Are Medical Premiums Tax Deductible?
Written by
Rudri Patel
Edited by
Joe Evans
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Wondering if you can write off your health insurance costs on your taxes? You’re not alone. Every year, taxpayers ask the same question: Are medical premiums tax-deductible?
The short answer: Yes, but only in certain situations. If you’re self-employed, you can usually deduct 100% of your premiums. If you’re an employee, you might be out of luck — unless you meet a few specific conditions.
In this guide, we’ll walk you through:
- When premiums are deductible (and when they aren’t)
- The rules for employees vs. self-employed individuals
- What IRS forms to use
- What other medical expenses can you deduct
- How to calculate your deduction the easy way
Let’s break it all down.
Quick Answer: When Are Medical Premiums Tax-Deductible?
Here’s a snapshot of common scenarios:
| Situation | Are Medical Premiums Tax-Deductible? | Notes |
|---|---|---|
| Self-employed, paying out of pocket | Yes | You can deduct 100% of premiums using Form 7206 |
| W-2 employee with pre-tax payroll plan | No | Already excluded from taxable income |
| W-2 employee paying with after-tax money | Sometimes | Must itemize and exceed 7.5% of AGI |
| COBRA coverage or ACA marketplace plan | Sometimes | Deductible if not subsidized and paid with after-tax funds |
| Medicare (Parts B, D, Medigap) | COBRA coverage or an ACA marketplace plan | Deductible if you itemize or are self-employed |
Are Medical Premiums Tax-Deductible for Employees?
If you’re an employee, most premiums you pay through your job aren’t deductible, because they’re taken out of your paycheck before taxes. That means you’ve already received the tax break.
However, your premiums may be deductible if:
- You pay for coverage out of pocket with after-tax money
- You’re paying COBRA or ACA marketplace premiums without a subsidy
- You’re covering a domestic partner not listed as your dependent
But there’s a catch: You must itemize your deductions and only the portion of your medical expenses that exceeds 7.5% of your adjusted gross income (AGI) counts. In 2022, only about 12% of tax filers itemized deductions, which means most people won’t qualify unless they have significant out-of-pocket medical costs.
Are Medical Premiums Tax-Deductible for the Self-Employed?
Yes — if you’re self-employed and pay for your insurance, you can deduct your medical premiums even if you don’t itemize your deductions.
This includes premiums for:
- Health insurance
- Dental and vision plans
- Qualified long-term care insurance
To qualify, you must:
- Have a net profit for the year
- Not eligible for other health insurance (like through a spouse’s employer)
- Pay premiums using your funds
The average annual health insurance premium for individual coverage was $8,435 in 2023, according to the Kaiser Family Foundation. This deduction can make a real impact on your tax bill.
How To Calculate the Deduction (Self-Employed Only)
Here’s how to calculate your deduction if you qualify:
Self-Employed Deduction Steps:
- Total your premiums for the year
- Confirm you have a net business profit (your deduction can’t exceed your business income)
- Complete Form 7206
- Transfer the amount to Schedule 1, Line 17
- Attach to your Form 1040 when you file
Tip: If you’re partially self-employed and partially an employee during the year, you can only deduct premiums for the months you were self-employed.
What Other Medical Expenses Are Deductible?
If you itemize your deductions and meet the 7.5% AGI threshold, you can also deduct other unreimbursed medical expenses, including:
- Doctor and hospital bills
- Prescription medications and insulin
- Dental and vision care
- Hearing aids and batteries
- Long-term care services
- Medical travel (21 cents per mile in 2024)
Over 17% of Americans faced high out-of-pocket healthcare costs in 2023, making these deductions even more valuable for those who itemize.
How To Claim the Deduction
There are a few key ways to claim your deduction. Let’s dig into it:
For Self-Employed Individuals:
- Complete Form 7206
- Transfer the deduction to Schedule 1, Line 17
- Attach both to Form 1040
- Keep documentation of every payment
For Employees (Itemized Deduction):
- Use Schedule A to report medical expenses
- Deduct only the amount that exceeds 7.5% of AGI
- Include premiums, copays, prescriptions and more
- Keep receipts, bills, and insurance records in case of an audit
Final Take to GO: What To Know Before You File
If you’ve paid out of pocket for health coverage this year, don’t leave money on the table. Whether you’re self-employed, switching jobs or covering your own ACA plan, it’s worth checking if those premiums qualify for a tax break.
Here’s what to remember:
- Are medical premiums tax-deductible? Yes — if you’re self-employed or meet itemization rules
- Use Form 7206 and Schedule 1 if you’re self-employed
- Use Schedule A if you’re itemizing as a W-2 employee or retiree
- No double-dipping: premiums paid pre-tax (via payroll, HSA or FSA) aren’t deductible again
- Keep records of every premium payment and medical expense in case of an audit
Bottom line: A little tax prep now can save you big later. If your medical expenses are piling up, make sure you know what qualifies and claim every dollar you can.
FAQs About Medical Premium Deductions
Here are the answers to some of the most frequently asked questions about whether medical premiums are tax-deductible and how they work:- Can I deduct premiums for COBRA coverage?
- Yes -- if you paid with after-tax dollars and itemize deductions.
- Are ACA marketplace premiums deductible?
- Yes, if you paid them yourself and did not receive a premium tax credit or subsidy.
- What about Medicare?
- Yes -- Medicare Part B, Part D and Medigap premiums are deductible if you itemize or are self-employed and pay for them directly.
- Can I deduct premiums if I switch jobs mid-year?
- Yes, but only for the period when you paid with after-tax dollars or were self-employed.
Data is accurate as of August 6, 2025, and is subject to change.
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