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Insurance Premiums: Medical Expense Deductions (2025 IRS Guide)

This guide covers “Insurance Premiums” within medical expense deductions. The following material presents the IRS treatment of this topic, including the qualifications, exceptions, and examples in the source section. Read the rules alongside the facts of your own situation before deciding what to report, deduct, or document.

Adapted from Publication 502 (2025), Medical and Dental Expenses, published by the Internal Revenue Service. This guide retains the source edition’s years, amounts, deadlines, and examples. It is guidance for that edition, not a statement that the same figures apply to every tax year.

Context for these rules

Following is a list of items that you can include in figuring your medical expense deduction. The items are listed in alphabetical order.

This list doesn’t include all possible medical expenses. To determine if an expense not listed can be included in figuring your medical expense deduction, see What Are Medical Expenses, earlier.

Insurance Premiums

You can include in medical expenses insurance premiums you pay for policies that cover medical care. You can’t include in medical expenses insurance premiums that were paid and for which you are claiming a credit or deduction. Medical care policies can provide payment for treatment that includes:

  • Hospitalization, surgical services, X-rays;

  • Prescription drugs and insulin;

  • Dental care;

  • Replacement of lost or damaged contact lenses; and

  • Long-term care (subject to additional limitations). See Qualified Long-Term Care Insurance Contracts under Long-Term Care, later.

If you have a policy that provides payments for other than medical care, you can include the premiums for the medical care part of the policy if the charge for the medical part is reasonable. The cost of the medical part must be separately stated in the insurance contract or given to you in a separate statement.

Employer-Sponsored Health Insurance Plan

Don’t include in your medical and dental expenses any insurance premiums paid by an employer-sponsored health insurance plan unless the premiums are included on your Form W-2, Wage and Tax Statement. Also, don’t include any other medical and dental expenses paid by the plan unless the amount paid is included on your Form W-2.

Example.

You are a federal employee participating in the premium conversion plan of the Federal Employee Health Benefits (FEHB) program. Your share of the FEHB premium is paid by making a pre-tax reduction in your salary. Because you are an employee whose insurance premiums are paid with money that is never included in your gross income, you can’t deduct the premiums paid with that money.

Long-term care services.

Contributions made by your employer to provide coverage for qualified long-term care services under a flexible spending or similar arrangement must be included in your income. This amount will be reported as wages on your Form W-2.

Retired public safety officers.

If you are a retired public safety officer, don’t include as medical expenses any health or long-term care insurance premiums that you elected to have paid with tax-free distributions from a retirement plan. This applies only to distributions that would otherwise be included in income.

Health reimbursement arrangement (HRA).

If you have medical expenses that are reimbursed by a health reimbursement arrangement, you can’t include those expenses in your medical expenses.

Medicare Part A

If you are covered under social security (or if you are a government employee who paid Medicare tax), you are enrolled in Medicare Part A. The payroll tax paid for Medicare Part A isn’t a medical expense.

If you aren’t covered under social security (or weren’t a government employee who paid Medicare tax), you can voluntarily enroll in Medicare Part A. In this situation, you can include the premiums you paid for Medicare Part A as a medical expense.

Medicare Part B

Medicare Part B is a supplemental medical insurance. Premiums you pay for Medicare Part B are a medical expense. Check the information you received from the Social Security Administration to find out your premium.

Medicare Part D

Medicare Part D is a voluntary prescription drug insurance program for persons with Medicare Part A or B. You can include as a medical expense premiums you pay for Medicare Part D.

Personal Protective Equipment

You can include in medical expenses the amounts you pay for personal protective equipment, such as masks, hand sanitizer and hand sanitizing wipes, for the primary purpose of preventing the spread of Coronavirus Disease 2019 (COVID-19). For more information, see IRS Announcement 2021-7.

Prepaid Insurance Premiums

Premiums you pay before you are age 65 for insurance for medical care for yourself, your spouse, or your dependents after you reach age 65 are medical care expenses in the year paid if they are:

  1. Payable in equal yearly installments or more often; and

  2. Payable for at least 10 years, or until you reach age 65 (but not for less than 5 years).

Unused Sick Leave Used To Pay Premiums

You must include in gross income cash payments you receive at the time of retirement for unused sick leave. You must also include in gross income the value of unused sick leave that, at your option, your employer applies to the cost of your continuing participation in your employer’s health plan after you retire. You can include this cost of continuing participation in the health plan as a medical expense.

If you participate in a health plan where your employer automatically applies the value of unused sick leave to the cost of your continuing participation in the health plan (and you don’t have the option to receive cash), don’t include the value of the unused sick leave in gross income. You can’t include this cost of continuing participation in that health plan as a medical expense.

Insurance Premiums You Can’t Include

You can’t include premiums you pay for:

  • Life insurance policies;

  • Policies providing payment for loss of earnings;

  • Policies for loss of life, limb, sight, etc.;

  • Policies that pay you a guaranteed amount each week for a stated number of weeks if you are hospitalized for sickness or injury;

  • The part of your car insurance that provides medical insurance coverage for all persons injured in or by your car because the part of the premium providing insurance for you, your spouse, and your dependents isn’t stated separately from the part of the premium providing insurance for medical care for others; or

  • Health or long-term care insurance if you elected to pay these premiums with tax-free distributions from a retirement plan and these distributions would otherwise have been included in income.

Taxes imposed by any governmental unit, such as Medicare taxes, aren’t insurance premiums.

Coverage for nondependents.

Generally, you can’t deduct any additional premium you pay as the result of including on your policy someone who isn’t your spouse or dependent, even if that person is your child under age 27. However, you can deduct the additional premium if that person is:

  • Your child whom you don’t claim as a dependent because of the rules for children of divorced or separated parents;

  • Any person you could have claimed as a dependent on your return except that person received $5,200 or more of gross income or filed a joint return; or

  • Any person you could have claimed as a dependent except that you, or your spouse if filing jointly, can be claimed as a dependent on someone else’s 2025 return.


Also, if you had family coverage when you added this individual to your policy and your premiums didn’t increase, you can enter on Schedule A (Form 1040) the full amount of your medical and dental insurance premiums.

Using the guidance

Keep the documents that establish the dates, amounts, and circumstances described above. References to other chapters, forms, worksheets, or earlier and later sections refer to the linked IRS publication. Check the full publication and its updates before relying on a rule for a different tax year or a situation not addressed here.

Sources and further reading

The cited U.S. government text is in the public domain. Source accessed October 28, 2026. Fynoptic has organized this material for educational use and is independent of, and not endorsed by, the IRS.

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