Quick Answer
Medical expense bunching involves timing medical payments to concentrate them in alternating tax years, helping you exceed the 7.5% AGI threshold. A taxpayer with $100,000 AGI needs $7,500 in medical expenses before any deduction. Bunching $15,000 of expenses into one year creates a $7,500 deduction versus $0 spread across two years.
Best Answer
Robert Kim, Tax Return Analyst
Taxpayers with moderate medical expenses who struggle to exceed the 7.5% threshold
How medical expense bunching works
Medical expense bunching is a timing strategy where you deliberately concentrate medical payments into alternating tax years to exceed the 7.5% of AGI threshold. Instead of spreading expenses evenly, you "bunch" them to create deductible amounts in some years while taking the standard deduction in others.
Example: The power of bunching
The Johnson family has $80,000 AGI and typically spends $5,000 annually on medical expenses. Their 7.5% threshold is $6,000, so they get no medical deduction.
Without bunching (2 years):
With bunching (2 years):
Bunching strategies and timing techniques
Advanced bunching: The alternating year strategy
Example: High medical expense family
The Williams family (AGI: $120,000, threshold: $9,000) implements a 2-year bunching cycle:
Bunching Year (2026):
Standard Deduction Year (2027):
What expenses can you bunch?
Easily controlled timing:
Partially controllable:
Cannot control:
Key factors for successful bunching
What you should do
1. Calculate your medical expense threshold for the current tax year
2. Track all medical expenses throughout the year to identify bunching opportunities
3. Coordinate with healthcare providers about payment timing flexibility
4. Use our refund estimator to model the tax impact of different bunching scenarios
5. Review prescription timing to see if you can shift refills between years
Key takeaway: Bunching medical expenses into alternating years can create substantial tax deductions where none existed before. A family spending $10,000 over two years might save $1,500+ in taxes through strategic timing versus $0 without bunching.
Key Takeaway: Medical expense bunching turns unusable below-threshold expenses into valuable deductions by concentrating payments in alternating tax years.
Bunching vs. non-bunching scenarios by income level
| AGI | 7.5% Threshold | Annual Expenses | Without Bunching (2 years) | With Bunching (2 years) | Tax Savings* |
|---|---|---|---|---|---|
| $60,000 | $4,500 | $4,000 | $0 deduction | $3,500 deduction | ~$420 |
| $100,000 | $7,500 | $7,000 | $0 deduction | $6,500 deduction | ~$1,430 |
| $150,000 | $11,250 | $10,000 | $0 deduction | $8,750 deduction | ~$1,925 |
| $200,000 | $15,000 | $14,000 | $0 deduction | $13,000 deduction | ~$4,160 |
More Perspectives
Michelle Woodard, Tax Policy Analyst
High-income taxpayers with substantial medical expenses but high AGI thresholds
High earner bunching requires larger amounts
With AGI over $200,000, your 7.5% threshold exceeds $15,000, requiring significant expense bunching to create meaningful deductions. However, high earners often have complex medical situations that generate substantial expenses.
Multi-generational bunching strategy
High earners supporting elderly parents and managing their own family's medical needs can bundle expenses across multiple dependents:
Example: Executive with $400,000 AGI (threshold: $30,000) coordinates:
AMT considerations: Medical expenses remain deductible for Alternative Minimum Tax, making bunching valuable even for AMT taxpayers.
Timing with stock sales: Consider bunching medical expenses in years with lower AGI due to tax-loss harvesting or reduced bonus payments.
Key Takeaway: High earners need to bunch substantial amounts across multiple family members, but the tax savings can be significant due to higher marginal tax rates.
Robert Kim, Tax Return Analyst
Retirees with lower AGI who can more easily benefit from bunching strategies
Retirees have unique bunching advantages
Lower retirement income creates lower 7.5% thresholds, making bunching more effective with smaller expense amounts. Additionally, retirees have more control over the timing of medical procedures and expenses.
Retirement-specific bunching opportunities
Long-term care insurance: Annual premiums can be timed and bunched with other medical expenses. For 2026, taxpayers over 70 can deduct up to $5,880 in long-term care premiums.
Medicare timing: Coordinate Medicare supplement premium payments with other bunched expenses.
Example: Retired couple (AGI: $55,000, threshold: $4,125) bunches:
RMD coordination: Consider bunching medical expenses in years when Required Minimum Distributions increase your AGI.
Key Takeaway: Retirees can effectively bunch smaller medical expense amounts due to lower AGI thresholds and greater control over timing.
Sources
- IRS Publication 502 — Medical and Dental Expenses
- IRS Publication 17 — Your Federal Income Tax (For Individuals)
Reviewed by Michelle Woodard, Tax Policy Analyst on February 28, 2026
This content is for educational purposes only and is not a substitute for professional tax advice. Consult a qualified tax professional for advice specific to your situation.