Can health insurance premiums and long-term care insurance premiums be deducted in 2026?

1. Who can deduct health insurance premiums in 2026 — the short answer

You can deduct health insurance premiums in 2026 if they count as unreimbursed medical expenses and you itemize — and only the portion of total medical expenses that exceeds 7.5% of your adjusted gross income (AGI) is deductible ^{[1] [5]}. Separately, self‑employed taxpayers who meet the eligibility rules may claim a deduction for premiums as an adjustment to income (reducing AGI) rather than an itemized deduction ^{[1] [2]}.

2. The itemize threshold that limits most people

The dominant rule: medical and dental expenses — including qualifying insurance premiums — are deductible only to the extent they exceed 7.5% of AGI for the year ^{[1] [5]}. That means the majority of taxpayers who take the standard deduction will not realize a premium deduction; only those whose total unreimbursed medical costs are relatively large and who itemize can use this break ^[1].

3. The self‑employed carve‑out that matters for small business owners

If you are self‑employed and have net profit, you may be eligible to deduct health insurance premiums as an adjustment to income for yourself, your spouse and dependents — this deduction is claimed even if you don’t itemize and is subject to eligibility rules (months you were not eligible to participate in an employer plan, deduction limited to earned income, etc.) ^{[1] [6] [2]}. Employer‑paid amounts or pre‑tax cafeteria plan contributions generally aren’t deductible because they are already excluded from income ^{[1] [5]}.

4. Medicare premiums and marketplace subsidies — nuance and reporting

Medicare premiums (Parts B, D, Medicare Advantage) are treated as qualified medical expenses and can be included when itemizing medical expenses — for 2026, the standard Part B premium is reported as $202.90, according to CMS and industry summaries — but the same 7.5% AGI floor applies ^{[7] [8]}. Marketplace premium tax credits lower how much premium you effectively pay; any premium subsidy you receive reduces the deductible amount because it’s not an out‑of‑pocket expense ^{[9] [10]}.

5. Long‑term care insurance: separate favorable rules and 2026 increases

Tax‑qualified LTC insurance premiums are explicitly treated as medical expenses and are deductible to the extent medical expenses exceed 7.5% of AGI — but they are also capped by age‑based IRS limits that rise each year for inflation. Reporting for 2026 shows the IRS/industry guidance increased the age‑based caps by roughly 3%; for example, the limit for taxpayers aged over 70 is cited as $6,200 for 2026 ^{[1] [3] [4]}. Only policies meeting federal “tax‑qualified” rules are eligible ^{[11] [12]}.

6. Practical implications and common pitfalls

Most people with employer‑sponsored coverage or small unreimbursed medical bills will not get a deduction because employer premium contributions are pre‑tax and because the 7.5% AGI floor is high ^{[1] [5]}. Self‑employed people should track months of eligibility and ensure premiums aren’t already paid or counted by an employer plan; marketplace credits reduce deductible amounts; and LTC policies must be tax‑qualified to use the age‑based caps ^{[6] [9] [13]}.

7. Competing perspectives in the reporting

Industry groups and LTC advocates emphasize the expanded 2026 LTC caps and frame them as a planning advantage, especially for older taxpayers and small business owners ^{[3] [12]}. Tax guidance and mainstream tax publications underscore the limits created by the 7.5% AGI floor and the reality that few taxpayers will pass that threshold ^{[1] [14]}. Both views are consistent: LTC premiums have special caps that improved for 2026, but the AGI threshold remains the gating rule for deductibility ^{[1] [4]}.

8. What current sources do not address

Available sources do not mention specific procedural changes for 2026 tax forms or step‑by‑step IRS worksheets beyond standard Publication 502 and Form 7206 instructions; they also do not provide individualized examples that would show when itemizing beats the standard deduction for a particular household ^{[5] [2]}.

Bottom line: yes — qualified LTC premiums are deductible within IRS age caps and health insurance premiums can be deductible either as unreimbursed medical expenses above 7.5% of AGI or via the self‑employed health insurance deduction — but both routes carry eligibility rules and practical limits that will keep the deduction out of reach for many taxpayers ^{[1] [2] [4]}.