By Elizabeth Russell Owen, CPA | Private Client Tax Services Practice Leader
If you had significant medical expenses last year, you may be wondering what you can deduct on your 2025 income tax return. Income-based thresholds and other rules can make it difficult to claim the medical expense deduction. At the same time, more types of expenses may qualify than many taxpayers realize.
Limits on the Deduction
Medical expenses are deductible only if they were not reimbursed by insurance and were not paid through tax-advantaged accounts such as Flexible Spending Accounts or Health Savings Accounts. Even then, these expenses are deductible only to the extent that they exceed 7.5% of your adjusted gross income (AGI).
For example, if your 2025 AGI is $100,000, your medical expenses must exceed $7,500 before any deduction is allowed. If you incurred $10,000 in eligible medical expenses, only $2,500 would be deductible. In addition, medical expenses can be claimed only if you itemize deductions. To benefit from itemizing, your total itemized deductions must exceed the standard deduction.
Due to changes under the Tax Cuts and Jobs Act that were made permanent by last year’s One Big Beautiful Bill Act (OBBBA), many taxpayers no longer itemize. However, the OBBBA also significantly increased the state and local tax deduction limit. As a result, some taxpayers who have not itemized in recent years may benefit from doing so for 2025. If this applies to you, it may also be worth reconsidering whether the medical expense deduction could reduce your taxable income.
What Expenses Are Eligible?
If you expect to itemize deductions on your 2025 income tax return, now is a good time to review your medical expenses and determine whether they exceed the 7.5% of AGI threshold. Eligible expenses extend well beyond hospital stays and physician visits.
Transportation costs related to medical care qualify as deductible expenses. This includes taxi fares, public transportation, or mileage for using your personal vehicle. For 2025, medical mileage can be calculated at 21 cents per mile, in addition to tolls and parking. Certain actual vehicle costs, such as gas and oil, may also qualify, although general expenses like insurance, depreciation, and maintenance do not.
Health insurance premiums can also be deductible. Even if your employer provides coverage, the portion of premiums you pay out of pocket may qualify as long as those amounts were not paid pretax through payroll deductions. Premiums for long-term care insurance are also deductible, subject to annual limits based on age. For 2025, the deductible limits range from $480 for individuals age 40 and under to $6,020 for individuals over age 70.
Medical services provided by individuals other than physicians may qualify as well, provided they are related to the treatment of a medical condition rather than general health. Physical therapy following surgery, acupuncture treatments, and psychological care are all examples of qualifying services. Certain long-term care services required by chronically ill individuals may also be eligible.
The cost of eyeglasses, contact lenses, hearing aids, dentures, prescription medications, and most dental work can be included as medical expenses. Purely cosmetic procedures generally do not qualify, although cosmetic surgery that is medically necessary may be deductible. Prescription medications qualify, but nonprescription drugs do not, even if recommended by a physician.
Expenses related to smoking-cessation programs may also be deductible. This includes fees paid to participate in an approved program and the cost of prescribed medications designed to alleviate nicotine withdrawal. Nonprescription nicotine gum and certain patches generally do not qualify.
Weight-loss programs can be deductible when undertaken as treatment for a disease diagnosed by a physician, such as obesity or hypertension. In these cases, program fees and meeting costs may qualify, though food expenses typically do not. Obtaining a written medical diagnosis is strongly recommended.
You may also deduct medical expenses you pay on behalf of dependents, including children. In certain situations, you may deduct expenses paid for a parent or grandparent who would otherwise qualify as your dependent but fails to meet income or filing-status requirements. For divorced parents, medical expenses are generally deductible by the parent who pays them.
Don’t leave potential deductions on the table.
If you had significant medical expenses in 2025, now is the time to review them with your ATA advisor. We can help determine what qualifies, whether itemizing makes sense, and how to optimize your overall tax outcome.