Understanding Medical and Dental Expenses Deductions for 2024: What Qualifies

U.S. tax rules for the current filing season reaffirm what counts as deductible medical expenses, including dental care and insurance, and who can claim them—guidance that matters to many immigrant families in the United States 🇺🇸 who often pay out of pocket.

The Internal Revenue Service standard remains clear: you can only count expenses you actually paid during the current tax year, and you can deduct only the portion that exceeds 7.5% of your adjusted gross income (AGI). The rules cover a wide list of eligible costs and set bright lines on what doesn’t qualify, with special rules for spouses and dependents in 2024.

What counts as a medical expense

Medical expenses are costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and costs that affect any part or function of the body. This includes equipment, supplies, and diagnostic devices. Dental care and insurance premiums are included.

To qualify, the expense must mainly help prevent or relieve a physical or mental condition. Items that do not qualify include purely cosmetic procedures, general wellness items (like vitamins), and vacations.

Timing rules: when expenses are deductible

Timing matters: only include amounts you paid during the tax year, even if the care occurred earlier. Prepaid treatment isn’t deductible until the care is actually provided. This is critical for families who pay deposits for future procedures.

Who you can claim for (2024 rules)

You can generally deduct medical expenses you paid for:

• Yourself
• Your spouse
• A dependent (or a person who would have been your dependent), either when the services were given or when you paid

For 2024, an individual who would have been your dependent is not eligible if any of the following apply:

• They had gross income of $5,050 or more
• They filed a joint return
• You (or your spouse if filing jointly) could be claimed as a dependent on someone else’s return

Practical examples

1. Mary received medical treatment before marrying Bill. Bill paid the bill after they married. Bill can include those expenses in his medical expense deduction even if they file separate returns.

• If Mary had paid the expenses herself, Bill couldn’t include them on his separate return; Mary would claim what she paid on hers.
• If they file a joint return, they combine the medical expenses both paid for the deduction.

1. John paid medical expenses this year for his wife Louise, who died last year. John then married Belle and filed a joint return with Belle this year. Because John was married to Louise when she received the services, he can include those expenses in his medical expense deduction for this year.

Policy details on deductible items

To the extent you weren’t reimbursed, deductible items include:

• Insurance premiums for medical care, including Medicare Parts B and D, covering:
  • Hospitalization, surgical services, and X-rays
  • Prescription drugs and insulin
  • Replacement of lost or damaged contact lenses
  • Long-term care (limited)
• If you’re 65 or older but not entitled to Social Security benefits, premiums voluntarily paid for Medicare Part A
• Insurance premiums for dental care
• Prescription medicines and insulin
• Care from licensed practitioners: acupuncturists, chiropractors, dentists, eye doctors, medical doctors, occupational therapists, osteopathic doctors, physical therapists, podiatrists, psychiatrists, psychoanalysts (medical care only), and psychologists
• Medical examinations, X-ray and laboratory services, and insulin treatments a doctor ordered
• Diagnostic tests (full-body scans, pregnancy tests, blood sugar test kits)
• Nursing help (including your share of employment taxes paid)
• Hospital care, clinic costs, and lab fees
• Qualified long-term care services
• Programs to stop smoking and prescription medicines to ease nicotine withdrawal
• A weight-loss program as treatment for a specific disease (including obesity) diagnosed by a doctor
• Treatment for drug or alcohol addiction
• Medical aids: eyeglasses, contact lenses, hearing aids, braces, crutches, wheelchairs, guide dogs (including upkeep)
• Vision surgery to improve defective vision (laser eye surgery, radial keratotomy)
• Breast pumps and supplies that assist lactation

Meals and lodging rules

You may include meals and lodging at a hospital or similar facility if the principal reason for being there is medical care.

Lodging not in a hospital may qualify if all these are true:

• The lodging is primarily for and essential to medical care.
• A doctor in a licensed hospital or related medical facility provided the services.
• The lodging isn’t lavish or extravagant.
• There’s no significant personal pleasure or vacation element.

Limits:

• Deduction for lodging can’t exceed $50 per night per person.
• If a parent travels with a sick child, up to $100 per night can be included for lodging.
• Meals aren’t included in these lodging amounts.

Nursing home, transportation, and car use

• Nursing home costs for medical care can qualify.
• Transportation is deductible when primarily for, and essential to, care:
  • Bus, taxi, train, plane, or ambulance fares
  • Transportation for a parent who must accompany a child who needs care
  • Transportation for a nurse or other necessary attendant when the patient can’t travel alone
  • Regular visits to see a mentally ill dependent if recommended as part of treatment

Car use:

• Deduct out-of-pocket costs like gas and oil for medical trips (not depreciation, insurance, general repair, or maintenance).
• Or use the 2023 standard mileage rate of 22 cents per mile for medical travel.
• Add parking and tolls under either method.

Capital improvements to accommodate medical needs

Capital expenses (home modifications or special equipment) can be deductible. Rules:

• If the improvement increases property value, only the portion above that value increase counts as a medical expense.
• If it does not increase property value, the full cost counts.

Common qualifying modifications:

• Constructing entrance or exit ramps
• Widening doorways and hallways
• Installing railings, support bars, bathroom modifications
• Lowering or modifying kitchen cabinets and equipment
• Moving or modifying electrical outlets and fixtures
• Installing porch lifts and other lifts (note: elevators generally add value)
• Modifying fire alarms, smoke detectors, warning systems
• Modifying stairways, adding handrails or grab bars, changing door hardware
• Modifying entrance areas and grading ground for access

What is NOT deductible

Not every health-related cost qualifies. Non-deductible items include:

• Diet food
• Cosmetic surgery unless correcting a deformity from congenital issues, accident/trauma, or disfiguring disease
• Life insurance or income protection policies
• Medicare tax on wages/tips, or Medicare paid as part of self-employment or household employment taxes
• Nursing care for a healthy baby
• Illegal operations or drugs
• Imported drugs not approved by the FDA (including foreign-made versions without FDA approval)
• Nonprescription medicines, except insulin (includes nicotine gum and certain nicotine patches)
• Over-the-counter drugs without a prescription—even aspirin doesn’t qualify without a prescription
• Travel a doctor told you to take for rest or a change
• Funeral, burial, or cremation costs

Payroll and reporting considerations

• Employees who pay insurance through pre-tax payroll deductions can’t claim those amounts again as a personal deduction. Pre-tax amounts aren’t deductible.
• Check your W-2 Box 1 wages to see what’s included: About Form W-2
• Certain self-employed taxpayers or S corporation shareholders might benefit more by taking insurance costs as an adjustment to income rather than an itemized medical deduction—check eligibility for your situation.

Practical implications for families and newcomers

• Only the portion of combined medical and dental care costs that exceeds 7.5% of AGI is deductible—this threshold makes careful recordkeeping essential.
• Newcomers often miss eligible items because receipts, invoices, or doctor recommendations aren’t kept together across the tax year (analysis by VisaVerge.com).

Important: Keep receipts, invoices, prescriptions, doctor recommendations, and records of payment together for the tax year in which you paid the expense.

Where to get official guidance

For full, official IRS guidance on medical and dental expenses and deductible rules, see: IRS Publication 502: Medical and Dental Expenses. This publication aligns with the rules summarized here and helps taxpayers apply them within the proper tax year.