Are Long-Term Health Insurance Premiums Tax Deductible? | Tax

Many long-term care premiums may count as medical expenses, with caps tied to age and the 7.5% AGI rule for itemizers.

Premiums feel like a bill that never quits. If you’ve carried a policy for years, it’s natural to ask whether any of that cost can lower your taxes.

The answer depends on what your policy is. People use “long-term health insurance” to mean regular medical coverage kept for years, long-term care insurance, or long-term disability coverage. Tax rules don’t treat those the same.

Below you’ll see the two main deduction paths, how qualified long-term care (LTC) premium caps work, and a clean way to document and claim what you’re allowed to claim.

Are Long-Term Health Insurance Premiums Tax Deductible For Most People?

Often, only in a narrow way. Most employees get a tax break for eligible premiums only if they itemize deductions and their unreimbursed medical spending beats the 7.5% of adjusted gross income (AGI) floor. The IRS states this rule in Topic No. 502 (Medical and dental expenses).

If you take the standard deduction, your premiums usually won’t change your federal taxable income. One big exception is the self-employed health insurance deduction, which can let certain taxpayers deduct eligible premiums without itemizing. The IRS explains the mechanics and limits in the Instructions for Form 7206.

Long-Term Health Insurance Premiums Tax Deduction Rules For Itemizers

Itemizing works like this: you total eligible medical expenses you paid out of pocket during the year, then you subtract 7.5% of your AGI. Only the amount above that floor is deductible.

Premiums tend to matter most when they sit beside other big medical costs in the same year: dental work, hearing aids, prescriptions, therapy, travel for care, or a hospital bill. The IRS list of what counts is in Publication 502 (Medical and Dental Expenses).

What Counts As Premiums For Schedule A Purposes

Schedule A is picky about double benefits. If premiums were paid with pre-tax payroll deductions, or you were reimbursed from an employer plan or a tax-favored account, you generally can’t claim the same dollars again as an itemized medical deduction.

So your first job is sorting: which premiums were fully out of pocket, and which were already sheltered from tax.

Why Long-Term Care Premiums Get Special Treatment

Qualified LTC insurance has a special rule: a capped amount of premiums can be treated as medical care. The cap is set by age, and it’s applied per covered person.

Not every policy that mentions “long-term care” is qualified. Publication 502 explains what a qualified LTC contract is and what it can include.

Which Premiums Usually Count And Where They Show Up

This table is a sorting tool. Find the row that matches your coverage and you’ll know where to start on your return.

Type Of Premiums	Where They Can Show Up	What Usually Decides Eligibility
Qualified long-term care (LTC) insurance	Schedule A; also may be part of Form 7206 for eligible self-employed filers	Policy meets qualified LTC rules; includible amount is capped by age
Regular health insurance (medical, dental, vision)	Schedule A; also may be part of Form 7206 for eligible self-employed filers	Unreimbursed premiums; Schedule A users must beat the 7.5% AGI floor
Medicare Part B, Part D, Medicare Advantage	Schedule A; sometimes Form 7206 when a self-employed deduction applies	Unreimbursed premiums; Schedule A floor still applies
COBRA continuation coverage	Schedule A; also may be part of Form 7206 for eligible self-employed filers	Paid out of pocket; treated as health insurance premiums in Publication 502
Employer plan paid through pre-tax payroll	Usually not deductible again	Cost already excluded from taxable wages
Premiums reimbursed by HRA/FSA or paid with HSA funds	Usually not deductible again	Another tax benefit already applied to those dollars
Long-term disability insurance	Often not deductible as a medical expense	Rules hinge on who paid the premiums and whether benefits are taxable
Accident or critical illness policies	Case-by-case under Publication 502	Policy design can affect whether premiums qualify as medical care

How The 7.5% AGI Floor Works In Real Life

The 7.5% floor is why two taxpayers with the same premiums can get different outcomes. A household with higher AGI has a higher floor, so it takes more medical spending before a deduction appears.

Do this quick check before you spend time on receipts:

• Pull last year’s AGI from your return.
• Multiply it by 0.075.
• Estimate your total unreimbursed medical spending for the year, including eligible premiums.

If your estimate doesn’t beat the floor, itemizing may still happen for other reasons, but your medical deduction is likely to be zero.

Self-Employed Filers May Have A Cleaner Path

If you have net profit from self-employment, you may be able to deduct eligible health insurance premiums as an adjustment to income. That means the deduction can apply even when you take the standard deduction.

The IRS instructions for Form 7206 spell out what can be included and what can block the deduction. Two blockers show up often:

• Employer plan eligibility. If you (or your spouse) were eligible for a subsidized employer health plan for a month, that month’s premiums usually can’t be claimed under the self-employed deduction, even if you didn’t enroll.
• Business income limits. The deduction generally can’t exceed the earned income from the business that provides the plan.

Qualified LTC premiums can fit here too, with the same age-based caps used for Schedule A.

Eligible Long-Term Care Premium Limits By Age

For qualified LTC policies, only premiums up to an annual cap per person can be treated as medical care. The IRS posts the caps in its volunteer tax materials. The figures below come from the IRS Eligible Long-Term Care Premium Limits page for calendar year 2025.

Age At End Of 2025	Max Amount Treated As Medical Care (Per Person)	Where You Use The Cap
40 or less	$480	Schedule A and Form 7206 calculations
41–50	$900	Schedule A and Form 7206 calculations
51–60	$1,800	Schedule A and Form 7206 calculations
61–70	$4,810	Schedule A and Form 7206 calculations
71 or older	$6,020	Schedule A and Form 7206 calculations

How To Check If Your LTC Policy Is Qualified

Start with your policy declarations page and annual statements. Many insurers label qualified LTC coverage clearly. If you see language saying the contract is a “qualified long-term care insurance contract,” save that page with your tax file.

If your coverage is a rider inside a life insurance policy, look for a statement that breaks out the LTC portion of premiums. If the paperwork is unclear, Publication 502 is the IRS reference that lists the features of a qualified contract and the general boundaries of what counts as long-term care services.

How To Claim The Deduction Cleanly

Use this workflow to avoid common filing mistakes.

Step 1: Gather The Right Proof

• Annual insurer premium statement(s) showing amounts paid and who was covered
• Proof of payment (bank records, credit card statements, cancelled checks)
• Payroll records showing whether premiums were pre-tax or after-tax
• Records of reimbursements from an HRA, FSA, or other plan

Step 2: Total Premiums That Were Truly Out Of Pocket

Subtract any amounts that were reimbursed or paid with pre-tax dollars. Your goal is the net cost you bore.

Step 3: Choose One Claim Location Per Dollar

If you qualify for the self-employed health insurance deduction, you generally claim eligible premiums through Form 7206 and you stop there for those premium dollars. If you don’t qualify, or you prefer itemizing for other reasons, eligible premiums can be part of Schedule A medical expenses.

Step 4: Apply The LTC Cap Per Person

For each person covered by a qualified LTC contract, cap the includible premiums using the age-based limit for the tax year. Use each person’s age at year end, not at purchase date.

Step 5: Keep A One-Page Note For Next Year

Write down the policy type, who was covered, how you treated the premiums, and which documents back the number. Next year’s filing will be faster, and you’ll avoid re-learning the same details.

Common Scenarios That Shift The Outcome

Premiums Paid Through Work vs. Paid Directly

Two employees can pay the same sticker premiums and end up with different tax results. If one paid through pre-tax payroll and the other paid directly after tax, only the after-tax payer may have any shot at a Schedule A medical deduction.

Large One-Time Medical Costs In The Same Year

Itemizing often turns on timing. If you had surgery, dental implants, or major vision work in the year, those costs may push you over the 7.5% floor and make your eligible premiums “count” in a way they wouldn’t in a quieter year.

Switching Into Employer Eligibility Midyear

For self-employed filers, being eligible for a subsidized employer plan for part of the year can limit the deduction for those months. A job change in June can change what you can claim for January through May.

Bottom Line

Long-term health insurance premiums can be tax deductible, but only under specific rules. Qualified long-term care premiums may count as medical expenses up to an age-based cap, and regular health insurance premiums may count when you itemize or when you qualify for the self-employed health insurance deduction. Start by classifying your policy, subtracting reimbursements, then claim the net amount in one place on the return.