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How have medical expense deduction rules changed from 2025 to 2026?
Executive summary
The basic rule for claiming the medical expense deduction — that you may deduct unreimbursed medical and dental expenses that exceed 7.5% of your adjusted gross income (AGI) when you itemize — remains in place for 2025 and 2026 (IRS Topic No. 502) [1]. The practical landscape changed mostly because of two related items noted in reporting: [2] inflation adjustments and regulatory figures tied to HSAs/HDHPs and out‑of‑pocket limits were increased for tax year 2026 (IRS announcement), and [3] the size of the standard deduction that determines whether taxpayers itemize is shifting between 2025 and 2026 in ways that will change how many taxpayers can benefit from the medical deduction (multiple tax outlets) [4] [5] [6].
1. The core deduction rule has not been rewritten — the 7.5% AGI hurdle stands
The Internal Revenue Service continues to permit an itemized deduction for medical and dental expenses only to the extent those expenses exceed 7.5% of your AGI; that threshold is the central rule for both 2025 and 2026 tax years as described in IRS Topic No. 502 [1].
2. Why itemizing — and the size of the standard deduction — is the pivotal change for many taxpayers
Whether you get any benefit from medical expenses depends on whether you itemize or take the standard deduction. For 2025 the standard deduction amounts are relatively high (examples cited for individuals and married filing jointly), and multiple outlets note that 2026 will see meaningful changes to standard deduction levels that will affect the “itemize vs. standard” calculus — several advisers urge that taxpayers “bunch” deductible medical expenses into years where itemizing makes sense because the standard deduction is changing after 2025 (NerdWallet, CNBC, OurTaxPartner) [7] [5] [6]. OurTaxPartner and CNBC highlight that the TCJA-era high standard deduction is scheduled to change around the end-of-2025 sunset, which will alter how easy or hard it is to clear the itemizing threshold [6] [5].
3. 2026 inflation adjustments affect health‑savings/HDHP limits and out‑of‑pocket figures — practical knock‑on effects
The IRS announced tax year 2026 inflation adjustments that raise deductible and out‑of‑pocket thresholds for high-deductible health plans (HDHPs) and Medical Savings Accounts (MSAs): for self-only HDHP deductibles, the minimum increases $50 to $2,900 and the maximum out‑of‑pocket rises $150 to $5,850; family limits are also increased [4]. Those increases do not themselves change how the Schedule A medical deduction is calculated, but they shift the affordable‑care, HSA/MSA and insurance dynamics that determine whether taxpayers pay unreimbursed medical bills (which are the only expenses eligible for the deduction) [4].
4. Reimbursements and tax-advantaged accounts remain exclusions
All sources reiterate that you cannot include medical expenses that were reimbursed by insurance, an employer, an HSA or an FSA — those amounts are excluded from the Schedule A medical deduction because they were already tax‑advantaged or compensated (Publication 502; OurTaxPartner; CNBC) [8] [9] [5].
5. Practical planning advice and divergent framings in coverage
Tax guides and outlets give similar tactical advice but frame stakes differently. NerdWallet and TurboTax emphasize recordkeeping and that you must itemize to claim the deduction [7] [10]. OurTaxPartner and some commentators frame 2025 as a last year of the “high” TCJA standard deduction and encourage “bunching” elective medical spending into 2025 if you’re near the itemizing cutoff; that advice rests on expectations about 2026 standard deduction changes [6]. The IRS sources do not promote timing strategies; they report inflation adjustments and the statutory rules [4] [1].
6. What the provided sources do not say (limits of available reporting)
Available sources do not mention any change to the 7.5% AGI threshold itself for 2025 vs. 2026 — IRS Topic No. 502 continues to describe the same threshold [1]. Available sources do not provide finalized official 2026 standard deduction dollar amounts in one consolidated IRS publication in this set; coverage about the standard deduction’s post‑2025 trajectory appears in analyst pieces and tax‑service commentary rather than a single IRS rule text supplied here [4] [5] [6].
7. Bottom line for taxpayers
If you already itemize and routinely exceed 7.5% of AGI in medical costs, the mechanics of the deduction remain unchanged [1]. If you typically take the standard deduction, whether you’ll benefit from medical deductions in 2026 depends primarily on the changed standard deduction environment and on whether your expenses are unreimbursed [6] [1]. Also watch the IRS 2026 inflation adjustments for HSA/HDHP contribution and deductible limits — these change how much you might pay out of pocket and thus how much unreimbursed medical expense you have to claim [4].
If you want, I can pull together a short calculator example showing how the 7.5% threshold, sample AGIs and projected 2025 vs. 2026 standard deductions affect whether a given level of medical spending yields any federal tax deduction — tell me your filing status and AGI and I’ll run the numbers using figures cited in these sources.