How much medical expenses are deductible in 2026? Only the unreimbursed medical and dental costs above 7.5% of your adjusted gross income (AGI) are deductible, and only if you itemize on Schedule A rather than taking the standard deduction (Source: IRS Topic No. 502). At $60,000 of AGI the 7.5% floor is $4,500, so $15,000 of qualifying bills leaves a $10,500 deduction. The quick-reference table below maps common AGI levels to the floor and to the deductible amount.
For 2026, unreimbursed medical and dental expenses are deductible only to the extent they exceed 7.5% of your adjusted gross income, and only if you itemize on Schedule A (Form 1040) rather than claiming the standard deduction. The 7.5% floor is set by IRC §213(a) and is permanent (Source: IRS Topic No. 502). Hypothetical example: on $75,000 of AGI the 7.5% floor is $5,625, so $11,584 of qualifying expenses would yield a $5,959 deduction.
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How much of your medical expenses are deductible in 2026? The 7.5% of AGI floor
You can deduct only the unreimbursed medical and dental expenses that exceed 7.5% of your 2026 adjusted gross income, and you must itemize on Schedule A (Form 1040) to claim any of it (Source: IRS Topic No. 502). Multiply your AGI by 7.5% to find the floor, then subtract it from your total qualifying expenses; the remainder is your deduction. Expenses covered or reimbursed by insurance never count.
Worked examples of the 7.5% math
The examples below are hypothetical and are meant only to show the arithmetic (Source: IRS Topic No. 502; Instructions for Schedule A). The first dollars of expenses equal to the floor are never deductible; only dollars above the threshold count.
- $75,000 AGI: floor is 7.5% x $75,000 = $5,625. With $11,584 of unreimbursed qualifying expenses, you deduct $11,584 minus $5,625, or $5,959.
- $50,000 AGI: floor is 7.5% x $50,000 = $3,750. With $5,000 of qualifying expenses, you deduct $5,000 minus $3,750, or $1,250.
How much is deductible at common AGI levels (quick reference)
How much of your medical expenses are deductible in 2026 depends only on your AGI and your total unreimbursed bills. Multiply AGI by 7.5% to get the floor, then subtract it from your bills. The table maps common AGI levels to the floor and to the deductible amount at a sample bill. The sample-bill figures are hypothetical and for illustration only (Source: IRS Topic No. 502).
| Your AGI | 7.5% floor (not deductible) | Sample unreimbursed bills | Amount deductible |
|---|---|---|---|
| $30,000 | $2,250 | $8,000 | $5,750 |
| $50,000 | $3,750 | $10,000 | $6,250 |
| $60,000 | $4,500 | $15,000 | $10,500 |
| $75,000 | $5,625 | $12,000 | $6,375 |
| $100,000 | $7,500 | $15,000 | $7,500 |
| $150,000 | $11,250 | $20,000 | $8,750 |
Plug in your own numbers (three steps):
1. Add up your unreimbursed qualifying medical and dental bills paid in 2026.
2. Multiply your AGI by 0.075 to get your 7.5% floor.
3. Subtract the floor from your bills. Any positive remainder is your deductible amount (usable only if you itemize and your total itemized deductions beat the standard deduction).
2026 medical expense deduction figures at a glance
The table below gathers the 2026 numbers that drive the calculation in one place: the AGI floor, the standard deduction you must beat to benefit from itemizing, the medical mileage rate, and the long-term care premium caps. Each figure carries its source and is detailed in the sections that follow.
| 2026 item | Amount | Source |
|---|---|---|
| AGI floor (deduct only above this) | 7.5% of AGI | IRC §213(a); IRS Topic No. 502 |
| Standard deduction, single / MFS | $16,100 | Rev. Proc. 2025-32 |
| Standard deduction, married filing jointly | $32,200 | Rev. Proc. 2025-32 |
| Standard deduction, head of household | $24,150 | Rev. Proc. 2025-32 |
| Extra standard deduction if 65+ or blind (each) | $2,050 single/HoH; $1,650 MFJ/MFS | Rev. Proc. 2025-32 |
| Medical mileage rate, Jan 1 to Jun 30, 2026 | 20.5 cents per mile | IRS Notice 2026-10 |
| Medical mileage rate, Jul 1 to Dec 31, 2026 | 23.5 cents per mile | IRS midyear update (2026) |
| Deductible LTC premium cap (per person, by age) | $500 / $930 / $1,860 / $4,960 / $6,200 | Rev. Proc. 2025-32, §3.27 |
| LTC benefit per-diem limit | $430 per day | Rev. Proc. 2025-32, §3.62 |
| Health FSA salary-reduction limit (carryover) | $3,400 ($680 carryover) | Rev. Proc. 2025-32, §3.15 |
The two gates: clearing 7.5% and beating the standard deduction
Clearing the 7.5% floor is only the first gate. To get any benefit you also have to pass a second gate: your total itemized deductions, medical plus items like mortgage interest and state and local taxes (SALT), must exceed your standard deduction. Because the standard deduction is large, the medical deduction most often helps in a catastrophic-cost year or for someone already itemizing (Source: IRS Topic No. 502).
The 2026 standard deduction amounts you must beat, set by Rev. Proc. 2025-32 under IRC §63(c), are below. Taxpayers 65 or older, or blind, add an extra amount on top.
| Filing status (2026) | Standard deduction | Extra if 65+ or blind (each) |
|---|---|---|
| Married filing jointly / surviving spouse | $32,200 | $1,650 |
| Head of household | $24,150 | $2,050 |
| Single | $16,100 | $2,050 |
| Married filing separately | $16,100 | $1,650 |
A married couple filing jointly generally needs itemized deductions above $32,200 before itemizing beats the standard deduction, which is why an already-itemizing homeowner stacking medical costs onto mortgage interest and SALT is often the taxpayer who benefits.
Passing the first gate but not the second produces no benefit. Hypothetical: a single filer with $60,000 AGI has a $4,500 floor and $9,500 of qualifying expenses, so $5,000 clears the floor. But if that $5,000 plus other itemized deductions of $8,000 totals only $13,000, it falls short of the $16,100 standard deduction, so the standard deduction wins and the medical expenses add nothing to the return.
Which medical expenses are tax-deductible in 2026?
Deductible expenses are payments for the diagnosis, cure, mitigation, treatment, or prevention of disease, and for treatments affecting a part or function of the body, when not reimbursed (Source: IRS Topic No. 502; Pub. 502). Frequently missed but qualifying items include long-term care services, after-tax health insurance premiums, medical transportation and lodging, and capital improvements made for a medical need. The list below reflects commonly qualifying categories.
- Fees to doctors, dentists, surgeons, specialists, and other medical practitioners
- Prescription medications and insulin
- Hospital care and nursing-home care for medical reasons
- Mental health treatment, including psychiatric and psychological care
- Acupuncture, chiropractic care, and treatment for addiction or smoking cessation
- Dental and vision care, including eyeglasses, contact lenses, and LASIK
- Hearing aids, wheelchairs, crutches, and prosthetics
- Reproductive care such as prescribed birth control, IVF, and vasectomy
- Physician-prescribed weight-loss programs to treat a specific disease
- Qualified long-term care services and eligible LTC insurance premiums (up to the age caps)
- Medically necessary transportation and lodging, plus after-tax health insurance premiums
- Capital improvements to a home for a medical reason, to the extent cost exceeds any rise in home value
Which medical expenses are not tax-deductible
Some common costs never qualify as deductible medical expenses, even in a high-expense year, because they are personal in nature or are not tied to the diagnosis or treatment of a specific condition (Source: IRS Topic No. 502; Pub. 502). Knowing which items to exclude keeps your Schedule A total accurate and reduces the chance of an adjustment. The categories below are frequently claimed in error.
- Over-the-counter medicines without a prescription (aside from insulin)
- Cosmetic procedures and teeth whitening
- Toiletries such as toothpaste, and general toiletries
- Funeral and burial costs
- Health insurance premiums paid by an employer or with pre-tax dollars
- Non-prescription nicotine gum and patches
- General health items and gym memberships not tied to a diagnosed condition
You cannot double-dip with HSA, FSA, or HRA money
Expenses paid from a Health Savings Account, health Flexible Spending Arrangement (FSA), or Health Reimbursement Arrangement are already funded with pre-tax dollars, so they cannot be deducted again on Schedule A (Source: IRS Pub. 502). The 2026 health FSA salary-reduction limit is $3,400, with a maximum carryover of $680 (Source: Rev. Proc. 2025-32, §3.15).
Whose medical expenses can you include?
You may include qualifying expenses you paid for yourself, your spouse, and your dependents, which can include some parents you support (Source: IRS Topic No. 502; Pub. 502). The person’s status as your spouse or dependent is tested either when the services were provided or when you paid, which can matter for a child or parent whose status changes during the year.
Long-term care insurance premiums and the 2026 age-based caps
Eligible long-term care (LTC) insurance premiums count as deductible medical care in 2026, but only up to an annual per-person cap that rises with age (Source: Rev. Proc. 2025-32, §3.27, tax year 2026). Periodic payments received under a qualified LTC contract are also subject to a per-diem limit of $430 per day for 2026 (Source: Rev. Proc. 2025-32, §3.62). The amount within the cap must still clear the 7.5% floor with your other medical costs.
| Age at year-end (2026) | Deductible LTC premium cap (per person) |
|---|---|
| 40 or under | $500 |
| 41 to 50 | $930 |
| 51 to 60 | $1,860 |
| 61 to 70 | $4,960 |
| Over 70 | $6,200 |
Medical transportation, mileage, and lodging
Transportation that is primarily for and essential to medical care is deductible, including car costs plus parking and tolls, and lodging up to $50 per night per person when travel is primarily for and essential to care at a licensed facility (Source: IRS Topic No. 502; Pub. 502). You may use actual costs or the IRS standard medical mileage rate.
For 2026 that rate is 20.5 cents per mile for January 1 through June 30 (Source: IRS Notice 2026-10) and 23.5 cents per mile for July 1 through December 31, following an IRS midyear increase (Source: IRS, 2026 standard mileage rates update). Meals while traveling for care are generally not deductible.
What is new for the medical expense deduction 2026
The core rule did not change: the One Big Beautiful Bill Act (OBBBA, Public Law 119-21) did not amend IRC §213, so the 7.5% floor and the itemize requirement still apply in 2026 (Source: IRS Topic No. 502). Three 2026-specific points are widely misunderstood and are worth stating precisely.
The OBBBA cap on the value of itemized deductions
Beginning in 2026, OBBBA limits the value of itemized deductions for taxpayers in the top 37% bracket, capping the benefit at roughly 35 cents per dollar rather than the full 37 cents (Source: One Big Beautiful Bill Act, Public Law 119-21). It does not change which medical expenses qualify or the 7.5% floor. Taxpayers in the top bracket can confirm the mechanics with a qualified tax professional.
The new senior deduction is not a medical break
OBBBA created a temporary additional deduction of $6,000 per eligible individual age 65 or older ($12,000 for a married couple if both qualify) for tax years 2025 through 2028 (Source: IRS, “Check your eligibility for the new enhanced deduction for seniors”). It is available whether or not you itemize and phases out for modified AGI above $75,000 (single) or $150,000 (joint). It is a senior deduction, not a lower medical floor; seniors still use the same 7.5% threshold as everyone else.
State floors can differ from the federal 7.5%
Some states set their own medical expense floor rather than following the federal 7.5%. New Jersey, for example, allows a deduction for unreimbursed medical expenses that exceed 2% of gross income, a lower threshold than the federal one (Source: N.J.S.A. 54A:3-3; New Jersey Division of Taxation). Because state rules vary and change, and many states conform to the federal 7.5% figure, confirm your own state’s current floor with that state’s tax authority.
Special situations: self-employment and filing separately
Two situations follow different rules from the standard Schedule A path (Source: IRS Topic No. 502; Pub. 502). A self-employed person may handle health insurance premiums through a separate provision, and a married couple can sometimes change the math by filing separately when medical costs are concentrated in one spouse.
Self-employed health insurance premiums
Self-employed individuals may generally deduct health insurance premiums as an above-the-line adjustment to income using Form 7206, rather than as an itemized deduction on Schedule A (Source: IRS Instructions for Form 7206). That route can reduce AGI directly and does not require itemizing.
Filing separately when one spouse has high medical costs
Because the 7.5% floor is based on AGI, filing separately measures the floor against only one spouse’s AGI, which changes how the calculation works when medical costs and income are concentrated in one spouse. Whether that produces a larger or smaller overall result depends on the full return, including a $16,100 standard deduction and credits that married filing separately can limit (Source: IRS Topic No. 502; Rev. Proc. 2025-32).
How to calculate and claim it on Schedule A (Line 1)
You claim the deduction by itemizing on Schedule A (Form 1040) and entering only the amount of unreimbursed expenses that exceeds the 7.5% AGI floor (Source: Instructions for Schedule A). Total medical and dental expenses go on Line 1, your AGI on Line 2, the 7.5% floor on Line 3, and the deductible excess on Line 4. Because itemizing helps only when your total itemized deductions beat the standard deduction, follow these steps.
- Add up all unreimbursed qualifying medical and dental expenses you paid during the year.
- Find your AGI on Form 1040 or 1040-SR and multiply it by 7.5% to get your floor.
- Subtract the floor from your total expenses; the excess is your medical deduction.
- Enter that excess on Schedule A, Line 4, and total it with your other itemized deductions.
- Compare your itemized total to your 2026 standard deduction and claim whichever is larger.
One timing rule matters: you deduct expenses in the year you paid them, not the year the care was provided, regardless of when you were billed (Source: IRS Pub. 502).
Bunching medical expenses into one tax year
Because only expenses above the floor count and itemizing has to beat the standard deduction, some taxpayers concentrate elective or scheduled medical costs into a single year so the total clears both gates in that year (Source: IRS Topic No. 502; Pub. 502). Since deductions follow the year of payment, timing when you pay, rather than when care occurs, is the lever. Because the floor rises with AGI, a Roth conversion done in a high-medical-cost year adds ordinary income that both raises AGI and lifts the 7.5% floor, which can shrink the deductible portion even as the deduction offsets some conversion income; the offset is therefore partial, not dollar-for-dollar (Source: IRS Topic No. 502; Pub. 590-B). Sizing the move matters here, so it can help to review how much to convert to Roth and the Roth conversion deadline for 2026 before you act. Related timing questions can also interact with Medicare IRMAA brackets and required minimum distributions.
Work with Q3 Advisors
Q3 Advisors is a registered investment adviser focused on retirement tax planning. This article is educational and is not advice; for guidance on your own circumstances, consult a qualified tax or financial professional.
Frequently asked questions
The answers below address the questions taxpayers most often ask about the 2026 medical expense deduction, including how much is deductible, the 7.5% floor, what qualifies, mileage, and whether itemizing is worthwhile. Each answer reflects federal rules under IRC §213 and IRS guidance for tax year 2026 (Source: IRS Topic No. 502). Confirm your own situation with a qualified tax professional.
How much of medical expenses are deductible in 2026?
Only the unreimbursed medical and dental expenses that exceed 7.5% of your AGI are deductible in 2026, and only if you itemize (Source: IRS Topic No. 502). Hypothetically, at $75,000 of AGI the floor is $5,625, so $11,584 of qualifying expenses yields a $5,959 deduction. Everything up to the floor is not deductible.
What is the medical expense deduction floor for 2026?
For 2026, the floor is 7.5% of your adjusted gross income. Only unreimbursed medical and dental expenses above that amount are deductible, and only if you itemize on Schedule A (Form 1040) instead of taking the standard deduction (Source: IRS Topic No. 502). At $50,000 of AGI, for example, the floor is $3,750.
Is the 7.5 percent medical floor permanent?
Yes. The 7.5% of AGI threshold is set by IRC §213(a) and is permanent; it was made permanent for tax years after 2020 by the Consolidated Appropriations Act, 2021 (Public Law 116-260), and OBBBA (Public Law 119-21) did not change it (Source: IRS Topic No. 502; Public Law 116-260). There is no separate, lower floor for seniors as there was before 2017.
Can you deduct medical expenses without itemizing?
No. The medical expense deduction is an itemized deduction claimed on Schedule A, so you cannot take it while claiming the standard deduction (Source: IRS Topic No. 502). One related exception sits outside Schedule A: a self-employed person may deduct health insurance premiums as an above-the-line adjustment on Form 7206 without itemizing.
What is the medical mileage rate for 2026?
For 2026 the IRS medical mileage rate is 20.5 cents per mile for January 1 through June 30 (Source: IRS Notice 2026-10) and 23.5 cents per mile for July 1 through December 31 after a midyear increase (Source: IRS 2026 mileage update). You may instead deduct actual vehicle costs, and parking and tolls are deductible under either method.
Are long-term care insurance premiums deductible in 2026?
Yes, eligible LTC insurance premiums are deductible medical care in 2026 up to a per-person cap that rises with age: $500 (40 or under), $930 (41 to 50), $1,860 (51 to 60), $4,960 (61 to 70), and $6,200 (over 70) (Source: Rev. Proc. 2025-32, §3.27). The amount within the cap still has to clear the 7.5% floor with your other medical costs.
Whose medical expenses can I include on my return?
You can include qualifying expenses you paid for yourself, your spouse, and your dependents, which may include some parents you support (Source: IRS Topic No. 502; Pub. 502). Status as a spouse or dependent is tested either when the care was provided or when you paid, which matters when a person’s status changes during the year.
Do I deduct expenses in the year incurred or the year paid?
You deduct medical expenses in the year you actually paid them, not the year the care was provided or billed (Source: IRS Pub. 502). If you pay by check, the date you mail or deliver it generally counts; if you pay by credit card, the expense counts in the year of the charge, not when you pay the card.
Which medical expenses are not tax-deductible?
Non-qualifying costs include over-the-counter medicines without a prescription, cosmetic procedures and teeth whitening, toiletries, funeral costs, pre-tax or employer-paid premiums, non-prescription nicotine products, and general gym memberships (Source: IRS Topic No. 502; Pub. 502). Expenses already paid from an HSA, FSA, or HRA also cannot be deducted again.
Is it worth claiming medical expenses on taxes?
It is worth claiming only when your itemized deductions, medical plus items like mortgage interest and SALT, exceed your 2026 standard deduction, which is $32,200 for joint filers and $16,100 for single filers (Source: Rev. Proc. 2025-32). That usually means a catastrophic-cost year or a taxpayer who already itemizes.
Are medical expenses tax deductible in 2026?
Yes, if you itemize on Schedule A and your unreimbursed qualifying expenses exceed 7.5% of your AGI (Source: IRS Topic No. 502). You cannot claim the deduction while taking the standard deduction, and you cannot deduct amounts reimbursed by insurance or paid from a tax-advantaged health account.
Sources
IRS Topic No. 502, Medical and Dental Expenses: https://www.irs.gov/taxtopics/tc502
IRS Publication 502: https://www.irs.gov/publications/p502
Instructions for Schedule A (Form 1040): https://www.irs.gov/instructions/i1040sca
IRS Standard Mileage Rates (Notice 2026-10 and 2026 midyear update): https://www.irs.gov/tax-professionals/standard-mileage-rates
Rev. Proc. 2025-32 (2026 inflation adjustments): https://www.irs.gov/pub/irs-drop/rp-25-32.pdf
IRS, Check your eligibility for the new enhanced deduction for seniors: https://www.irs.gov/newsroom/check-your-eligibility-for-the-new-enhanced-deduction-for-seniors
IRS Publication 590-B (Roth conversions and distributions): https://www.irs.gov/publications/p590b
IRS Instructions for Form 7206 (Self-Employed Health Insurance Deduction): https://www.irs.gov/instructions/i7206
Consolidated Appropriations Act, 2021, Public Law 116-260
One Big Beautiful Bill Act, Public Law 119-21
N.J.S.A. 54A:3-3 (New Jersey medical expense deduction): https://www.nj.gov/treasury/taxation/njit13.shtml
