Ask the Editor, October 24: What Medical Expenses are Deductible?

Each week, in our Ask the Editor series, Joy Taylor, The Kiplinger Tax Letter Editor, answers questions on topics submitted by readers. This week, she’s looking at nine questions on the tax deduction for medical expenses. (Get a free issue of The Kiplinger Tax Letter or subscribe.)

1. Can I claim medical expenses and the standard deduction?

Question: I normally claim the standard deduction when I file my Form 1040. This year, I have incurred lots of medical expenses. Can I deduct them and take the standard deduction?

Joy Taylor: No. The medical expense write-off is an itemized deduction claimed on Schedule A of Form 1040. You cannot take the standard deduction if you are itemizing deductions on Schedule A. It’s an either/or situation – either you claim the standard deduction OR you itemize deductions on Schedule A. You can’t do both.

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2. Are Medicare premiums deductible?

Question: This will be the first year I am claiming medical expenses on Schedule A of the Form 1040. My spouse and I each pay monthly premiums for our Medicare coverage. Are the premiums we pay deductible medical expenses?

Joy Taylor: Yes. Taxpayers who itemize on Schedule A can deduct qualifying medical expenses to the extent that the total amount exceeds 7.5% of adjusted gross income. You can claim medical expenses that are not reimbursed by insurance for yourself, your spouse and your dependents.

To qualify as a deduction, the expense must be incurred primarily to alleviate or prevent a physical or mental disability or illness. The broad list of eligible expenses includes out-of-pocket payments for medical services rendered by doctors, dentists, optometrists and other medical practitioners; mental health services; health insurance premiums (including Medicare Parts B and D); annual physicals; amounts paid for in vitro fertilization; prescription drugs and insulin (but not over-the-counter drugs); hearing aids; transportation to and from the doctor’s office; the unreimbursed costs of long-term care; and many home improvements to accommodate a disability or illness. For more information about what qualifies, see IRS Publication 502, “Medical and Dental Expenses.”

3. Can we deduct long-term-care costs?

Question: My spouse is going into a long-term-care facility. Can we deduct our unreimbursed costs for the care that is not paid by insurance as a medical expense on Schedule A of Form 1040 if we otherwise itemize?

Joy Taylor: Medical expenses are deductible on Schedule A of the Form 1040 only to the extent the total exceeds 7.5% of your adjusted gross income. You will likely be able to deduct your spouse’s unreimbursed long-term-care costs as medical expenses. Long-term-care expenses include the costs of assisted living, in-home care and nursing home services.

The long-term care must be medically necessary for one who is chronically ill, meaning at least two activities of daily living can’t be performed without help for 90 days or more. Anyone in need of long-term care because of dementia or other cognitive impairment is also considered chronically ill if substantial supervision is needed to protect the individual’s health and safety.

The chronic illness must be certified by a licensed health care practitioner. The cost of meals and lodging at a facility or nursing home counts as medical expenses if a person is mainly there for medical care.

4. Are long-term-care insurance premiums deductible?

Question: I pay annual premiums for a long-term-care insurance policy. Can I deduct the premiums I pay as medical expenses on Schedule A of the Form 1040?

Joy Taylor: The premiums you pay for a long-term-care policy are deductible medical expenses, subject to limitations. For most taxpayers, these premiums are medical costs deductible by itemizers on Schedule A of the Form 1040 to the extent that total medical expenses exceed 7.5% of adjusted gross income. Self-employed individuals can deduct these premiums on Schedule 1 of Form 1040.

The deduction for long-term-care premiums is capped based on age. The older you are, the higher the tax break. For 2025, taxpayers who are 71 or older can deduct as much as $6,020 per person. Filers age 61 to 70 can deduct up to $4,810 per person. People aged 51 to 60 can deduct up to $1,800 each. Individuals who are 41 to 50 can take up to $900. And people age 40 and younger can deduct no more than $480. For 2026, these monetary caps are $6,200, $4,960, $1,860, $930 and $500, respectively.

Note that a tax break related to paying long-term-care premiums takes effect next year. Generally, pre-age distributions from IRAs and workplace retirement plans are hit with a 10% early withdrawal tax, in addition to any regular income tax that is due on the distribution. Beginning in 2026, you can withdraw up to $2,500 from your 401(k) or other plan each year to help pay for long-term-care premiums without having to pay the additional 10% tax if you are younger than 59½.

5. Do costs for a drug rehab program qualify?

Question: Are the costs for a drug treatment program deductible medical expenses?

Joy Taylor: Yes, the cost of treatment for drug use or alcoholism is a medical expense. And many other health and wellness costs also qualify as deductible medical costs. These include the cost of a smoking cessation program, nutritional counseling for a doctor-diagnosed disease, and a weight-loss program to help with the treatment of obesity, hypertension, heart disease or other physical illness diagnosed by a physician. Note thought that the cost of diet foods, weight-loss supplements or reduced-calorie beverages are not deductible medical expenses.

6. Are teeth whitening procedures tax deductible?

Question: I paid a dentist lots of money last year to get my teeth whitened. Can I deduct the cost as a medical expense on Schedule A of my Form 1040?

Joy Taylor: Unfortunately, no. The costs of procedures to improve your appearance generally aren’t deductible. These include, for example, a weight-reduction program, a gym membership or cosmetic surgery to improve your appearance. Teeth whitening and hair transplants don’t count either.

7. Can I deduct costs for service animals?

Question: We are getting a service dog for my child who has epilepsy. Can I deduct the cost of the dog and his veterinary bills?

Joy Taylor: Yes. Amounts you pay to purchase a service dog, and the costs of training, food, grooming and veterinary care, are deductible medical expenses. These animals assist the visually impaired and others who have physical disabilities, so the owner can write off the costs of buying and caring for their dogs on Schedule A of Form 1040 to the extent total medical expenses incurred exceed 7.5% of adjusted gross income.

In some cases, the cost of an emotional support animal may be deducted as medical expenses. The owner must show that he or she is using the animal primarily for medical care to alleviate a mental disability or illness.

Read more on tax breaks for parents of children with disabilities.

8. Is the cost of medicine from abroad deductible?

Question: I am thinking of buying medicine from another country because I cannot get it here in the U.S. Can I deduct the cost of that medicine?

Joy Taylor: It depends. Buying medicine from abroad can come with a hefty tax price. The cost is generally not deductible as a medical expense on Schedule A. That’s because federal law bars importing many drugs from other countries. There are some exceptions to this general rule. For one, you can include the cost of an imported drug in deductible medicals if the drug was imported legally, for example, as announced by the Food and Drug Administration (FDA). You can also include in medicals a drug’s cost if you purchased and used that drug in another country, provided the drug is legal in the other country and in the United States.

9. Do costs for abortion procedures qualify?

Question: Is the cost of an abortion a deductible medical expense?

Joy Taylor: It depends. People who itemize on Schedule A can include in medical expenses the amount paid for a legal abortion, meaning the procedure is performed in a state where abortion is legal. Transportation costs are also deductible. If you drive there, you can deduct out-of-pocket costs or use the standard mileage rate for medical driving, which is 21¢ per mile for 2025. Hotel expenses of up to $50 a night can also be deducted if the abortion is provided by a doctor in a licensed hospital or a medical care facility. You can deduct up to an additional $50 a night for a traveling companion’s lodging. Meals aren’t deductible.

About Ask the Editor, Tax Edition

Subscribers of The Kiplinger Tax Letter, The Kiplinger Letter and The Kiplinger Retirement Report can ask Joy questions about tax topics. You'll find full details of how to submit questions in each publication. Subscribe to The Kiplinger Tax Letter, The Kiplinger Letter or The Kiplinger Retirement Report.

We have already received many questions from readers on topics related to tax changes in the One Big Beautiful Bill and more. We will continue to answer these in future Ask the Editor round-ups. So keep those questions coming!

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