Most adults should keep their medical records at home for at least 10 years after the most recent visit or treatment. That’s the minimum recommended by the American Health Information Management Association (AHIMA), the leading professional body for health information management. Some records, though, deserve a permanent spot in your files. The right timeline depends on whether you’re holding onto records for tax purposes, insurance disputes, or long-term health tracking.
The 10-Year Baseline
AHIMA recommends keeping adult health and medical records for 10 years after the most recent encounter with a provider. This covers office visit notes, lab results, imaging reports, discharge summaries, and specialist consultations. Ten years gives you a solid window to reference past diagnoses, track chronic conditions, and catch patterns your current doctor might need to see.
This matters more than you might think, because your doctors aren’t guaranteed to have your records forever. Every state sets its own rules for how long providers must retain files, and the range is wide. Florida physicians are required to keep records for just five years after your last visit. North Carolina hospitals must hold them for 11 years after discharge. Arkansas requires 10 years for hospital records. If you switch doctors, move to a new state, or a practice closes, your personal copies may be the only copies that exist.
Records You Should Keep Permanently
Certain documents remain useful for your entire life and should never be discarded:
- Vaccination records. You’ll need proof of immunizations for travel, employment in healthcare or education, college enrollment, and sometimes immigration paperwork. Reconstructing a complete vaccination history from childhood is often impossible. New York State’s Department of Health notes that if you’re 35 and trying to track down childhood immunization records, the law doesn’t require your old doctor or hospital to still have them.
- Records of major surgeries and hospitalizations. Future surgeons and anesthesiologists need to know about prior procedures, implanted devices, and past reactions to anesthesia.
- Chronic condition history. If you’ve been diagnosed with diabetes, heart disease, cancer, autoimmune disorders, or mental health conditions, keep the original diagnosis records, treatment plans, and medication history indefinitely.
- Family medical history notes. These aren’t clinical documents, but a written record of conditions that run in your family is one of the most valuable health documents you can own.
- Genetic test results. These don’t expire or change over time, and they carry implications for your children and siblings as well.
Tax-Related Medical Records
If you deduct medical expenses on your tax return or use a Health Savings Account (HSA) or Flexible Spending Account (FSA), the IRS has its own retention rules. You need to keep receipts, explanation of benefits (EOB) statements, and proof of payment for at least three years from the date you filed the return claiming those expenses, or two years from the date you paid the tax, whichever is later.
That timeline stretches to six years if you underreported your income by more than 25% of your gross income. And if you didn’t file a return at all, the IRS says to keep records indefinitely. For HSA and FSA expenses specifically, hold onto itemized receipts showing what was purchased, the date, and the amount. Your account administrator can request verification years after the fact.
Insurance Billing and Claims Records
Keep EOB statements and billing records for at least a year after a claim is fully resolved. If a claim is denied, you have 180 days (six months) from the denial notice to file an internal appeal through your insurer. Having the original bills, provider notes, and any prior authorization paperwork on hand makes that process far smoother.
For larger disputes, such as out-of-network balance billing or coordination between two insurers, hold onto paperwork until the issue is completely settled and you’ve confirmed your account shows a zero balance. Medical billing errors can surface months after treatment, so a cushion of one to two years beyond final payment is reasonable.
Children’s Medical Records
Keep your child’s complete medical records until they’re well into adulthood. State requirements for providers vary: Nevada requires records for minors to be kept until the patient turns 23, while North Carolina extends that to age 30. But providers sometimes fall short of even these minimums, especially smaller practices.
At a minimum, retain your child’s records until they turn 25 or 30. This ensures they have documentation through college, early career health screenings, and the transition to their own insurance. Vaccination records, growth charts, developmental screening results, and any childhood diagnoses (asthma, ADHD, allergies, broken bones) should be passed along to your child as a permanent part of their personal health file.
Storing Records Safely
Medical records contain exactly the kind of information identity thieves target: full names, dates of birth, Social Security numbers, insurance policy numbers, and diagnostic codes. How you store them matters as much as how long you keep them.
For paper records, a fireproof lockbox or a home safe works for the documents you access occasionally. A bank safe deposit box is better for records you rarely need but can’t afford to lose, like surgical reports or genetic test results.
Digital copies add a layer of protection against fire, floods, and simple disorganization. Scan important documents and store them in a cloud service that offers end-to-end encryption, two-factor authentication, and strong access controls. Several major cloud providers meet healthcare-grade security standards, including features like private encryption keys that ensure even the storage company can’t read your files. Keep a local backup on an encrypted external drive as well, stored separately from your computer.
When to Safely Destroy Old Records
Once records have passed their useful retention period, don’t just toss them in the recycling bin. Paper records should be cross-cut shredded, not strip-cut (strip-cut documents can be reassembled). Many communities hold free shredding events, and office supply stores often offer shredding services by the pound.
For digital files, simply deleting them from your computer doesn’t erase the data. Use a secure deletion tool that overwrites the file, or if you’re disposing of an old hard drive or USB stick, physically destroy it. This sounds extreme, but a single medical record can contain enough personal information to open fraudulent accounts in your name.
A Simple Filing System
The easiest approach is to sort records into three categories. The first is your permanent file: vaccinations, major diagnoses, surgeries, family history, and genetic tests. These never get purged. The second is your 10-year rolling file: routine visit notes, lab work, imaging, prescriptions, and specialist consultations. Once a record is more than 10 years old and doesn’t document anything in your permanent category, it can go. The third is your financial file: EOBs, receipts, and billing statements, kept for three to six years depending on your tax situation.
Review your files once a year. It takes 30 minutes and keeps the system from becoming overwhelming. Each time you add new records, move anything that’s aged out of the 10-year or financial window into the shred pile. What you’re left with is a lean, useful archive that protects both your health and your identity.