17, without itemizing at all (Source: IRS Instructions for Form 7206, 2025).
Are Medicare Part B premiums tax deductible?
Yes. Part B premiums are deductible as a medical expense (Source: IRS Publication 502). The standard Part B premium is $185.00 per month in 2025 and $202.90 per month in 2026 (Source: CMS). Higher earners pay income-related surcharges, which are also deductible. On Schedule A, Part B counts only toward medical costs above 7.5% of adjusted gross income.
Can I deduct Medicare premiums if I take the standard deduction?
Generally no, not through Schedule A, because the itemized medical deduction requires you to itemize instead of taking the standard deduction (Source: IRS Tax Topic 502). The exception is the self-employed health insurance deduction, which is claimed above the line on Schedule 1 and is available even if you take the standard deduction (Source: IRS Instructions for Form 7206).
Are Medicare premiums tax deductible if you are self-employed?
Yes, often. Self-employed taxpayers may deduct Medicare premiums above the line on Schedule 1 (Form 1040), line 17, using Form 7206, without itemizing and without the 7.5% AGI floor (Source: IRS Instructions for Form 7206, 2025). The deduction cannot exceed business earned income and is barred for months you had access to subsidized employer coverage (Source: IRC 162(l)).
Is Medicare Part A tax deductible?
Only if you pay a premium for it. About 99% of beneficiaries get premium-free Part A through payroll taxes, and that Medicare tax is not deductible (Source: CMS; IRS Publication 502). Those who voluntarily enroll and pay a Part A premium, which is $311 to $565 per month in 2026, may include it as a medical expense (Source: CMS, 2026 fact sheet).
Are Medicare Advantage premiums tax deductible?
Yes. Medicare Advantage (Part C) premiums are treated as amounts paid for insurance covering medical care under IRC 213(d), so they are deductible on the same basis as Part B (Source: IRS Publication 502). Retirees include them on Schedule A above the 7.5% floor, and self-employed people may deduct them above the line on Schedule 1 using Form 7206.
Are Medigap premiums tax deductible?
Generally yes. Medigap (Medicare Supplement) premiums are treated as amounts paid for insurance covering medical care under IRC 213(d) and are deductible on the same basis as other medical insurance (Source: Cornell LII). One difference: Publication 969 excludes Medigap premiums from tax-free Health Savings Account distributions, even though other Medicare premiums may be paid from an HSA once you are age 65 or older (Source: IRS Publication 969, 2025).
How much of my medical expenses can I deduct?
On Schedule A, only the portion of total qualifying medical expenses that exceeds 7.5% of your adjusted gross income (Source: IRS Publication 502). For example, at $75,000 of AGI the first $5,625 is not deductible, and expenses above that amount are. The self-employed deduction is not subject to this floor but is capped at your business earned income (Source: IRC 162(l)).
Can I deduct my spouse’s Medicare premiums?
Often yes. On Schedule A, a spouse’s Medicare premiums count among your family medical expenses subject to the 7.5% AGI floor (Source: IRS Publication 502). Under the self-employed deduction, a policy may cover your spouse, dependents, and any child who was under age 27 at the end of the year when figuring the deduction (Source: IRS Instructions for Form 7206, 2025).
Sources
IRC 213 (medical expenses; 7.5% AGI floor), Cornell LII: https://www.law.cornell.edu/uscode/text/26/213
IRC 162(l) (self-employed health insurance deduction), Cornell LII: https://www.law.cornell.edu/uscode/text/26/162
IRS Publication 502 (Medical and Dental Expenses): https://www.irs.gov/publications/p502
IRS Tax Topic 502: https://www.irs.gov/taxtopics/tc502
IRS Instructions for Form 7206 (2025): https://www.irs.gov/instructions/i7206
IRS Publication 575 (public safety officer exclusion): https://www.irs.gov/publications/p575
IRS Publication 969 (Health Savings Accounts and Medicare premiums): https://www.irs.gov/publications/p969
IRS, S Corporation Compensation and Medical Insurance Issues: https://www.irs.gov/businesses/small-businesses-self-employed/s-corporation-compensation-and-medical-insurance-issues
IRS Notice 2008-1 (2% shareholder health insurance deduction): https://www.irs.gov/pub/irs-drop/n-08-01.pdf
IRS, One Big Beautiful Bill Act: Tax deductions for seniors: https://www.irs.gov/newsroom/one-big-beautiful-bill-act-tax-deductions-for-working-americans-and-seniors
CMS 2026 Medicare Parts B premiums and deductibles: https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
IRS Rev. Proc. 2025-32 (2026 inflation adjustments, LTC caps): https://www.irs.gov/pub/irs-drop/rp-25-32.pdf
