Medical expense deduction: the receipts and statements to gather
By Arthur Teboul, DokuTrak · Published
In brief
Tax deductions for medical expenses count only on Schedule A, and only for the part of your costs above 7.5% of your adjusted gross income (IRS Topic no. 502). To reach that line, gather insurer statements, itemized bills, pharmacy printouts, a mileage log for medical trips and every reimbursement you received.
The checklist: Medical expense file: bills, EOBs and care trips
Keep one column per family member. Total each group in the margin, subtract what insurance or an employer paid back, then set the sum against 7.5% of your AGI.
- PDFPrint it or tick it off on screen.Free, no email
- WordEdit it and send it under your name.Free, with your email
- Excel trackerOne row per item, with a status column.Free, with your email
Build your own list: Answer 10 yes-or-no questions and the tax document checklist generator combines the lists that apply into one checklist.
Insurer and pharmacy records
- Explanation of benefits statements for each personFrom each insurer, for all claims in the year
- Yearly prescription printout from each pharmacyPrescribed drugs and insulin only
- Proof of what you paid after insuranceCard or bank statements matched to each bill
Care and treatment bills
- Itemized bills from doctors, dentists, hospitals and labsPatient name, date of service and amount due
- Therapy, mental health and addiction treatment receiptsFrom the licensed provider or program
- Nursing home or in-home care invoicesWith the medical part shown apart from room and board where needed
- Doctor’s note for a weight-loss or special programNames the disease the program treats
Equipment and home changes
- Receipts for glasses, contacts, hearing aids and batteriesDate and patient on each receipt
- Receipts for crutches, wheelchairs and other devicesPurchase or rental, for the year
- Contractor invoice for a ramp, lift or other medical home changeWith the doctor’s recommendation
- Appraisal or estimate of how much the change raised the home valueOnly the cost above the rise in value counts
Medical travel
- Mileage log for trips to careDate, clinic or hospital, miles; 2026 trips dated for the mid-year rate change
- Parking and toll receiptsFor the same trips as the mileage log
- Lodging receipts for care away from homeNightly rate and number of people
Payments back and income
- Insurance and employer reimbursementsChecks, EOB payments and plan statements
- HSA or FSA payout recordsCosts paid from these accounts do not count again
- Pay stubs showing pre-tax health deductionsPre-tax payroll costs are not deducted twice
- Last year’s return, for an AGI estimateHelps test the floor before gathering everything
First check: will your medical costs clear the floor?
The 7.5% floor is the share of your AGI that medical costs must pass before any of them count (IRS Topic no. 502). For example, with an AGI of $60,000, the first $4,500 of costs gives no deduction (IRS Topic no. 502). Only the amount above it goes on Schedule A.
Then the total must beat your standard deduction, or itemizing does not help. The bar to clear is $15,750 single or $31,500 joint on a 2025 return, rising to $16,100 and $32,200 for 2026 (IRS, Working Families Tax Cuts). Mortgage interest, state taxes and gifts to charity are added to the medical part first.
So do a rough sum before you gather every receipt. A year with surgery, a long hospital stay or nursing home care often clears both lines. A year of routine checkups often does not.
| Step | What you need | Where it comes from |
|---|---|---|
| Estimate AGI | Prior return plus the W-2s and 1099s received so far | Your preparer or your own records |
| Find the floor | AGI times 7.5% (IRS Topic no. 502) | A simple worksheet |
| Total the costs you paid | Bills, EOBs, pharmacy and mileage records | Providers, insurers, your own log |
| Subtract what was paid back | Insurance and employer reimbursements | EOBs and plan statements |
| Compare with the standard deduction | All itemized deductions together | Schedule A worksheet |
What counts as a medical expense, and what does not
Publication 502 lists what you can include, item by item (IRS Publication 502). It covers you, your spouse and your dependents. It also covers a relative who would be your dependent but for one rule, such as having $5,200 or more of gross income in 2025 (IRS Publication 502).
Drugs count only when prescribed, with insulin as the one exception (IRS Publication 502). A weight-loss program counts only when it treats a disease a physician diagnosed, such as obesity or heart disease (IRS Publication 502). Ask for the doctor’s note in that case, since the receipt alone does not show it.
- Usually included: doctor, dentist and hospital bills, hearing aids and batteries, glasses, contact lenses, crutches, therapy and stop-smoking programs (IRS Publication 502).
- Not included: cosmetic surgery, health club dues, nonprescription drugs, nutritional supplements and teeth whitening (IRS Publication 502).
- Nursing home care counts, including meals and lodging, if a principal reason for being there is medical care (IRS Publication 502).
- Costs paid with a tax-free HSA payout do not count again; the HSA checklist covers those records.
The paper behind each cost
A card statement shows that you paid, but not for what. The IRS needs the service, the patient and the date. That is why the best records come from the provider and the insurer, not the bank.
An explanation of benefits is the statement your insurer sends after each claim, showing what it paid and what you owe. It is often the fastest way to total a year of care. Pair it with the provider’s receipt to prove you paid your share.
Pharmacies can print a yearly history of prescriptions filled, with the amount you paid. Ask for one per family member. It replaces dozens of small register receipts.
Keep reimbursements in the same folder. The deduction only covers costs not paid back by insurance or anyone else (IRS Topic no. 502). A refund check from a provider or a payout from an employer plan cuts the total.
Mileage, parking and lodging for medical trips
Driving to chemotherapy, dialysis or the physical therapist is a medical expense, and many people forget it. Those drives use the medical rate, not the business one: 21 cents a mile on a 2025 return, then 20.5 cents for 2026 trips through June and 23.5 cents after (IRS standard mileage rates).
Because the 2026 rate changes mid-year, note the date of each appointment drive; the mileage log checklist shows a log layout that works. Parking at the hospital and tolls on the way are added on top, whether you use the mileage rate or actual costs (IRS Publication 502).
Lodging for care away from home can count too, but not more than $50 a night for each person (IRS Publication 502). A parent who travels with a sick child can include up to $100 a night (IRS Publication 502). Meals on the trip are not included unless they are part of inpatient care (IRS Publication 502).
Home changes and other special cases
Capital expenses are costs for equipment or home changes whose main purpose is medical care, such as a ramp or a stair lift (IRS Publication 502). If the change raises the value of the home, only the cost above that rise counts (IRS Publication 502). So keep the contractor’s invoice and an appraisal or estimate of the value change.
A death in the family adds one more rule. An estate can treat medical bills it pays as paid by the person who died, if it pays them within the 1-year period after the death (IRS Publication 502). Keep the bills and the dates paid with the final return papers.
Insurance premiums you pay after tax are also medical costs. The health insurance checklist lists the forms that go with them, so they are not repeated here.
Sending the medical file to your preparer
Sort first by person, then by type of cost. Send the total for each type with the papers behind it.
- Download every explanation of benefits for the year from each insurer.
- Ask each pharmacy for a yearly printout per person.
- Add itemized bills and proof of payment for costs the insurer did not cover.
- Total your medical miles by period, plus parking and tolls.
- List every reimbursement, and note any cost paid from an HSA or FSA.
Questions people ask
Can I deduct medical expenses without itemizing?
No. Medical and dental costs are deducted on Schedule A, which means you itemize, and only the part above 7.5% of AGI counts (IRS Topic no. 502).
Can I deduct mileage to the doctor?
Yes, at the medical rate: 21 cents a mile for 2025, and 23.5 cents for appointments in the second half of 2026 (IRS standard mileage rates). Parking fees and tolls can be added (IRS Publication 502).
Can I deduct medical bills I paid for my parent?
Often, yes. You can include costs for a person who would be your dependent except for certain rules, such as having too much gross income (IRS Publication 502). Keep the bills in your name as the payer.
Do I need receipts to claim medical expenses?
You need records that show the patient, the service, the date and what you paid after insurance. An explanation of benefits with the provider’s bill does this best. Bank and card statements alone do not show what was bought.
Sources
- IRS Topic no. 502: Medical and dental costs are deductible on Schedule A to the extent they exceed 7.5% of AGI, and only if not paid back by insurance or otherwise.
- IRS Publication 502: What is and is not included, the dependent income exception, insulin, weight-loss programs, nursing homes, parking and tolls, the $50 lodging limit, capital expenses and expenses paid by an estate.
- IRS standard mileage rates: Medical mileage is 21 cents for 2025, 20.5 cents for January to June 2026 and 23.5 cents for July to December 2026.
- IRS, Working Families Tax Cuts: The standard deduction is $15,750 single and $31,500 joint for 2025, and $16,100 and $32,200 for 2026.
About the author
Arthur Teboul (Founder, DokuTrak) is building DokuTrak after watching professionals lose hours chasing clients for documents over email. Arthur Teboul.
Editorial standards
How this page was made (methodology): it is built from the primary sources listed under Sources, and every rule and figure on it links to the source it comes from. Last updated October 25, 2026. Spotted an error or a rule that changed? Contact us.
Ask once. DokuTrak does the chasing.
- Your client uploads from one link, with no account and no password.
- Reminders go out on a schedule, by default 2, 5, 10 and 14 days after the request, until the file arrives.
- With AI review switched on in your workspace (it is off by default), each upload gets a first pass that flags a file that is not the requested document or an unreadable or blurry scan. It says so when it is not sure.
- You accept every file or mark it for re-upload, and your client gets the note by email. The AI never accepts a file.