Taxpayers who drive to doctors, dialysis centers and pharmacies can count 23.5 cents a mile toward their medical deduction for trips from July 1, 2026, up from 20.5 cents a mile for trips in the first six months of the year. The Internal Revenue Service reset the medical rate in the middle of the tax year instead of waiting for January. Only people whose medical bills are large enough to be deducted at all will see any benefit.
Three cents a mile looks small on a single trip. A retiree who logs 3,000 medical miles between July 1 and Dec. 31 has $705 of mileage expense at the higher rate, against $615 for the same miles at 20.5 cents. Those dollars go into the same pot as prescriptions, premiums and doctor bills, and the pot has to clear a hurdle before anything comes off the tax bill.
The question for retirees with regular treatment is whether their total medical bills clear the hurdle that makes mileage count at all. Topic No. 502 says medical expenses are deductible only to the extent they exceed 7.5 percent of adjusted gross income, and only for people who itemize on Schedule A. For a household with $50,000 of adjusted gross income, the first $3,750 of medical costs, mileage included, produces no deduction.
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Two medical rates inside one tax year
The IRS standard mileage rates page lists 20.5 cents a mile for medical travel from Jan. 1 through June 30, 2026, and 23.5 cents from July 1 through Dec. 31. The same 23.5 cents applies to military moves, which the table groups with medical miles. Each trip is priced at the rate for the date it was driven, so a January appointment stays at 20.5 cents.
The mid-year change came through Announcement 2026-11, printed in Internal Revenue Bulletin 2026-29 and dated July 13, 2026. It modifies Notice 2026-10 and says the change “results from recent increases in the price of fuel.” The revised rates cover expenses paid or incurred on or after July 1, 2026.
The same announcement moved the business rate from 72.5 to 76 cents a mile, but each category keeps its own line on the table. A trip to a cardiologist is figured at the medical rate, never the business rate. The charity rate stays at 14 cents a mile in both halves of the year, so volunteer driving does not share in the increase.
Which trips count, and when the deduction pays
IRS Topic No. 502 says deductible transportation must be “primarily for and essential to” medical care that qualifies for the medical expense deduction. A drive to a hospital, a clinic or a pharmacy to fill a prescription fits that test. A trip made mainly for another purpose, with a doctor’s visit tacked on, does not.
Taxpayers choose between two methods for car costs. One is actual out-of-pocket spending such as gas and oil. The other is the standard mileage rate for medical expenses, which is the 20.5 and 23.5 cent figure. Tolls and parking can be added on top of either method, so a parking receipt from the hospital garage belongs in the same folder as the mileage log.
The itemizing rule is the part that surprises people. A taxpayer who takes the standard deduction gets nothing for medical miles, however many were driven. Mileage matters most in a year with surgery, chemotherapy, dialysis or long-term care, when the medical total is large enough that itemizing can beat the standard deduction.
A concrete case shows how the pieces fit. Suppose a retiree with $50,000 of adjusted gross income has $6,000 of medical costs for the year, including the mileage. The first $3,750 is absorbed by the 7.5 percent floor, which leaves $2,250 as the medical deduction on Schedule A. Every extra mile added to the log raises that $2,250 by 20.5 or 23.5 cents.
Building a mileage log that adds up
A patient who drives 20 miles round trip to dialysis three times a week drives 60 miles a week. Over 26 weeks in the second half of the year, that is 1,560 miles, worth $366.60 at 23.5 cents. The same schedule in the first half of the year is worth $319.80 at 20.5 cents, for a full-year mileage expense of $686.40. These figures are an illustration, not a typical case.
Dollars follow from dates, so the log should record the date, the destination, the reason for the trip and the miles driven. Odometer readings at the start and end of a trip back up the miles. Appointment cards, pharmacy receipts and hospital parking stubs show why each trip was taken, and they tie it to medical care.
The IRS’s current edition of Publication 502 is the 2025 edition, so it does not carry the July 2026 rate. The standard mileage rates page is where the 20.5 and 23.5 cent figures are listed. Medical miles driven in 2026 are reported on the 2026 return filed in 2027, using the two rates for the two halves of the year.
No 2027 mileage rates appear on the IRS page yet. The agency changed this year’s rate after fuel prices rose, which shows that the figure is not locked in for a full calendar year. Taxpayers planning for 2027 should treat 23.5 cents as the 2026 second-half rate and wait for the IRS to publish the next one.
Logging miles to the clinic this year?
Medical mileage only helps when the year’s medical total clears the 7.5 percent floor and the itemized total beats the standard deduction. A retiree who guesses wrong either leaves a deduction unclaimed or itemizes for no gain. The 3,000-mile example above is worth $705 as an expense, but only the part above the floor reaches the tax bill.
Cut Your Retirement Tax Bill: 12 Moves puts the 2026 numbers on one page, with the 12 moves and the form to use for each. It also works out how much of your Social Security is taxed on one worksheet, which is the other half of the picture for a retiree who is deciding whether to itemize.
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
