Medical Expense Deduction Tool
Which medical costs clear the 7.5% floor — and what a high-cost year is worth
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Clears the 7.5% Floor
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Your Floor (7.5% of AGI)
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Actual Tax Saved
Which medical costs clear the 7.5% floor — and what a high-cost year is worth
The medical expense deduction is the code's disaster clause: it only activates when health costs exceed 7.5% of your AGI — a floor designed to limit it to genuinely burdensome years. That makes it useless in normal years and surprisingly valuable in the bad ones: a major surgery, fertility treatment, long-term care, or a low-income year with normal expenses. This tool computes your floor, the slice that clears it, and — the part people miss — whether that slice actually survives the standard-deduction comparison.
At $75,000 AGI, the floor is $5,625 — the first $5,625 of medical costs never deduct. And clearing the floor only matters if your itemized total (medical + SALT + mortgage + charity) beats $15,000/$30,000. The calculator runs both hurdles, because plenty of "deductible" medical expenses save $0 at the second one.
| Category | Examples |
|---|---|
| The obvious | Deductibles, copays, surgery, prescriptions, dental, vision, mental health |
| Premiums | Health/dental/vision premiums paid AFTER-tax (not payroll pre-tax), Medicare B/C/D, long-term care premiums (age-capped: ~$1,800 at 50s, ~$6,000 at 70s) |
| Travel for care | 21¢/mile, parking, tolls, lodging up to $50/person/night — huge for out-of-town treatment |
| The surprising | Fertility treatment, weight-loss programs for diagnosed conditions, smoking cessation, guide animals, home modifications for medical need (ramps, rails — deductible beyond any home-value increase), special-education tuition with a doctor's recommendation |
| Not eligible | Cosmetic procedures, general vitamins, gym memberships (mostly), anything reimbursed by insurance/FSA/HSA |
Because of the floor, $12,000 of costs spread across two years ($6,000 each vs a $5,625 floor) deducts almost nothing — the same $12,000 stacked in one calendar year deducts $6,375. When major care is coming, cluster the controllables: schedule the surgery and the dental work in the same year, prepay January's treatment in December, buy the glasses and hearing aids in the expensive year. Pair the stacked year with bunched charitable giving for a maximal itemizing year, then take the standard deduction after.
In ordinary years, pre-tax vehicles beat this deduction without any floor: the HSA and FSA save your bracket + FICA from dollar one. The deduction is the backstop for costs beyond those accounts' limits — which is exactly what catastrophic years produce. (Note: expenses paid from HSA/FSA money can't also be deducted — no double-dipping.)
Yours, your spouse's, dependents' — and anyone you COULD have claimed as a dependent but for income tests (a parent you support, even if they file). Parents' care costs you pay directly are commonly missed.
Only after-tax premiums: marketplace plans without subsidies, Medicare B/C/D, COBRA, long-term care (with age caps). Payroll premiums are already pre-tax — counting them again is double-dipping the IRS catches.
If primarily for medical care (including for chronic illness with care-plan certification), fully countable — often the largest medical deductions in the code, easily clearing any floor. Assisted-living costs qualify proportionally to the medical component.
No — those dollars were never taxed, so deducting them again is prohibited. The deduction applies to out-of-pocket costs beyond your tax-advantaged accounts.
Substantially: the floor is 7.5% of THIS year's AGI, so low-income years (job loss, retirement, sabbatical) make normal medical spending suddenly deductible — the same logic as Roth-conversion timing, inverted.
Receipts/EOBs for the expenses, mileage logs for travel, prescriptions or doctor's letters for gray-area items (special education, home modifications, weight-loss programs). A high-medical year deserves one folder.
Yes — every figure computes locally in your browser.
In ordinary years, fund the HSA and forget this deduction exists. In the expensive year — and most families eventually have one — stack the calendar, sweep the eligible list, and let the disaster clause do what it was written for.