What this line means
The total amount you paid for medical and dental expenses during the year that were not reimbursed by insurance. This includes payments for doctors, dentists, surgeons, hospital services, prescription drugs, medical equipment, and health insurance premiums you paid with after-tax dollars. Only the amount exceeding 7.5% of your AGI is deductible. 1
Does this apply to you?
- You paid significant out-of-pocket medical expenses during the year (surgery, dental work, ongoing treatment)
- You paid health insurance premiums with after-tax money (not through your employer’s pre-tax plan)
- You paid for long-term care services or long-term care insurance premiums
- You had unreimbursed costs for prescription medications, medical devices, or therapy
- You paid travel expenses to get medical care (mileage, parking, tolls, airfare for treatment)
Easy to overlook
Health insurance premiums paid with after-tax dollars count If you pay for health insurance outside of an employer plan — through the ACA marketplace without the premium tax credit, COBRA premiums, or Medicare Part B and Part D premiums — those premiums are deductible medical expenses. Employer plan premiums paid with pre-tax payroll deductions do not count because they are already excluded from income. 2 IRS Publication 502 — Medical and Dental Expenses
Medical travel expenses add up fast The IRS allows you to deduct mileage (21 cents per mile in 2025) for trips to doctors, pharmacies, and hospitals. You can also deduct parking and tolls. For treatment in another city, airfare, hotel, and meals during the trip qualify. Cancer patients traveling for specialized treatment often have thousands in deductible travel expenses they never claim. 3 General filing pattern — overlooked medical deductions
Watch out for this
Including expenses reimbursed by insurance or paid from a Health Savings Account (HSA) or Flexible Spending Account (FSA). Only expenses you paid out of pocket with after-tax dollars qualify. If your insurance paid $8,000 of a $10,000 surgery, only your $2,000 copay counts. HSA and FSA distributions are already tax-free, so including them here double-dips.
Footnotes
-
IRS Publication 502, Medical and Dental Expenses, Section on AGI Threshold. https://www.irs.gov/pub/irs-pdf/p502.pdf ↩
-
IRS Publication 502, Medical and Dental Expenses. https://www.irs.gov/pub/irs-pdf/p502.pdf ↩
-
IRS Schedule A (Form 1040) Instructions. See also IRS Publication 17, Your Federal Income Tax. https://www.irs.gov/pub/irs-pdf/p17.pdf ↩