This guide is general information, not tax advice. The medical-expense deduction is fact-specific and changes with tax law. Confirm your situation with a qualified tax professional before filing.
The two gates before anything is deductible
- You must itemize. The medical deduction lives on Schedule A (Form 1040). If you take the standard deduction, medical expenses give you nothing.
- Only the amount above 7.5% of AGI counts. Per IRS Publication 502: "Generally, you can deduct on Schedule A (Form 1040) only the amount of your medical and dental expenses that is more than 7.5% of your AGI."
Example: with $80,000 AGI, the first $6,000 of medical spending (7.5%) is not deductible. Only dollars above $6,000 count — and only if your total itemized deductions beat the standard deduction.
What foreign care qualifies
Publication 502 defines deductible medical care by what it is, not where it happens. Care abroad qualifies if it would qualify at home: legal, medically necessary, not cosmetic. A covered surgery, dental work, or a physician-diagnosed weight-loss treatment performed overseas is deductible on the same basis as the US equivalent.
The travel and lodging rules (this is where people over-claim)
| Cost | Deductible? | Rule / limit (IRS Pub 502) |
|---|---|---|
| The medical procedure itself | Yes | If legal, necessary, non-cosmetic |
| Airfare / plane, bus, taxi, train fares to care | Yes | "Amounts you pay for transportation to another city if the trip is primarily for and essential to receiving medical services" |
| Driving your own car | Yes, limited | Standard medical mileage rate of 21 cents/mile (2025), plus parking and tolls |
| Lodging | Yes, capped | Up to $50/night per person, only if care is by a doctor in a licensed hospital or equivalent, lodging isn't lavish, and there's no significant vacation element |
| A companion's lodging | Yes, capped | Up to another $50/night when the companion is necessary |
| Meals while traveling for care | No | Not deductible as a medical travel cost |
| A trip for general health / change of environment | No | Excluded even on a doctor's advice |
Source: IRS Publication 502 (2025), Transportation and Lodging sections. Verify the current-year mileage rate before filing — the IRS resets it annually.
What you cannot deduct
- Anything reimbursed by insurance or paid from an HSA/FSA — no double-dipping. Pre-tax dollars are already tax-advantaged.
- Cosmetic procedures for appearance.
- Meals, sightseeing, and the vacation portion of a medical trip.
- Prescription drugs imported from abroad, unless legal in both countries and (except insulin) prescribed — the same rule that governs the deduction.
Currency conversion
Convert each foreign expense to US dollars at the exchange rate on the date you paid. A credit-card statement showing the posted USD amount is the cleanest record. Keep itemized, dated invoices (translated if needed) for every line you deduct.
A simple worked example (illustrative)
Assume $90,000 AGI (7.5% floor = $6,750). Over the year:
| Item | Amount |
|---|---|
| Dental implants in Mexico (unreimbursed) | $6,000 |
| Airfare to the clinic city | $500 |
| Lodging, 3 nights at $50 cap | $150 |
| US medical/dental (unreimbursed) | $2,500 |
| Meals during the trip | not deductible |
| Total qualifying medical | $9,150 |
| Less 7.5% AGI floor | −$6,750 |
| Potential Schedule A medical deduction | $2,400 |
This deduction only helps if total itemized deductions exceed your standard deduction. Figures illustrative; your numbers and the current standard-deduction amount will differ.
Recordkeeping checklist
- Itemized, dated invoice for each procedure (translated if not in English).
- Proof of payment showing the USD amount.
- Travel receipts (airfare, transport) and lodging receipts, capped at $50/night.
- Documentation of medical necessity for borderline care (a letter of medical necessity helps).
- A note of any insurance/HSA/FSA reimbursement to subtract.
Frequently asked questions
Is medical tourism tax deductible?
Sometimes. Unreimbursed medical care received abroad can count toward the itemized medical-expense deduction on Schedule A, on the same terms as US care — you deduct only the portion of total medical costs above 7.5% of your adjusted gross income, and only if you itemize. This guide is general information, not tax advice; the medical-expense deduction is fact-specific and changes with tax law, so confirm your situation with a qualified tax professional before filing.
Can I deduct travel and lodging for surgery abroad?
Transportation to another city if the trip is primarily for and essential to receiving medical services is deductible; driving your own car is deductible at the standard medical mileage rate of 21 cents/mile (2025), plus parking and tolls; and lodging is deductible up to $50/night per person under specific conditions. Meals while traveling for care are not deductible. Verify the current-year mileage rate before filing — the IRS resets it annually.
Can I deduct care I paid for with my HSA or FSA?
No. Anything reimbursed by insurance or paid from an HSA/FSA cannot be deducted — no double-dipping, because pre-tax dollars are already tax-advantaged. Keep a note of any insurance/HSA/FSA reimbursement to subtract from what you claim. The medical-expense deduction is fact-specific; confirm your situation with a qualified tax professional before filing.
Related VitalityScout guides
Sources
- IRS, Publication 502 (2025), Medical and Dental Expenses — 7.5% AGI threshold, foreign care, transportation (21¢/mile 2025), lodging ($50/night), trips, imported medicines. https://www.irs.gov/publications/p502
- IRS, About Schedule A (Form 1040) — where itemized medical expenses are reported. https://www.irs.gov/forms-pubs/about-schedule-a-form-1040
The 21¢/mile medical mileage rate is the 2025 figure and the IRS resets it annually. The 7.5% AGI threshold and $50/night lodging cap are current as of the 2025 publication. Confirm all figures with a tax professional before filing.
Disclaimer
This page is general information, not tax, legal, or financial advice. The medical-expense deduction is fact-specific and changes with tax law, and figures used in examples are illustrative. Confirm your situation and all current-year figures with a qualified tax professional before filing.