What medical expenses are deductible on federal taxes in 2026 and what limits apply?
Executive summary
For tax year 2026 you can deduct unreimbursed medical and dental expenses only if you itemize, and only the portion that exceeds 7.5% of your adjusted gross income (AGI) (IRS Topic No. 502; Publication 502) [1] [2]. The types of qualifying costs include doctor and hospital bills, certain travel and transportation for medical care, and some insurance premiums that were paid with after‑tax dollars — but amounts reimbursed or paid with pre‑tax plans like HSAs or employer premium conversions are not deductible [1] [2] [3].
1. Who can claim the deduction — the simple gatekeeper
You must itemize on Schedule A to claim medical expense deductions; taxpayers who take the standard deduction cannot use this break. The IRS states the deduction is available for medical and dental expenses you paid for yourself, your spouse and your dependents to the extent those expenses exceed 7.5% of your AGI [1] [2].
2. What counts as a deductible medical expense — the core list
Qualifying costs include amounts paid to diagnose, treat or prevent disease and for treatments affecting any part or function of the body — common examples in IRS guidance are doctor and hospital services, prescription drugs, and dental work. Transportation primarily for and essential to medical care also qualifies (including car mileage at the IRS medical rate, tolls, parking, taxi/bus fare and ambulance) [1] [2].
3. What does not qualify or is excluded — watch the “double dip” rules
Expenses reimbursed by insurance, employer plans, FSAs or HSAs cannot be included in your deductible total. Pre‑tax premium payments made through employer premium conversion or cafeteria plans are excluded unless those premiums were actually included in Box 1 of your W‑2 [1] [2]. Sources emphasize you cannot “double‑dip” — if you paid with tax‑favored dollars from an HSA or FSA, those dollars already received tax benefit and the expense is not deductible [2] [3].
4. The 7.5% AGI threshold — how it works in practice
You total your unreimbursed medical expenses for the year, then subtract 7.5% of your AGI; only the excess is deductible on Schedule A. Multiple financial guides and the IRS reiterate that unless your out‑of‑pocket costs are high relative to your income, most taxpayers get no federal tax benefit because the standard deduction is often larger [1] [4] [5].
5. Premiums, Medicare and special cases — what to watch
Some premiums paid with after‑tax dollars can be deductible (for example, certain long‑term care or Medicare premiums if not paid pre‑tax), but many employer‑sponsored premiums paid pre‑tax are excluded. Publication 502 and practitioner guides spell out nuances for federal employees in premium conversion plans or for people reimbursed later; if you were reimbursed in a later year or paid with pre‑tax salary reductions, different reporting rules and timing issues apply [2] [1].
6. Inflation adjustments and related 2026 figures — parallel tax items
While the 7.5% threshold itself remains the operative rule, the IRS released 2026 inflation adjustments that affect related health tax items: HSA and FSA contribution limits and high‑deductible plan parameters changed for 2026 (for example, HSA individual cap rising to $4,400 and FSA cap to $3,400), and those shifts affect whether taxpayers use tax‑favored accounts instead of the itemized medical deduction [6] [3].
7. Practical implications and alternative strategies
Because the standard deduction is higher for many taxpayers, advisers in the reporting (NerdWallet, H&R Block, TurboTax summaries) stress that only those with substantial unreimbursed bills clear the 7.5% hurdle — and states sometimes have different thresholds that can produce state tax benefits even when federal deduction fails [5] [7] [4]. The reporting also underscores that using HSAs/FSAs remains a more powerful tax tool for many taxpayers than waiting for an itemized deduction [3] [2].
Limitations and where reporting is silent: available sources do not mention any law change to the 7.5% threshold for 2026; the IRS and tax outlets in the provided set present 7.5% as the controlling limit and focus on qualified expenses and exclusions [1] [6] [2]. If you want step‑by‑step totals for your situation, consult Publication 502 and Schedule A instructions or a tax professional because the sources here provide rules and examples but not individualized calculations [2].