Are Medicare Premiums Tax Deductible? (2026)

Direct Answer: Are Medicare Premiums Deductible in 2026?

Depends on your tax situation, but the split comes down to one factor: self-employment status. Self-employed taxpayers can deduct 100% of Medicare Part B, Part D, Medigap, and Medicare Advantage premiums above the line on Schedule 1, with no itemizing required. Everyone else can only deduct Medicare premiums by itemizing on Schedule A, and only the portion of total medical expenses that exceeds 7.5% of adjusted gross income in 2026 counts toward the deduction.

Which Medicare Premiums Count as Deductible Medical Expenses

Medicare premiums qualify as deductible medical expenses under Internal Revenue Code Section 213(d), the same provision that covers doctor visits, prescription drugs, and long-term care insurance. Part B premiums ($202.90 a month for most enrollees in 2026), Part D premiums, Medigap premiums, and Medicare Advantage premiums all count. Original Medicare enrollees who owe a monthly Part A premium ($311 or $565 in 2026, depending on work history) because they lack 40 quarters of work credits can deduct that premium too.

Income-Related Monthly Adjustment Amount (IRMAA) surcharges on Medicare Part B and Medicare Part D also count as deductible premium costs in 2026, since the IRS treats the surcharge as part of the premium rather than a separate penalty. Long-term care insurance premiums are deductible too, subject to age-based dollar caps that adjust each year, and they stack with Medicare premiums when you calculate the 7.5% AGI threshold.

The Self-Employed Health Insurance Deduction for Medicare Premiums

Self-employed sole proprietors, partners, and more-than-2%-owners of an S corporation can deduct Medicare premiums as an above-the-line adjustment to income on Schedule 1, Line 17 of Form 1040. The deduction reduces adjusted gross income directly, so there is no need to itemize and the 7.5% AGI floor that applies to Schedule A never comes into play.

• The deduction cannot exceed your net self-employment income for 2026.
• You, and your spouse if filing jointly, must not be eligible for subsidized coverage through an employer plan for the months claimed.
• Covers Part B, Part D, Medigap, and Medicare Advantage premiums for you, your spouse, and your dependents.
• S corporation shareholders who own more than 2% claim it through wages reported on Form W-2 plus their personal Form 1040, not directly on the corporate return.

Itemizing on Schedule A: the 7.5% AGI Threshold in 2026

Retirees who are not self-employed can only deduct Medicare premiums by itemizing on Schedule A instead of taking the 2026 standard deduction ($16,100 single, $32,200 married filing jointly, $24,150 head of household). Total medical and dental expenses, including all Medicare premiums, must exceed 7.5% of adjusted gross income before any of it is deductible; only the amount above that threshold counts.

A retiree with $60,000 in 2026 adjusted gross income would need more than $4,500 in combined medical costs, Medicare premiums included, before the first deductible dollar appears. Taxpayers 65 or older also get an additional standard deduction ($2,050 single, $1,650 per qualifying spouse for 2026), which raises the bar for itemizing to make sense in the first place.

Using an HSA to Pay Medicare Premiums Tax-Free

Health Savings Account holders who enroll in Medicare can withdraw existing HSA funds tax-free to pay Part B, Part D, and Medicare Advantage premiums, even though new HSA contributions stop the month Medicare coverage begins. Medigap premiums are the one exception: the IRS does not allow tax-free HSA withdrawals for Medigap, so those premiums must go through the itemized-deduction or self-employed route instead.

The 2026 HSA contribution limits are $4,400 for self-only coverage and $8,750 for family coverage, but those limits only matter for people who have not yet enrolled in Medicare. Building an HSA balance before enrolling gives you a tax-free pool to draw from for Medicare premiums for years afterward.

How to Claim the Medicare Premium Deduction

Claiming the deduction correctly starts with confirming which category applies before opening a tax form. Two paths exist for the 2026 tax year, filed in early 2027: the above-the-line self-employed deduction or the itemized Schedule A deduction.

• Step 1: Total your 2026 Medicare premium payments using your Social Security benefit statement (Form SSA-1099) and Medicare Advantage or Part D billing records.
• Step 2: Determine your path. Self-employed filers use Schedule 1, Line 17. Non-self-employed filers itemize on Schedule A, Line 1.
• Step 3: Add other qualifying medical costs (dental, vision, long-term care premiums) if itemizing, then subtract 7.5% of your 2026 AGI.
• Step 4: File Form 1040 with the correct schedule attached by April 15, 2027, or by October 15, 2027 with a filed extension.

Alternatives if You Don't Qualify to Deduct Medicare Premiums

Taxpayers who take the 2026 standard deduction and are not self-employed still have options for lowering the real cost of Medicare premiums outside the tax code.

• Bunch medical expenses into one tax year (schedule elective procedures, stock up on prescriptions) to clear the 7.5% AGI threshold and itemize that year only.
• Apply for a Medicare Savings Program (MSP) through your state Medicaid office, which can pay your Part B premium directly if your income qualifies.
• Apply for Extra Help (the Part D Low-Income Subsidy) to reduce or eliminate Part D premiums and cost-sharing based on your 2026 income.
• Contribute to an HSA before enrolling in Medicare so the balance is available tax-free for premiums later.
• Ask a former employer about a retiree Health Reimbursement Arrangement (HRA), which can reimburse Medicare premiums tax-free without an itemized deduction.

Can self-employed people deduct Medicare premiums in 2026?

Yes. Self-employed sole proprietors, partners, and more-than-2% S corporation shareholders can deduct 100% of Medicare Part B, Part D, Medigap, and Medicare Advantage premiums as an above-the-line deduction on Schedule 1, Line 17. No itemizing is required and the 7.5% AGI floor does not apply. The deduction cannot exceed your net self-employment income for 2026, and you cannot claim it for any month you were eligible for subsidized employer coverage.

Can I deduct my Medicare Part B premium if I take the standard deduction?

No. If you take the 2026 standard deduction ($16,100 single, $32,200 married filing jointly) instead of itemizing, you cannot separately deduct your Part B premium. Medicare premiums only become deductible when you itemize on Schedule A and your total medical expenses exceed 7.5% of your adjusted gross income, or when you qualify for the self-employed health insurance deduction.

Are Medigap premiums tax deductible in 2026?

Yes, under the same rules as other Medicare premiums. Medigap premiums count as qualified medical expenses on Schedule A if you itemize and exceed the 7.5% AGI threshold, and self-employed taxpayers can deduct them above the line on Schedule 1. The one exception is HSA funds: the IRS does not allow tax-free HSA withdrawals to pay Medigap premiums, unlike Part B, Part D, and Medicare Advantage.

Can I use my HSA to pay Medicare premiums?

Yes, for Part B, Part D, and Medicare Advantage premiums, once you are enrolled in Medicare. Withdrawals from an existing HSA balance to pay these premiums are tax-free. You cannot contribute new money to an HSA once Medicare coverage starts, and Medigap premiums are not an eligible HSA expense, so those still require the itemized or self-employed deduction route.

What is the 7.5% AGI threshold for medical expense deductions?

The 7.5% AGI threshold is the floor the IRS applies to itemized medical expenses: only the portion of your total medical costs, including Medicare premiums, that exceeds 7.5% of your adjusted gross income is deductible on Schedule A. For a retiree with $60,000 in 2026 AGI, the first $4,500 of medical costs is not deductible; only spending above that amount counts.

Can I deduct my spouse's Medicare premiums?

Yes. If you are self-employed, you can include your spouse's Medicare Part B, Part D, Medigap, and Medicare Advantage premiums in your above-the-line deduction on Schedule 1, as long as neither of you was eligible for subsidized employer coverage. If you itemize instead, you can include your spouse's premiums with your own medical expenses on Schedule A when calculating whether you clear the 7.5% AGI threshold.

Is the Medicare Part A premium deductible if I have to pay for it?

Yes. Most people do not pay a Part A premium because they have 40 quarters of Medicare-taxed work history, but people with 30 to 39 quarters pay a reduced 2026 premium of $311 a month, and those with fewer than 30 quarters pay the full 2026 premium of $565 a month. That premium is deductible under the same rules as Part B: above the line if self-employed, or itemized on Schedule A above the 7.5% AGI threshold otherwise.

Does a Medicare Advantage premium count as a deductible medical expense?

Yes. Medicare Advantage premiums are treated the same as Original Medicare premiums for tax purposes: deductible above the line if you are self-employed, deductible on Schedule A if you itemize and clear the 7.5% AGI threshold, and eligible for tax-free HSA withdrawals if you have an existing HSA balance. Some Medicare Advantage plans have a $0 premium in 2026, in which case there is nothing to deduct.