What Expenses Aren’t Includible?: Medical Expense Deductions (2025 IRS Guide)
This guide covers “What Expenses Aren’t Includible?” 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.
What Expenses Aren’t Includible?
Following is a list of some items that you can’t include in figuring your medical expense deduction. The items are listed in alphabetical order.
Baby Sitting, Childcare, and Nursing Services for a Normal, Healthy Baby
You can’t include in medical expenses amounts you pay for the care of children, even if the expenses enable you, your spouse, or your dependent to get medical or dental treatment. Also, any expense allowed as a childcare credit can’t be treated as an expense paid for medical care.
Controlled Substances
You can’t include in medical expenses amounts you pay for controlled substances (such as marijuana) that aren’t legal under federal law, even if such substances are legalized by state law.
Cosmetic Surgery
Generally, you can’t include in medical expenses the amount you pay for cosmetic surgery. This includes any procedure that is directed at improving the patient’s appearance and doesn’t meaningfully promote the proper function of the body or prevent or treat illness or disease. You generally can’t include in medical expenses the amount you pay for procedures such as face lifts, hair transplants, hair removal (electrolysis), and liposuction.
You can include in medical expenses the amount you pay for cosmetic surgery if it is necessary to improve a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease.
Example.
An individual undergoes surgery that removes a breast as part of treatment for cancer. The individual pays a surgeon to reconstruct the breast. The surgery to reconstruct the breast corrects a deformity directly related to the disease. The cost of the surgery is includible in the individual’s medical expenses.
Dancing Lessons
You can’t include in medical expenses the cost of dancing lessons, swimming lessons, etc., even if they are recommended by a doctor, if they are only for the improvement of general health.
Diaper Service
You can’t include in medical expenses the amount you pay for diapers or diaper services, unless they are needed to relieve the effects of a particular disease.
Electrolysis or Hair Removal
See Cosmetic Surgery, earlier.
Flexible Spending Arrangement
You can’t include in medical expenses amounts for which you are fully reimbursed by your flexible spending arrangement if you contribute a part of your income on a pre-tax basis to pay for the qualified benefit.
Funeral Expenses
You can’t include in medical expenses amounts you pay for funerals.
Future Medical Care
Generally, you can’t include in medical expenses current payments for medical care (including medical insurance) to be provided substantially beyond the end of the year. This rule doesn’t apply in situations where the future care is purchased in connection with obtaining lifetime care, as explained under Lifetime Care—Advance Payments, or qualified long-term care insurance contracts, as explained under Long-Term Care, earlier.
Hair Transplant
See Cosmetic Surgery, earlier.
Health Club Dues
You can’t include in medical expenses health club dues or amounts paid to improve one’s general health or to relieve physical or mental discomfort not related to a particular medical condition.
You can’t include in medical expenses the cost of membership in any club organized for business, pleasure, recreation, or other social purpose.
Health Savings Accounts
You can’t include in medical expenses amounts you contribute to a health savings account. You can’t include expenses you pay for with a tax-free distribution from your health savings account. You also can’t use other funds equal to the amount of the distribution and include the expenses. For more information, see Pub. 969.
Household Help
You can’t include in medical expenses the cost of household help, even if such help is recommended by a doctor. This is a personal expense that isn’t deductible. However, you may be able to include certain expenses paid to a person providing nursing-type services. For more information, see Nursing Services, earlier, under What Medical Expenses Are Includible. Also, certain maintenance or personal care services provided for qualified long-term care can be included in medical expenses. For more information, see Long-Term Care, earlier, under What Medical Expenses Are Includible.
Illegal Operations and Treatments
You can’t include in medical expenses amounts you pay for illegal operations, treatments, or controlled substances whether rendered or prescribed by licensed or unlicensed practitioners.
Insurance Premiums
See Insurance Premiums under What Medical Expenses Are Includible, earlier.
Maternity Clothes
You can’t include in medical expenses amounts you pay for maternity clothes.
Medical Savings Account (MSA)
You can’t include in medical expenses amounts you contribute to an Archer MSA. You can’t include expenses you pay for with a tax-free distribution from your Archer MSA. You also can’t use other funds equal to the amount of the distribution and include the expenses. For more information on Archer MSAs, see Pub. 969.
Medicines and Drugs From Other Countries
In general, you can’t include in your medical expenses the cost of a prescribed drug brought in (or ordered and shipped) from another country. You can only include the cost of a drug that was imported legally. For example, you can include the cost of a prescribed drug the Food and Drug Administration announces can be legally imported by individuals.
You can include the cost of a prescribed drug you purchase and consume in another country if the drug is legal in both the other country and the United States.
Nonprescription Drugs and Medicines
Except for insulin, you can’t include in medical expenses amounts you pay for a drug that isn’t prescribed. A prescribed drug is one that requires a prescription by a doctor for its use by an individual.
Example.
Your doctor recommends that you take aspirin. Because aspirin is a drug that doesn’t require a physician’s prescription for its use by an individual, you can’t include its cost in your medical expenses.
Nutritional Supplements
You can’t include in medical expenses the cost of nutritional supplements, vitamins, herbal supplements, “natural medicines,” etc., unless they are recommended by a medical practitioner as treatment for a specific medical condition diagnosed by a physician. These items are taken to maintain your ordinary good health and aren’t for medical care.
Personal Use Items
You can’t include in medical expenses the cost of an item ordinarily used for personal, living, or family purposes unless it is used primarily to prevent or alleviate a physical or mental disability or illness. For example, the cost of a toothbrush and toothpaste is a nondeductible personal expense.
In order to accommodate an individual with a physical disability, you may have to purchase an item ordinarily used as a personal, living, or family item in a special form. You can include the excess of the cost of the item in a special form over the cost of the item in normal form as a medical expense. See Braille Books and Magazines under What Medical Expenses Are Includible, earlier.
Premium Tax Credit
You can’t include in medical expenses the amount of health insurance premiums paid by or through the premium tax credit. You also can’t include in medical expenses any amount of advance payments of the premium tax credit made that you did not have to pay back. However, any amount of advance payments of the premium tax credit that you did have to pay back can be included in medical expenses.
Surrogacy Expenses
You can’t include in medical expenses the amounts you pay for the identification, retention, compensation, and medical care of a gestational surrogate because they are paid for an unrelated party who is not you, your spouse, or your dependent.
Swimming Lessons
See Dancing Lessons, earlier.
Teeth Whitening
You can’t include in medical expenses amounts paid to whiten teeth. See Cosmetic Surgery, earlier.
Veterinary Fees
You generally can’t include veterinary fees in your medical expenses, but see Guide Dog or Other Service Animal under What Medical Expenses Are Includible, earlier.
Weight-Loss Program
You can’t include in medical expenses the cost of a weight-loss program if the purpose of the weight loss is the improvement of appearance, general health, or sense of well-being. You can’t include amounts you pay to lose weight unless the weight loss is a treatment for a specific disease diagnosed by a physician (such as obesity, hypertension, or heart disease). If the weight-loss treatment isn’t for a specific disease diagnosed by a physician, you can’t include either the fees you pay for membership in a weight-reduction group or fees for attendance at periodic meetings. Also, you can’t include membership dues in a gym, health club, or spa.
You can’t include the cost of diet food or beverages in medical expenses because the diet food and beverages substitute for what is normally consumed to satisfy nutritional needs.
See Weight-Loss Program under What Medical Expenses Are Includible, earlier.
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
- Publication 502 (2025), Medical and Dental Expenses: What Expenses Aren’t Includible? — Internal Revenue Service; 2025 edition.
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.