Can You Deduct Medical and Dental Expenses in Brazil on Your U.S. Taxes?

Brazil has become one of the most popular destinations for Americans seeking affordable, high-quality dental and medical care. From dental implants in São Paulo to IVF, the cost savings can be dramatic, often 50% to 80% less than equivalent procedures in the United States. But a question that stops many medical travelers in their tracks is: can I deduct these foreign medical and dental expenses on my U.S. tax return?

The answer is yes in many (but not all) cases; you can. But the rules are specific, and the devil is truly in the details.

The Legal Foundation: IRS Publication 502 and Section 213 Medical Deductions

The authority for deducting medical and dental expenses abroad comes from two sources: Section 213 of the Internal Revenue Code and IRS Publication 502, which is updated annually.

According to the IRS, you may deduct qualified medical expenses paid for yourself, your spouse, and your dependents, and critically, there is no requirement that the care be received in the United States.

As confirmed by IRS guidance, you can deduct the cost of medical procedures done in another country as long as the operation is legal and not classified as "unnecessary cosmetic surgery."

This is the same standard that applies to procedures performed domestically. That means a dental implant, a knee replacement, an eye procedure, or reconstructive surgery performed by a licensed provider in Brazil can potentially qualify just as it would at a U.S. hospital.

⚠ IMPORTANT: Tax law changes frequently. The information in this article reflects IRS Publication 502 (2025) and is for general educational purposes only. Always consult a licensed CPA or tax attorney before claiming deductions for international medical expenses.

The Core Requirement: You Must Itemize Deductions

This is the critical gateway that disqualifies many Americans from benefiting: you must itemize your deductions on Schedule A (Form 1040) rather than taking the standard deduction. For tax year 2025, the standard deduction is approximately $15,000 for single filers and $30,000 for married filing jointly. You should verify these figures with the IRS or your tax professional, as they adjust annually for inflation.

If your total itemized deductions, including mortgage interest, state taxes, charitable contributions, and medical expenses, do not exceed the standard deduction, itemizing will not benefit you.

For many Americans, the standard deduction is the better choice. However, if you incurred high medical costs during the year, the math may shift in your favor.

The 7.5% AGI Threshold: What It Means for You

Even if you itemize, you cannot deduct 100% of your medical expenses. According to IRS Publication 502 (2025), you can only deduct the portion of your total qualified medical and dental expenses that exceeds 7.5% of your Adjusted Gross Income (AGI). This threshold applies to all qualified medical expenses, domestic and international.

For example: if your AGI is $80,000, the threshold is $6,000 (7.5% of $80,000). If your total qualified medical expenses for the year were $10,000, including $7,500 for dental work in Brazil and $2,500 for U.S. doctor visits, you could potentially deduct $4,000 ($10,000 minus the $6,000 floor). The savings will depend on your effective tax bracket.

What Qualifies: Covered Medical and Dental Expenses Abroad

The IRS allows a broad range of expenses. When seeking care in Brazil, the following categories generally qualify, provided they meet the standard of being legal, medically necessary, and not purely cosmetic:

• Dental procedures: implants, crowns, bridges, root canals, extractions, and orthodontics (when medically prescribed)

• Surgical procedures: orthopedic surgery, cardiac procedures, gastrointestinal surgery, and other non-cosmetic operations

• Eye care: LASIK and other corrective eye procedures

• Cancer treatment and diagnostic imaging

• Prescription medications purchased legally abroad (note: prescription drugs shipped or purchased from foreign countries for import to the U.S. generally do not qualify — you should verify current IRS rules)

• Transportation costs: airfare, taxis, ride-shares, and other travel directly to and from your medical provider

• Lodging: up to $50 per person, per night, when lodging is essential to receiving the medical care, and there is no significant element of personal pleasure or vacation in the stay

What Does NOT Qualify: Exclusions and Limitations

Not every expense related to a medical trip to Brazil is deductible. The following categories are specifically excluded:

• Unnecessary cosmetic surgery procedures performed solely to improve appearance without a medical need do not qualify

• Meals during the trip (except meals provided as part of inpatient treatment at a medical facility)

• Lodging expenses that exceed $50 per person per night, or any lodging with a "significant element of personal pleasure, recreation, or vacation" if you extend your stay in Brazil for tourism; those extra nights are not deductible

• Expenses reimbursed by insurance: you can only deduct unreimbursed out-of-pocket costs

• Expenses paid with pre-tax funds from an HSA, FSA, or HRA

Currency Conversion: How to Report Foreign Expenses

A common question for Americans who pay for care in Brazilian reais (BRL) is how to translate those expenses into U.S. dollars for tax purposes. The IRS has no official exchange rate of its own. Per IRS guidance, you should use the yearly average currency exchange rate for the tax year, or the spot rate (the rate on the date you paid). The IRS will generally accept any posted exchange rate used consistently. Useful tools include the IRS's own Yearly Average Currency Exchange Rates page and publicly available currency converters. Keep records of your transactions in both currencies.

Documentation: What You Need to Keep

The IRS does not require you to submit receipts with your return, but you must retain documentation in case of an audit. If receipts are in Portuguese, they should be translated. Some financial advisors recommend having foreign-language medical receipts translated by a qualified third party. According to one benefits administration guidance source, if a receipt is in a foreign language, it must be translated by a third party and notarized for reimbursement purposes, though the notarization requirement may not apply to all IRS submissions. Consult your tax professional for current standards and save money by waiting to translate documents until requested, but where possible ask for receipts of foreign treatments in English.

Maintain the following records for any international medical expenses you plan to deduct:

• Itemized receipts from the Brazilian medical provider, showing date of service, type of service, patient name, and amount paid

• Proof of payment (bank statements, credit card statements)

• Your physician's recommendation or documentation of medical necessity where applicable

• Currency exchange rate documentation for the date(s) of payment

• Proof that the facility is a licensed hospital or equivalent medical care facility

Who Does NOT Qualify for This Deduction

Even with qualifying expenses, the following situations will typically result in no deduction benefit:

• Taxpayers who claim the standard deduction cannot take both the standard deduction and itemize medical expenses

• Taxpayers whose total medical expenses (domestic and international combined) do not exceed 7.5% of AGI

• Taxpayers whose expenses were fully or partially reimbursed by insurance; only unreimbursed amounts qualify

• Expenses for purely elective cosmetic procedures with no diagnosed medical need

• Travelers who combined medical care with significant leisure travel: the IRS specifically prohibits deductions for trips with a "significant element of personal pleasure, recreation, or vacation"

A Word for Expats and Digital Nomads in Brazil

Americans living in Brazil on a digital nomad visa or other long-term visa may have additional considerations. U.S. citizens are taxed on worldwide income regardless of where they reside, and they must still file U.S. tax returns annually.

Expats may also be eligible for the Foreign Earned Income Exclusion (FEIE) and the Foreign Tax Credit, both of which interact with itemized deductions in complex ways. If you are claiming both foreign income exclusion benefits and medical expense deductions, work with a tax professional who specializes in expat taxation to avoid errors.

Sources: IRS Publication 502 (2025), Medical and Dental Expenses; Internal Revenue Code Section 213; IRS guidance on foreign currency exchange rates for tax purposes. For the most current information, visit irs.gov/publications/p502.