Yes, they count. Most people still deduct nothing.

Search this question and every result says the same word: yes. That answer is correct and it is close to useless, because it stops one step before the part that decides your refund. Medicare premiums are a deductible medical expense. Whether deducting them puts a single dollar back in your pocket depends on two hurdles that most retirees never clear, and on one door that skips both.

Here is where the money actually goes on the return, and what has to be true for it to survive the trip.

Are Medicare premiums tax deductible?

Yes, as a medical expense, which is a narrower thing than it sounds. IRS Publication 502 is the list of what counts, and Medicare premiums are on it. But medical expenses aren't subtracted from your income the way a business expense is. They go on Schedule A, they get cut down by a floor tied to your income, and what's left only helps if you itemize at all.

So the useful version of the answer has three parts: which premiums count, where they go, and how much of them survives.Source: IRS, Publication 502, Medical and Dental Expenses.

Which Medicare premiums count?

Publication 502 names three of them by name, and the treatment differs by part.

Medicare Advantage and Medigap premiums aren't named in that list, and the honest way to say why is that they don't need to be. The general rule above them covers it: you can include premiums you pay for policies that cover medical care. An Advantage plan premium and a Medigap premium are both that. If you pay one, it belongs on the same line as your Part B premium.Source: IRS, Publication 502, Insurance Premiums.

Two things knock premiums back off the list. Anything an employer paid isn't yours to deduct unless it showed up in your W-2 wages. And anything you already got back, from insurance or any other source, has to be subtracted before you write the number down.

Where do Medicare premiums go on the tax return?

This is the part the general answers skip. Four lines on Schedule A (Form 1040), in order, and the fourth one is the only number that reaches your taxable income.

One line of the Schedule A instructions catches people who qualify for both routes: if you claimed the self-employed health insurance deduction on Schedule 1, line 17, you have to reduce the premiums on Schedule A by that amount. You can split premiums between the two, and you can't count the same dollar twice.Source: IRS, Instructions for Schedule A (2025).

Why does the 7.5% floor stop most people?

Because Medicare premiums, on their own, are usually smaller than the floor. Run the arithmetic on a normal retired couple.

The floor moves with your income, which is why the deduction behaves backwards from what people expect. A big withdrawal from a traditional IRA raises your AGI, and a higher AGI raises the floor your medical bills have to clear. That interaction is the same one behind the RMD tax torpedo, and it's worth looking at before you decide which account to draw from in a heavy medical year.

The deduction starts working when the rest of the medical column is large. Add a Medigap plan at $200 a month, Part D at $60 a month, $3,000 of dental work and a pair of hearing aids, and that same couple can be at $12,000 or more. Subtract the $4,500 floor and $7,500 reaches line 4. That's a real number. Then it meets the second hurdle.

Do you have to itemize to deduct Medicare premiums?

For this route, yes, and this is where the deduction dies for most households. Schedule A only does anything if your itemized total beats your standard deduction, and the standard deduction for someone 65 or older is large.

Take the couple above with $7,500 surviving the medical floor. Add $10,000 of state and local taxes, the most Schedule A allows, and $2,000 of charitable giving. Their itemized total is $19,500 against a standard deduction of $34,700. They take the standard deduction, and every dollar of that medical work changes nothing on the return.

That isn't a reason to skip the arithmetic. It's a reason to do it once, honestly, before spending an evening collecting receipts. If your mortgage is paid off and your state taxes are modest, the two hurdles together mean the medical deduction is out of reach in an ordinary year, and it arrives only in the year something expensive happens: a long nursing home stay, a surgery, a spouse in memory care.

If that's you, the deduction that doesn't require any of this is the $6,000 senior deduction. It's worth up to $6,000 per qualifying person aged 65 or older, it's claimed on Schedule 1-A, and you get it whether you itemize or take the standard deduction. Different rule, different form, no floor.

Is there a way to deduct Medicare premiums without the 7.5% floor?

There is, and it's the reason this article exists rather than the yes-or-no version. If you have self-employment income, your Medicare premiums can go on Schedule 1 (Form 1040), line 17 as the self-employed health insurance deduction. No floor. No itemizing. It comes off your income before AGI is even calculated.

The IRS says it in the instructions for the form itself, and the sentence is worth reading exactly as written: "Medicare premiums you voluntarily pay to obtain insurance in your name that is similar to qualifying private health insurance can be used to figure the deduction."Source: IRS, Instructions for Form 7206 (2025).

Most people figure the amount on the worksheet in the Form 1040 instructions. You need Form 7206 instead if you had more than one source of self-employment income, if you file Form 2555, or if long-term care premiums are in the mix.

Say a 67-year-old runs a consulting business with $30,000 of net profit and pays $2,220 of Part B, $720 of Part D and $2,400 of Medigap. That's $5,340, all of it on Schedule 1, line 17, with no floor to clear and no need to itemize. The same $5,340 on Schedule A would have been wiped out twice over.

The second effect is quieter and sometimes larger. Because this deduction lands above AGI, it lowers the income figure that decides how much of your Social Security is taxable, and the income figure that sets your Medicare surcharge two years later. One deduction, three places it lands. How Social Security gets taxed covers the first of those.

Does the IRMAA surcharge count too?

Yes. A high-income surcharge isn't a separate tax with its own rules. It's an addition to the Part B or Part D premium you pay, so it goes on line 1 with everything else.

The amounts are not small. In 2026, a single filer with modified AGI over $109,000, or a couple over $218,000, pays a Part B total between $284.10 and $689.90 a month instead of $202.90. At the top bracket that's $8,278.80 a year for a couple in Part B premiums alone, and the whole amount is a medical expense.Source: CMS, 2026 Medicare Parts A & B Premiums and Deductibles.

A surcharge you shouldn't be paying is a bigger win than a deduction. If your income dropped because you retired, sold a business or lost a spouse, the surcharge can be recalculated on the year you're actually living in. That's the IRMAA appeal and Form SSA-44, and the mechanics of the surcharge itself are in the IRMAA explainer.

What if the premium comes out of your Social Security check?

You still paid it. Money withheld from your benefit before it reaches your bank account is money you paid, and it counts exactly like a premium you wrote a check for. Publication 502 points you at the statement Social Security sent you to find the figure, which is the practical instruction: the amount is on your SSA-1099, not in your bank records, because it never passed through your account.Source: IRS, Publication 502, Medicare Part B.

That single fact is the most common way this deduction goes unclaimed. People add up what left their checking account, find no Medicare premiums there, and conclude they didn't pay any.

The honest verdict

Medicare premiums are deductible, and for most retirees that sentence is true and worthless. The 7.5% floor eats the premiums alone, and the standard deduction at 65 eats what's left of Schedule A. The households where this genuinely pays are narrower than the search results suggest: someone with self-employment income, and anyone having an expensive medical year on a modest income.

If you're neither, this deduction isn't yours, and hunting for receipts won't change that. Your money is in the senior deduction, which needs no itemizing, and in not overpaying a surcharge you can have recalculated.

Check the rule. Not the slogan.

What to check this week

• Pull your SSA-1099 and find the Medicare premiums withheld from your benefit. That's your starting number, and it isn't in your bank statements.
• Multiply your AGI by 0.075. If your total medical bills for the year are under that, stop here for this year.
• If they're over it, add the excess to your other itemized deductions and compare the total against $17,750 single or $34,700 for a couple both 65 or older.
• If you have any self-employment income, take the premiums to Schedule 1, line 17 first, and only put the remainder on Schedule A.
• If a surcharge is on your premium and your income has since dropped, file Form SSA-44 rather than waiting for it to correct itself.

Educational only

This is general information, not tax advice. The amounts above are for the 2025 tax year filed in 2026, and the eligibility rules for the self-employed deduction turn on facts specific to your business and your coverage. Confirm your own figures against IRS Publication 502 or with a preparer before filing.

Sources

• IRS: Publication 502 (2025), Medical and Dental Expenses (Part A, B and D premiums, insurance premiums generally, employer-paid premiums, the self-employed deduction)
• IRS: Topic no. 502, Medical and dental expenses (the 7.5% of AGI limit)
• IRS: Schedule A (Form 1040), 2025 (lines 1 through 4)
• IRS: Instructions for Schedule A (2025) (reducing Schedule A by the Schedule 1, line 17 amount)
• IRS: Instructions for Form 7206 (2025) (Medicare premiums in the self-employed health insurance deduction, Schedule 1 line 17, the limits)
• IRS: Publication 501 (2025) (standard deduction, Table 7 for people born before January 2, 1961)
• CMS: 2026 Medicare Parts A & B Premiums and Deductibles (2025 and 2026 Part B premiums, the 2026 income-related brackets)

Watch this on the channel

Same question, in full.

IRMAA: the Medicare surcharge on higher incomes

Medicare's $50 weight-loss deal: who actually qualifies

Watch on YouTube

Medicare Part D Premium Increase? What to Check Before Dec. 7

Watch on YouTube