Standard Deduction/itemize

As you’re filling out your 2023 Form 1040… You may ask whether you should itemize on Schedule A or take the standard deduction. Most filers take the standard deduction because it’s higher than their total
itemizations. But not all. Take people with big medical bills. Itemizers can claim medical expenses not reimbursed by insurance, for themselves, spouse and dependents. The cost must be incurred primarily to alleviate or prevent a physical or mental disability or illness. But there is a floor. Medical expenses are deductible only to the extent the total exceeds 7.5% of your AGI.

The list of eligible medical expenses is broader than most people think. It includes the basics, such as out-of-pocket payments to doctors, dentists, optometrists and other medical professionals; mental health services; hospital stays; health insurance and Medicare premiums; prescription drugs; glasses and hearing aids. Amounts paid for in vitro fertilization qualify as medical expenses. Ditto for medical driving. The 2023 standard mileage rate is 22¢ per mile.

The cost of treatment for drug use or alcoholism is a medical expense. Among other health and wellness costs that qualify as deductible medicals: A smoking cessation program. Nutritional counseling for a doctordiagnosed disease. A weight-loss program and certain special food to help with the treatment of obesity, hypertension, heart disease or other physical illness diagnosed by a physician.

But most food, weight loss supplements or low-calorie beverages aren’t eligible. Neither is a weight-reduction program or cosmetic surgery to improve your appearance, or gym membership fees. Teeth whitening and hair transplants don’t count either. A bipartisan group of federal lawmakers want to expand the deduction to include up to $1,000 of the cost ($2,000 for spouses) of gyms and other fitness activities.

If you, your spouse or your dependent requires long-term care… You may be able to deduct the unreimbursed costs as medical expenses. Longterm- care expenses include the costs of assisted living, in-home care and nursing home services. The long-term care must be medically necessary for one who is chronically ill. The costs of meals and lodging at an assisted living facility or a nursing home count as medical expenses for people mainly there for medical care.

Premiums you pay for a long-term-care policy are deductible medicals, too. But the deduction is capped based on age. The older you are, the greater the write-off.

Also eligible: Certain home improvements to adapt to a disability or illness. For instance, ramps, wide doorways or entrances, railings and wheelchair lifts. Plus veterinary costs and food for a service dog to aid
people with disabilities. The cost of the dog also qualifies. An emotional support animal counts if needed primarily for the owner’s medical care to alleviate a mental disability or illness.