What are IRS approved medical expenses?

IRS-qualified medical expenses are the costs paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for treatments affecting any part or function of the body.

Eligible Expenses

• Practitioners and Services: Fees for doctors, dentists, surgeons, chiropractors, psychiatrists, psychologists, and physical therapy.
• Treatments and Care: Inpatient hospital care, addiction treatment, and prescribed stop-smoking programs.
• Equipment and Supplies: Prescription eyeglasses, contact lenses, hearing aids, crutches, wheelchairs, and diagnostic devices.
• Insurance and Travel: Premiums for medical and long-term care insurance, plus out-of-pocket transportation costs essential to medical care.
• Medications: Insulin and prescription drugs.

Ineligible Expenses

• General Health: Vitamins, nutritional supplements, and general health club dues (unless prescribed to treat a specific diagnosed disease like obesity).
• Cosmetic Procedures: Elective cosmetic surgery and teeth whitening.
• Personal Items: Toothpaste, toiletries, and cosmetics.
• Nonprescription Drugs: Over-the-counter medicines (though some may be reimbursable via an HSA or FSA with a prescription or specific rules, they generally do not qualify for itemized tax deductions).

You can review complete details and the full index of items in IRS Publication 502. Note that to claim these on your taxes, your total unreimbursed expenses must exceed 7.5% of your Adjusted Gross Income (AGI) and you must itemize deductions. You cannot double-dip by deducting expenses paid using tax-advantaged accounts like an HSA or FSA.

The $2,500 expense rule, officially known as the de minimis safe harbor election, is an IRS tax provision that allows businesses to immediately deduct the full cost of low-cost tangible property in a single tax year instead of capitalizing and depreciating it over several years.

Key Rules and Limits

• The Threshold: Businesses without an Applicable Financial Statement (AFS, such as an audited financial statement) can expense items costing up to $2,500 per invoice or individual item. If a business has an audited AFS, the limit increases to $5,000.
• Qualifying Items: This applies to tangible property like office furniture, computers, tablets, small tools, and equipment. It does not apply to inventory or land.
• Invoices vs. Items: The limit applies to what is listed on the invoice. If an invoice breaks out individual items, each item is tested separately against the $2,500 limit.

How to Use the Rule

• Consistency: You must match your bookkeeping to your tax deduction; you must expense these items on your books throughout the year.
• Annual Election: It is a "use it or lose it" choice that you must make every year. You elect it by attaching a specific statement titled "Section 1.263(a)-1(f) de minimis safe harbor election" to your timely filed federal tax return. Many popular tax software programs handle this automatically if you check the appropriate box.

The 10 most commonly overlooked tax deductions include everyday expenses, state taxes, and specific out-of-pocket costs that taxpayers frequently forget to claim.

Top 10 Overlooked Tax Deductions

• State Sales Taxes: You can choose to deduct state and local sales taxes instead of state and local income taxes, which is especially helpful if you live in a state without an income tax or made a large purchase like a car.
• Out-of-Pocket Charitable Contributions: Expenses incurred while doing volunteer work—such as parking fees, tolls, and charitable driving mileage (valued at 14 cents per mile)—are deductible.
• Student Loan Interest Paid by Others: If a parent or someone else pays your student loan, you can still claim the deduction on your taxes as long as you are the person legally required to repay the loan.
• Jury Pay Turned Over to Employer: If your employer kept your daily jury duty pay while you used your paid time off, you can deduct the amount you turned over to them from your taxable income.
• Refinancing Mortgage Points: When you refinance a mortgage, you cannot deduct all the points in a single year; instead, you must deduct them gradually (amortize them) over the life of the new loan.
• State Income Tax Paid in Spring: Any state income tax you paid in the spring of the filing year for a prior year's return can sometimes be added to your itemized deductions.
• Educator Expenses: Eligible K-12 teachers can deduct out-of-pocket spending on classroom supplies and books.
• Gambling Losses: If you itemize your deductions, you can deduct gambling losses up to the total amount of your reported gambling winnings.
• Moving Expenses for Military: While civilian moving expense deductions are largely paused, active-duty military members moving under orders for a permanent change of station can still deduct qualified moving costs.
• Alimony Paid: If your divorce agreement was finalized on or before December 31, 2018, the alimony payments you make to a former spouse remain tax-deductible.

You can review more details and advice on maximizing your return with tools like the TurboTax Tax Tips Guide or general filing info from H&R Block Tax Center.

Claiming medical expenses on your taxes is only worth it if your total unreimbursed out-of-pocket medical costs exceed 7.5% of your adjusted gross income (AGI) and your total itemized deductions beat the standard deduction.

The Two Major Hurdles

To get any tax savings from medical expenses, you must pass two strict tests:

• The 7.5% AGI Threshold: You can only deduct the portion of your medical costs that goes above 7.5% of your AGI. If your AGI is $60,000, the first $4,500 of medical bills cannot be deducted. Only costs past that amount count.
• Itemizing vs. Standard Deduction: You cannot take the standard deduction and claim medical expenses; you must itemize your deductions on Schedule A. Your combined itemized expenses (medical, mortgage interest, state/local taxes, and charity) must be higher than the standard deduction ($16,100 for single filers or $32,200 for married filing jointly in 2026) to make a difference.

What Counts as a Qualifying Expense

If you meet the criteria, you can deduct unreimbursed costs for the IRS Topic no. 502:

• Diagnosis and Treatment: Doctor visits, surgeries, dental care, eye exams, and mental health therapy.
• Supplies and Equipment: Prescription drugs, insulin, eyeglasses, hearing aids, and wheelchairs.
• Insurance and Travel: Unreimbursed health or long-term care insurance premiums, plus travel costs for medical care (like parking, tolls, or mileage at 21 cents per mile).
• Exclusions: You cannot deduct expenses paid with pre-tax funds like an HSA or FSA, or costs reimbursed by insurance. Cosmetic procedures and general health items (like vitamins or gym memberships) also do not qualify unless specifically prescribed to treat a disease.

You can deduct the portion of your unreimbursed medical and dental expenses that exceeds 7.5% of your adjusted gross income (AGI), but only if you itemize your deductions on Schedule A (Form 1040) instead of taking the standard deduction.

How the Calculation Works

• Find your threshold: Multiply your AGI by 7.5% (0.075).
• Subtract the threshold: Only the amount of your qualified medical expenses above that number can be written off.
• Example: If your AGI is $50,000, your 7.5% threshold is $3,750. If you have $5,000 in total out-of-pocket medical bills, you can write off $1,250 ($5,000 minus $3,750).

Requirements to Claim

• Itemizing: Your total itemized deductions (medical expenses, mortgage interest, state and local taxes, charitable gifts) must be higher than the Standard Deduction for your filing status to make itemizing worthwhile.
• Out-of-pocket costs: Expenses must not be paid using pre-tax dollars (like an HSA or FSA) and must not be reimbursed by insurance.
• Who it covers: You can include costs for yourself, your spouse, and your dependents.

What Counts as a Medical Expense?

• Care and treatment: Doctor visits, dental care, vision exams, surgeries, and mental health therapy.
• Medications: Prescription drugs and insulin (over-the-counter drugs do not count).
• Equipment: Eyeglasses, hearing aids, crutches, and wheelchairs.
• Travel: Public transit, taxis, or mileage for driving to medical appointments (calculated at the standard medical mileage rate).
• Insurance: Unreimbursed health and long-term care insurance premiums paid with after-tax money.

For full details on specific qualifying costs, check IRS Publication 502.