Medical Expense Deductions for Immigrants: What You Can Claim on Schedule A

Can Immigrants Deduct Medical Expenses?

Yes - immigrants who qualify as US tax residents can deduct medical expenses on Schedule A of their federal tax return. The deduction applies to qualifying expenses that exceed 7.5% of your adjusted gross income (AGI) for the year. Only the amount above that threshold is deductible.

For example, if your AGI is $60,000, the 7.5% floor is $4,500. If your qualifying medical expenses total $7,000, you can deduct $2,500.

The 7.5% AGI Threshold

The 7.5% threshold applies to all taxpayers, regardless of immigration status. It is calculated on your AGI - your gross income after above-the-line deductions like student loan interest or retirement contributions, but before itemized or standard deductions.

Higher-income individuals find this threshold harder to clear. Someone with $120,000 AGI must spend more than $9,000 on qualifying medical expenses before any deduction applies.

What Medical Expenses Qualify?

Qualifying Expenses

The IRS allows deductions for a broad range of medical costs paid for yourself, your spouse, and your dependents:

• Health insurance premiums (if you pay them yourself and they are not pre-tax through an employer)
• Dental care, including braces and dentures
• Vision care, including glasses and contact lenses
• Prescription medications
• Hospital and surgical fees
• Physical therapy and chiropractic care
• Hearing aids
• Mental health treatment and therapy
• Ambulance transportation
• Long-term care insurance premiums (subject to age-based limits)
• Medical equipment such as crutches, wheelchairs, and blood sugar monitors

Expenses That Do Not Qualify

• Cosmetic procedures not related to disease or injury
• Gym memberships or fitness programs (even if recommended by a doctor)
• Over-the-counter medications (unless prescribed)
• Vitamins and supplements (unless prescribed for a specific condition)
• Health insurance premiums paid by your employer pre-tax

Can You Deduct Foreign Medical Expenses?

Yes. The IRS does not restrict the medical expense deduction to care received in the United States. If you traveled back to Brazil, Mexico, or any other country for medical treatment, and you paid qualifying medical expenses there, those costs are deductible - provided you have documentation.

You will need receipts showing the provider's name, the date of service, and the amount paid. If documents are in a foreign language, maintain your own translation records. Currency amounts should be converted to US dollars using the exchange rate on the date of payment.

Travel costs related to medical care may also qualify, including:

• Airfare or mileage to a medical provider (at the IRS medical mileage rate of 21 cents per mile in 2024)
• Lodging up to $50 per night if travel away from home is medically necessary

HSA Contributions and Medical Expenses

How HSAs Work

A Health Savings Account (HSA) lets you contribute pre-tax dollars to pay for qualifying medical expenses. For 2024, contribution limits are:

• $4,150 for self-only coverage
• $8,300 for family coverage
• Additional $1,000 catch-up contribution if you are 55 or older

HSA contributions reduce your taxable income directly. Withdrawals for qualifying medical expenses are tax-free. This is separate from the Schedule A medical expense deduction.

HSA vs. Schedule A Deduction

You cannot claim the same expense as both an HSA distribution and a Schedule A deduction. If you pay a medical bill from your HSA, you cannot also list that expense on Schedule A.

Must You Itemize?

Yes. Medical expense deductions are only available if you itemize on Schedule A. For 2024, the standard deduction is:

• $14,600 for single filers
• $29,200 for married filing jointly
• $21,900 for head of household

If your total itemized deductions - including medical expenses, mortgage interest, state/local taxes (capped at $10,000), and charitable contributions - exceed the standard deduction, itemizing saves you more money.

Many immigrants do not own a home and have fewer itemized deductions, so it is worth calculating both options before deciding.

Key Documents to Keep

• Explanation of Benefits (EOB) from your insurer
• Receipts from doctors, hospitals, pharmacies, and clinics
• Proof of insurance premium payments
• Travel receipts for medically necessary trips
• HSA account statements

---

Get Your Personalized Form List

Medical deductions are just one piece of your tax picture. Answer a few questions about your situation and get a personalized checklist of forms and deductions relevant to your immigration status and income.

Start Your Free 5-Minute Diagnostic