Quick answer
Sometimes. If you’re self-employed, you can usually deduct your health insurance premiums directly from your income. Otherwise, premiums you pay with after-tax money, including marketplace premiums and Medicare premiums, count as medical expenses, but you can deduct only the part of your total medical expenses above 7.5% of your adjusted gross income, and only if you itemize. Premiums you pay through work with pre-tax money aren’t deductible, because they’re already untaxed.
Key takeaways
- Self-employed people can usually deduct premiums without itemizing, using Form 7206.
- Job-based premiums paid through payroll are usually pre-tax already.
- Other premiums count toward the medical expense deduction, which covers costs above 7.5% of AGI.
- Medicare Part B and Part D premiums count as medical expenses.
- HSA contributions are deductible even if you don’t itemize.
On this page
When health insurance premiums are deductible
| Your situation | Can you deduct premiums? |
|---|---|
| Self-employed with a net profit | Usually yes, as an adjustment to income (Form 7206), if you weren’t eligible for an employer-subsidized plan |
| Job-based coverage paid through payroll | No. Your share is usually already taken out before taxes |
| Marketplace or other individual plan | Yes, the part you paid after any tax credit, as an itemized medical expense |
| Medicare Part B, Part D, Medicare Advantage and Medigap | Yes, as an itemized medical expense |
| Long-term care insurance | Yes, up to a limit based on your age |
See health insurance for the self-employed for the self-employed deduction, and who is eligible for Medicare for Medicare coverage.
How the medical expense deduction works
If you itemize, add up your qualifying medical expenses for the year, including premiums you paid with after-tax money. You can deduct the amount above 7.5% of your AGI. For example, with an AGI of $60,000, the first $4,500 of medical expenses doesn’t count; if you had $10,000 in expenses, you could deduct $5,500.
Because the standard deduction is large, many people won’t benefit unless they had big medical bills.
Other medical expenses that count
The IRS lets you include many medical costs, such as:
- Acupuncture
- Breast pumps and supplies
- Eye exams, glasses, contact lenses and laser eye surgery
- Hearing aids
- Nursing home care when it’s mainly for medical care
- Surgery, other than cosmetic surgery
- Therapy, including psychotherapy
- Vasectomy
- Wheelchairs and crutches
- X-rays and lab fees
- Weight-loss programs, only when treating a specific disease diagnosed by a doctor, like obesity
- Wigs for hair loss from a disease, long-term care, and travel for medical care (21 cents a mile for 2025)
These examples come from IRS Publication 502. Don’t count anything that was reimbursed or paid with pre-tax money.
Health savings accounts
If you have an HSA-eligible plan, you can deduct HSA contributions you make yourself, even if you don’t itemize, up to $4,400 for self-only coverage or $8,750 for a family in 2026. Money you spend from the HSA on medical care is tax-free.
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Frequently asked questions
Are marketplace premiums tax-deductible?
The part you pay yourself, after any premium tax credit, counts as an itemized medical expense. If you’re self-employed, you may be able to deduct it as an adjustment to income instead.
Can I deduct health insurance through my employer?
Usually not, because your share is taken out of your pay before taxes.
Are Medicare premiums tax-deductible?
Yes. Part B, Part D, Medicare Advantage and Medigap premiums count as medical expenses if you itemize. Self-employed people may be able to deduct them as an adjustment to income.
Sources
This article is general information, not tax advice. Talk with a tax professional about your situation. Last reviewed September 2026.