If you had significant out-of-pocket medical costs in 2026, you may be able to deduct them on your federal return -- but only qualifying medical expenses that exceed 7.5% of your adjusted gross income (AGI), and only if you itemize deductions rather than taking the standard deduction.
The 7.5% AGI Floor
The threshold means you cannot deduct all medical expenses -- only the amount above 7.5% of AGI. For a filer with $60,000 in AGI, the floor is $4,500. If you paid $8,000 in qualifying medical costs, you can deduct $3,500 ($8,000 - $4,500).
What Qualifies
- Doctor, dentist, and specialist visit co-pays and fees not covered by insurance
- Hospital and surgery costs
- Prescription medications
- Medical equipment (wheelchairs, crutches, blood pressure monitors)
- Eyeglasses, contact lenses, and eye exams
- Mental health treatment and therapy
- Long-term care services and eligible long-term care insurance premiums
- Mileage driven for medical purposes (21 cents per mile in 2026)
- Hearing aids, fertility treatments, smoking cessation programs
- Health insurance premiums paid with after-tax dollars (not pre-tax through employer)
What Does Not Qualify
- Over-the-counter medications (unless prescribed)
- Cosmetic surgery not medically necessary
- Gym memberships and general wellness programs
- Premiums paid with pre-tax employer dollars
- Expenses reimbursed by insurance or an HSA/FSA
The Standard Deduction Comparison
For 2026, the standard deduction is $15,000 (single) and $30,000 (married filing jointly). Your total Schedule A deductions must exceed these amounts to make itemizing worthwhile. The medical expense deduction is most valuable in years with an extraordinary medical event -- major surgery, serious illness, or long-term care costs. For a side-by-side comparison, see the standard deduction vs. itemized guide.
Source
IRS Publication 502 (Medical and Dental Expenses); IRS Topic No. 502; IRS Rev. Proc. 2025-13 (2026 long-term care premium limits).