When itemizing deductions on your federal tax return, you may be able to claim unreimbursed medical expenses paid for yourself, your spouse, and your dependents. But the definition of a “dependent” for medical expense purposes isn’t always straightforward. The IRS provides specific guidelines that determine who qualifies, and in some cases, you can even deduct medical expenses for someone who is not your dependent on your return. In this detailed 2025 guide, we’ll explore who qualifies as a dependent for medical deduction purposes, what types of expenses are eligible, and how to claim the deduction properly.
Understanding Medical Expense Deductions
The IRS allows you to deduct unreimbursed medical and dental expenses that exceed 7.5% of your adjusted gross income (AGI) if you itemize on Schedule A of Form 1040. These expenses must be for you, your spouse, or your qualifying dependents. The deduction can include a wide range of services and treatments, from doctor visits and prescriptions to hospital stays and long-term care.
To maximize this deduction, you need to know exactly who counts as a qualifying individual for whom you can deduct expenses.
Who Is a Qualifying Dependent for Medical Deduction Purposes?
According to IRS rules, you can deduct medical expenses for the following individuals, even if they are not claimed as a dependent on your tax return:
- Your spouse
- Your dependents as defined for tax purposes
- Any person you could have claimed as a dependent (except due to income or filing status)
This means that even if you do not claim someone on your return because of income limitations or joint filing status, you may still deduct their medical expenses if you provided more than half of their total support during the year.
Criteria for a Dependent Under IRS Rules
To qualify as a dependent for medical expense deductions, the individual must meet the criteria for either a “qualifying child” or “qualifying relative” under IRS dependency rules.
1. Qualifying Child
A qualifying child must:
- Be your child, stepchild, foster child, sibling, or a descendant of any of them
- Be under age 19 (or under age 24 if a full-time student, or any age if permanently disabled)
- Live with you for more than half the year
- Not provide more than half of their own support
- Not file a joint return (except for refund purposes)
2. Qualifying Relative
A qualifying relative must:
- Not be a qualifying child of another taxpayer
- Either live with you all year as a member of your household, or be related to you
- Have gross income below $5,050 (for 2025, subject to inflation adjustment)
- Receive more than half of their total support from you
Even if someone doesn’t meet the gross income test (such as an elderly parent with high Social Security income), you may still be able to deduct their medical expenses if they would otherwise qualify and you pay for their care.
Can You Deduct Expenses for Someone Not Claimed as a Dependent?
Yes. The IRS allows you to deduct medical expenses for a person who would have qualified as your dependent except:
- They earned too much income
- They filed a joint return with someone else
- You or another taxpayer can be claimed as a dependent by someone else
This rule is particularly helpful when providing medical care for elderly parents or adult children who do not live with you but depend on you financially for their healthcare needs.
What Medical Expenses Are Deductible?
Once you establish that the person qualifies, you can deduct unreimbursed expenses paid for their care, including:
- Doctor visits, dental care, and surgeries
- Prescription medications and insulin
- Hospital and nursing care services
- Health insurance premiums (if not pre-tax or reimbursed)
- Medical equipment like wheelchairs and hearing aids
- Mileage, tolls, and transportation costs for medical care
- Psychiatric and psychological therapy
- Long-term care services and insurance (within IRS limits)
These expenses must be paid during the tax year, and they must not have been reimbursed by insurance or paid using pre-tax funds such as an HSA or FSA.
Special Considerations for Divorced or Separated Parents
If you and your former spouse share custody of a child, only the parent who actually paid the medical expense can deduct it—even if the other parent claims the child as a dependent. This is important to keep in mind when you share medical expenses or insurance coverage post-divorce.
Additionally, if you pay child support that includes healthcare expenses, and you are not the custodial parent, you can still deduct the out-of-pocket medical expenses you directly paid for your child’s care.
How to Claim the Deduction
To deduct medical expenses for a dependent:
- Itemize deductions using Schedule A on Form 1040
- Add up all unreimbursed medical expenses for yourself, your spouse, and qualifying dependents
- Subtract 7.5% of your AGI from the total medical expenses
- Enter the remaining amount on Line 4 of Schedule A
Only the amount above 7.5% of your AGI is deductible. For example, if your AGI is $100,000 and you spent $12,000 on medical care, your deductible amount is $4,500 ($12,000 – $7,500).
Recordkeeping Tips
To support your claim in case of an audit, keep the following documentation:
- Receipts and invoices for all medical services
- Proof of payment (checks, credit card statements)
- Doctor’s prescriptions, especially for medical equipment or therapy
- Proof of support for the dependent (e.g., bank transfers, rent payments, groceries)
- Written statement from healthcare providers confirming services rendered
Maintain these records for at least three years after you file your return, and consider storing digital backups for convenience and security.
Conclusion
Deducting medical expenses for dependents can provide substantial tax relief, especially when caring for children, elderly parents, or other loved ones with ongoing healthcare needs. The IRS allows you to include expenses for both traditional dependents and those who would otherwise qualify but don’t meet certain technical requirements. By understanding the rules and keeping detailed records, you can ensure that you’re maximizing your deductions and staying compliant with IRS guidelines in 2025.
If you’re unsure whether someone qualifies or how to calculate your total deduction, consult IRS Publication 502 or work with a licensed tax professional to evaluate your eligibility and documentation strategy.
