Short Answer
Under IRC §213(a), you can deduct unreimbursed medical and dental expenses only to the extent they exceed 7.5% of your adjusted gross income (AGI). The 7.5% floor is permanent (Consolidated Appropriations Act, 2021) and applies to all ages in both 2026 and 2025. It is an itemized deduction on Schedule A, so it only saves tax if your total itemized deductions exceed your standard deduction ($16,100 single / $32,200 MFJ for 2026). Qualified long-term care insurance premiums count toward the deduction but are capped by age - $500 to $6,200 per person for 2026 under §213(d)(10) - and you can add medical mileage at 20.5¢ per mile (2026). This calculator computes your deductible amount, compares it against your standard deduction, and shows the actual net tax benefit.
How the Medical Expense Deduction Is Calculated
The medical expense deduction has four computational steps. For full statutory rules, the complete list of qualifying expenses, and the bunching strategy, see our Medical Expense Deduction Guide.
Step 1: Total your qualified medical expenses Confirmed
Add your unreimbursed out-of-pocket medical and dental costs, plus capped long-term care insurance premiums, plus medical transportation (mileage at the medical rate, parking, tolls). Exclude anything reimbursed by insurance or paid from an HSA, FSA, or HRA. The full definition of "medical care" is in IRC §213(d).
Step 2: Cap long-term care premiums by age under §213(d)(10) Confirmed
Only "eligible long-term care premiums" count, limited by an age-banded per-person cap. For 2026: $500 (age 40 or less), $930 (41-50), $1,860 (51-60), $4,960 (61-70), $6,200 (71+). Premiums above your age cap are simply not included.
Step 3: Subtract the 7.5% AGI floor under §213(a) Confirmed
Multiply your AGI by 7.5%. Your deductible medical expense is the amount of qualified medical expenses above that floor. Formula: Deductible medical = max(0, Qualified medical expenses − 0.075 × AGI). Anything below the floor is lost.
Step 4: Compare total itemized against the standard deduction Confirmed
Add your deductible medical to your other itemized deductions (SALT, mortgage interest, charitable). You only benefit if this total exceeds your standard deduction ($16,100 single / $32,200 MFJ / $24,150 HOH for 2026). The calculator reports the net benefit: how much additional deduction the medical expenses actually buy you compared with the better of (a) the standard deduction or (b) itemizing without the medical.
The net-benefit formula
Net medical benefit = max(Standard deduction, Total itemized) − max(Standard deduction, Other itemized). If your only itemized deduction is medical, this reduces to max(0, Deductible medical − Standard deduction) - the medical has to clear the entire standard deduction on its own to help.
2026 and 2025 Long-Term Care Premium Caps and Medical Mileage
Eligible Long-Term Care Premium Cap by Age (IRC §213(d)(10), Per Person)
| Age at Year-End | 2026 (Rev. Proc. 2025-32) | 2025 (Rev. Proc. 2024-40) |
|---|
| 40 or younger | $500 | $480 |
| 41 to 50 | $930 | $900 |
| 51 to 60 | $1,860 | $1,800 |
| 61 to 70 | $4,960 | $4,810 |
| 71 or older | $6,200 | $6,020 |
These caps apply per person, so a married couple can deduct up to two caps using each spouse's own age. The capped premium is added to your other medical expenses before the 7.5% floor is applied. Hybrid life-LTC policies generally do not qualify.
Medical Standard Mileage Rate
| Tax Year | Rate | Source |
|---|
| 2026 | 20.5¢ per mile | IRS Notice 2026-10 |
| 2025 | 21¢ per mile | IRS Notice 2025-5 |
Use the standard medical mileage rate OR actual gas and oil costs - not both. Parking fees, tolls, taxi, bus, and ambulance fares are deductible in addition. Out-of-town lodging essential to medical care is deductible up to $50 per night per person.
What 7.5% of AGI Looks Like at Different Income Levels
The floor scales with AGI, so the same dollar of medical spending is worth more to a lower-AGI taxpayer. This is the central mechanic of the deduction.
7.5% AGI Floor and Deductible Amount on $12,000 of Qualified Medical Expenses
| AGI | 7.5% Floor | Deductible (on $12,000) |
|---|
| $40,000 | $3,000 | $9,000 |
| $60,000 | $4,500 | $7,500 |
| $80,000 | $6,000 | $6,000 |
| $120,000 | $9,000 | $3,000 |
| $160,000 | $12,000 | $0 |
At $160,000 AGI, $12,000 of medical expenses produces no deduction at all - the entire amount is below the floor. This is why the deduction overwhelmingly benefits lower-income filers, retirees, and taxpayers with catastrophic medical years.
Frequently Asked Questions
What is the medical expense deduction threshold for 2026?
Under IRC §213(a), you can deduct unreimbursed medical and dental expenses only to the extent they exceed 7.5% of your adjusted gross income (AGI). The 7.5% floor applies to both 2026 and 2025 and to all ages. For example, with $60,000 of AGI the floor is $4,500 - only medical expenses above $4,500 are deductible. The deduction is an itemized deduction claimed on Schedule A, so it only produces a tax benefit if your total itemized deductions exceed your standard deduction.
Is the 7.5% AGI floor permanent?
Yes. The Consolidated Appropriations Act, 2021 (Pub. L. 116-260) permanently set the medical expense floor at 7.5% of AGI for tax years beginning after December 31, 2020, and struck the former IRC §213(f) provision that had temporarily applied a 10% floor and a separate over-65 rule. The 7.5% threshold now applies to every taxpayer regardless of age. The One Big Beautiful Bill Act (OBBBA, P.L. 119-21) did not change the medical expense floor.
What medical expenses are deductible on Schedule A?
Under IRC §213(d) and IRS Publication 502, deductible medical care includes payments to doctors, dentists, surgeons, and other medical practitioners; hospital and nursing-home care when medical care is the principal reason; prescription medicines and insulin; medical equipment such as eyeglasses, contact lenses, hearing aids, wheelchairs, and crutches; qualified long-term care services and insurance premiums (subject to age caps); health insurance premiums you pay with after-tax dollars; and transportation primarily for and essential to medical care (mileage, parking, tolls, taxi, ambulance). You can include expenses you paid for yourself, your spouse, and your dependents.
What medical expenses are NOT deductible?
You cannot deduct expenses that were reimbursed by insurance or an employer, premiums paid with pre-tax dollars (such as employer cafeteria-plan premiums), or any expense paid from an HSA, FSA, or HRA - those are already tax-advantaged, so deducting them again would be double-dipping. Also non-deductible: nonprescription medicines (except insulin), toiletries, cosmetics, toothpaste, general health items, most cosmetic surgery, funeral and burial costs, and gym memberships for general health. Self-employed health insurance is deducted above-the-line under IRC §162(l), not on Schedule A.
How much long-term care insurance premium can I deduct?
Premiums for tax-qualified long-term care insurance count as medical expenses, but only up to an age-banded cap under IRC §213(d)(10). For 2026 (Rev. Proc. 2025-32) the per-person caps are $500 (age 40 or less), $930 (41-50), $1,860 (51-60), $4,960 (61-70), and $6,200 (71 or older). For 2025 (Rev. Proc. 2024-40) the caps are $480, $900, $1,800, $4,810, and $6,020. On a joint return each spouse applies their own age cap. The capped amount is then added to your other medical expenses and subject to the 7.5% AGI floor.
Can I deduct mileage for driving to medical appointments?
Yes. Transportation primarily for and essential to medical care is a deductible medical expense. You can use the medical standard mileage rate - 20.5 cents per mile for 2026 (IRS Notice 2026-10) and 21 cents per mile for 2025 (Notice 2025-5) - or actual gas and oil costs. Parking fees and tolls are deductible on top of the mileage rate. You can also include taxi, bus, ambulance, and out-of-town lodging up to $50 per night per person for trips essential to medical care.
Do medical expenses help if I take the standard deduction?
No. The medical expense deduction is an itemized deduction. It only reduces your tax if your total itemized deductions (medical above the 7.5% floor, plus state and local taxes, mortgage interest, and charitable contributions) exceed your standard deduction. For 2026 the standard deduction is $16,100 single, $32,200 MFJ, $24,150 HOH. If your medical expenses above the floor plus other itemized deductions are less than your standard deduction, the medical deduction produces no benefit - you would simply take the larger standard deduction instead.
Whose medical expenses can I include?
Under IRC §213(a) you can deduct medical expenses you paid for yourself, your spouse, and your dependents. You can also include expenses for a person who would be your dependent except that they had gross income above the dependent limit or filed a joint return. The expense is deductible in the year you paid it (the cash method), regardless of when the medical service was provided. If you pay a relative's medical bill directly, you may be able to include it even if you cannot claim them as a dependent, as long as the support and relationship tests are met.
How does an HSA or FSA affect my medical deduction?
Any medical expense you pay from a Health Savings Account (HSA), Flexible Spending Account (FSA), or Health Reimbursement Arrangement (HRA) is already paid with pre-tax dollars and cannot also be deducted on Schedule A - that would be double-dipping. Only your out-of-pocket, after-tax medical spending counts toward the 7.5% floor. For most taxpayers, paying routine medical costs through an HSA or FSA is more valuable than the Schedule A deduction because the HSA/FSA benefit applies from the first dollar, while the Schedule A deduction only helps above 7.5% of AGI and only if you itemize.
Does the medical deduction reduce my AGI?
No. The medical expense deduction is a below-the-line itemized deduction on Schedule A. It reduces taxable income but not adjusted gross income (AGI). This matters because AGI itself is the benchmark for the 7.5% floor - a circular-looking but settled rule. Above-the-line deductions (such as HSA contributions, the self-employed health insurance deduction under §162(l), and traditional IRA contributions) reduce AGI and therefore also lower the 7.5% floor, indirectly increasing your deductible medical amount.