Medical mileage: when the drive to the doctor counts
Driving to medical care is a medical expense you can deduct. What counts, what a mile is worth in 2026, and why it often saves nothing, because only costs above 7.5% of your income count, and only if you itemize.
Driving to a doctor, a dentist or a hospital is a medical expense, and you can deduct it with your other medical bills. Whether it lowers your tax depends on two things the miles cannot change: your medical costs have to come to more than 7.5% of your income, and you have to itemize. The sources are listed at the end.
What counts as medical driving
Section 213 of the tax code counts “transportation primarily for and essential to medical care” as medical care, and Publication 502 uses the same test. The drive to a doctor, a dentist, a hospital, a lab or a physical therapist counts. So do bus, taxi, train and plane fares, and an ambulance.
Whose care. Yours, your spouse’s and your dependents’. The Schedule A instructions add someone you could have claimed as a dependent except for their income, such as a parent you support. Publication 502 also counts trips for:
- a parent who “must go with a child who needs medical care”;
- a nurse or other person who can give the treatment a patient needs on the way to care, when the patient “is unable to travel alone”;
- “regular visits to see a mentally ill dependent, if these visits are recommended as a part of treatment.”
A child in hospital. Driving your child to the hospital and home again counts: it is the first case above. Publication 502 does not list visits on the days in between, so each of those drives has to pass the general test: was it primarily for, and essential to, the child’s care?
What does not count: going to and from work, “even if your condition requires an unusual means of transportation”; travel to another city for purely personal reasons; a trip for a change of scene or your general health, “even if the trip is made on the advice of a doctor”; and the car’s depreciation, insurance, repairs and maintenance.
What a medical mile is worth
You use one of two figures: what you actually spent on gas and oil for the trips, or the miles times the standard medical rate for the date of each drive. Parking and tolls are added to either.
| Miles driven | Medical rate |
|---|---|
| In 2025 | 21¢ a mile |
| January 1 – June 30, 2026 | 20.5¢ a mile |
| From July 1, 2026 | 23.5¢ a mile |
Notice 2026-10 set 20.5¢, and Announcement 2026-11 raised it to 23.5¢ from July 1 after fuel prices rose. It is less than a third of the business rate because, the IRS says, it is “based on only the variable costs” of running a car. Every 2026 rate is in the 2026 mileage rates.
When the care is in another city, Publication 502 also allows lodging: up to $50 a night for each person, the patient and someone traveling with them. The care has to be from a doctor in a licensed hospital or its equivalent, and the stay must not be lavish or part vacation. Meals are not included.
Only the part above 7.5% of your income
Section 213(a) allows medical expenses only “to the extent that such expenses exceed 7.5 percent of adjusted gross income.” The miles are not a deduction of their own. They go on line 1 of Schedule A with everything else you paid for care: after-tax premiums, copays, dental work, glasses. Line 3 takes 7.5% of your adjusted gross income (AGI), and only line 4, the part of line 1 above it, is deductible.
An example. A married couple filing jointly in 2026, with an AGI of $80,000, drove 1,200 miles to appointments: 500 by June 30 and 700 after. That is 500 × 20.5¢ = $102.50 plus 700 × 23.5¢ = $164.50, so $267. With $85 of hospital parking, the car comes to $352. Their other unreimbursed medical bills were $7,500.
| Schedule A | Amount |
|---|---|
| Line 1: medical and dental expenses ($7,500 + $352) | $7,852 |
| Line 2: AGI | $80,000 |
| Line 3: 7.5% of line 2 | $6,000 |
| Line 4: line 1 minus line 3 | $1,852 |
Had their other bills been $4,000, line 1 would be $4,352, under the $6,000 floor, and line 4 would be zero. The same 1,200 miles would be worth nothing.
Itemizing: the second condition
Line 4 is one itemized deduction among others on Schedule A: state and local taxes, mortgage interest, gifts to charity. You either itemize or take the standard deduction, and the instructions say your tax is lower “in most cases” with the larger. For 2026 the standard deduction is:
| Filing status | Standard deduction, 2026 |
|---|---|
| Single, or married filing separately | $16,100 |
| Head of household | $24,150 |
| Married filing jointly | $32,200 |
It is higher at 65 or older, or blind: $1,650 more for each, per spouse on a joint return, or $2,050 each if you are unmarried and not a surviving spouse.
Separately, for 2025 through 2028 there is a new deduction of up to $6,000 for each person 65 or older, phased out above $75,000 of modified AGI ($150,000 on a joint return). You get it whether you itemize or not, so it does not change the choice between the two.
The couple above gets something from their $1,852 only if their other itemized deductions come to more than $30,348. If not, they take the $32,200, and the medical miles save nothing.
So, plainly: for many people medical miles make no difference to their tax. They matter in a year of large medical bills you paid yourself, measured against your income, and to people who itemize anyway. Business miles on Schedule C are different: they lower your profit whether you itemize or not.
Nothing that was paid back
Publication 502 counts only amounts “for which you received no insurance or other reimbursement.” So leave out miles:
- that insurance, a health plan or anyone else paid you for;
- that you paid yourself back for from a health savings account (HSA);
- that a flexible spending arrangement (FSA) reimbursed, when you fund it from your pay before tax.
What to keep
Publication 502 says to keep records “to support your deduction”, but does not list what a record of medical driving has to show. The facts that make a business mileage log hold up do the same job here.
Records for medical driving
- for each trip: the date, where you went, whose care it was for, and the miles
- parking and toll receipts
- the doctor’s or hospital’s bills for the same dates
- what insurance, an HSA or an FSA paid back
- gas and oil receipts, if you use them instead of the rate
In OdoTax
A drive counts as medical when you file it as Medical. In the app, when a drive comes up to be sorted, tap Other deduction and pick Medical (sorting drives). A sorted drive can be changed from its page, under More, or on the web from Trips. Medical is a category, not a purpose: a personal drive with a purpose named “Medical” still counts for nothing. For a route you drive every week, such as to physical therapy, a frequent drive saved as Medical files each drive on it.
Each Medical drive is priced at the medical rate for its date, plus the parking and tolls you enter on it. The report puts the medical drives under Schedule A: a row under Deduction by form, a Schedule A Drives section with their miles, parking and tolls, and each drive in the trip log, marked Medical. The amount is part of the headline deduction, with a note that it “counts only if you itemize.”
That amount is the car alone, before the floor. The app does not know your AGI, your other medical bills or what was paid back, so it does not apply the 7.5% or take off reimbursements; the figure goes on line 1 with the rest. If a trip was for someone else’s care, say whose in the drive’s note, which the CSV export carries.
The app records the date, the start and end, and the miles of each drive on its own.
The free plan covers 35 drives a month, and Pro removes the limit.
The bottom line
Driving to medical care for yourself, your spouse or a dependent is a medical expense: in 2026, 20.5¢ a mile through June 30 and 23.5¢ from July 1, or gas and oil, plus parking and tolls, less anything paid back. Only the part of your medical costs above 7.5% of your AGI is deductible, and only if you itemize. In a year of ordinary medical bills that often means no saving at all.
Sources
- IRS, Publication 502: Medical and Dental Expenses (2025): What Are Medical Expenses?, Whose Medical Expenses Can You Include?, Transportation, Trips, Lodging, Flexible Spending Arrangement, Health Savings Accounts, How Do You Treat Reimbursements? and Recordkeeping; IRS, Topic no. 502, Medical and dental expenses.
- IRS, Schedule A (Form 1040), lines 1–4, the same on the 2026 draft; Instructions for Schedule A (2025): General Instructions and Medical and Dental Expenses.
- IRS, Notice 2026-10 (the 2026 standard mileage rates) and Announcement 2026-11, I.R.B. 2026-29 (the rates from July 1, 2026); IR-2025-128 (the medical rate is based only on variable costs).
- IRS, Rev. Proc. 2025-32, section 4.14 (the 2026 standard deduction, and the additional amount for the aged or blind), and IR-2025-103; IRS, Working Families Tax Cuts: Tax deductions for working Americans and seniors (the deduction for people 65 or older).
- 26 U.S. Code § 213: (a) the 7.5% floor; (d)(1) medical care, transportation included; (d)(2) lodging away from home.
This article is general information, not tax advice. Tax situations vary — check with a qualified professional before you file.