You can’t deduct the following expenses:
Cosmetic surgery to improve your appearance unless the surgery addresses problems resulting from an accident, deformity or disease. This includes teeth whitening.
Medical marijuana, even if it’s legal in your state, because it’s not legal under federal law.
Other nonprescription medications, except for insulin — even though those expenses are eligible for reimbursement if you contribute to a flexible spending account (FSA), health savings account (HSA) or similar pre-tax accounts. That includes herbal, nutritional or vitamin supplements unless a medical provider recommends them as treatment for a specific medical condition a physician has diagnosed.
Can I deduct Medicare premiums if self-employed?
If you’re self-employed, you may be able to deduct premiums for Medicare or other eligible health insurance from your income without having to itemize or meet the 7.5 percent threshold. Even if you were primarily retired but did some consulting work, you may be eligible to deduct all or part of your premiums, but your other out-of-pocket medical costs would have to qualify for the medical expense deduction.
First, your business must have made a profit after subtracting other expenses.
You can qualify for the self-employed health insurance deduction only if both you and your spouse were ineligible to participate in an employer-subsidized health plan. The calculation is more complicated if you received a subsidy for buying health insurance on the federal or a state insurance marketplace.
If you qualify, you can deduct premiums for Medicare Part B and Part A if you’re required to pay them, as well as Part D, Medicare Advantage and Medigap premiums, and eligible long-term care insurance premiums. You can claim this deduction as an adjustment to income on Schedule 1 when filing your Form 1040.
Like other deductions, your eligibility can vary by month, allowing you to take a partial-year deduction if you turned 65 this year and started paying your Medicare premiums.
Can I use money from my health savings account?
You can withdraw money tax-free from a health savings account (HSA) to pay Medicare premiums after you turn 65, including premiums for Medicare Part A, Part B, Part D prescription drug plans and Medicare Advantage. However, the IRS doesn’t allow tax-free HSA withdrawals for Medigap premiums.
You can’t make new contributions to an HSA after you enroll in Medicare, but you can make tax-free withdrawals for other eligible medical expenses at any age. You can’t take a tax deduction and tax-free HSA withdrawals for the same expenses.
This story, first published Oct. 27, 2022, was updated with changes, including 2025 tax law information.