The 7.5% AGI Floor Explained
You can only deduct medical expenses that exceed 7.5% of your adjusted gross income. This threshold was made permanent by the Consolidated Appropriations Act. For example: if your AGI is $60,000, the first $4,500 of medical expenses (including mileage) is not deductible — only the amount above $4,500 counts.
Because of this floor, most taxpayers with moderate medical expenses and an AGI above $50,000 will not benefit from the medical mileage deduction. This is by design — the deduction targets taxpayers with unusually high healthcare costs relative to income.
Itemizing vs the Standard Deduction
Medical expenses are an itemized deduction on Schedule A. You should only itemize if your total itemized deductions (mortgage interest, state and local taxes up to $10,000, charitable contributions, and medical expenses above the 7.5% floor) exceed the standard deduction. For 2026, the standard deduction is $16,100 for single filers and $32,200 for married filing jointly.
A bunching strategy can help: schedule elective medical procedures in a single tax year to push total expenses above the 7.5% threshold, then take the standard deduction in other years.
What Qualifies as Medical Travel
| Trip Type | Deductible? | Rate |
|---|---|---|
| Doctor, dentist, surgeon visits | Yes | 20.5¢ Jan-Jun; 23.5¢ Jul-Dec |
| Hospital and surgery travel | Yes | 20.5¢ Jan-Jun; 23.5¢ Jul-Dec |
| Physical therapy, occupational therapy | Yes | 20.5¢ Jan-Jun; 23.5¢ Jul-Dec |
| Pharmacy pickups (prescriptions) | Yes | 20.5¢ Jan-Jun; 23.5¢ Jul-Dec |
| Mental health / therapy appointments | Yes | 20.5¢ Jan-Jun; 23.5¢ Jul-Dec |
| Travel for dependent medical care | Yes | 20.5¢ Jan-Jun; 23.5¢ Jul-Dec |
| Cosmetic procedures (not medically necessary) | No | — |
Qualifying medical travel per IRS Publication 502.
Why the Medical Rate Is Lower Than Business
The business mileage rate is 72.5¢ for Jan-Jun 2026 and 76¢ for Jul-Dec, covering both fixed and variable vehicle costs — depreciation, insurance, fuel, maintenance, and registration. The medical rate is 20.5¢ for Jan-Jun and 23.5¢ for Jul-Dec, covering only variable costs: primarily fuel and maintenance. The IRS assumes you already own the car for personal reasons, so the fixed ownership costs would exist regardless of medical travel.
Recordkeeping for Medical Mileage
For each medical trip, record: date of travel, healthcare provider name and address, purpose of visit, and round-trip miles. Parking fees and tolls at medical facilities are deductible separately. If you take an Uber or taxi to a medical appointment, the fare is deductible as a medical transportation expense.
Medical mileage is claimed on Schedule A, Line 1 (medical and dental expenses). You do not need to submit the mileage log with your return, but keep it in case of audit.