Federal, exists in every state
Tax refunds and treatment-related deductions
Changes in annual earnings can change tax credits. High treatment costs can also make a medical-expense deduction useful.
What it is
Changes in annual earnings can change tax credits. High treatment costs can also make a medical-expense deduction useful.
Federal tax credits rise and fall at different incomes, so lower earnings do not always mean a larger refund. Unreimbursed treatment expenses may count toward a deduction if you itemize. A tax preparer can compare the options for your tax year.
Rules
- Only unreimbursed medical expenses above 7.5% of adjusted gross income are deductible, and only if you itemize. Mileage to treatment counts at the IRS medical rate (20.5 cents a mile through June 2026, 23.5 from July).
- Refundable credits are paid through a filed return, including when no tax is owed.
- For tax year 2025, Indiana's earned income credit is generally 10% of the qualifying federal credit. The largest federal credit is $8,046, making the arithmetic state maximum $804.60 before whole-dollar return rounding. That is not a predicted family refund. Schedule IN-EIC accompanies the state return, with Schedule 5 for IT-40 or Schedule F for IT-40PNR as applicable; part-year rules can change the amount.
What you get
- Federal credits, part of them refundable, paid on a filed return.
- Indiana’s refundable earned income credit is generally 10% of the qualifying federal credit.
- A possible medical-expense deduction when qualifying unreimbursed costs are high enough to itemize.
What to keep
- Every bill, insurance statement, parking, mileage and lodging record for treatment trips, from now.
If you decide to apply
- Keep treatment receipts, mileage and insurance statements with your tax records.
- Ask a free tax-help service or qualified preparer to review federal and Indiana credits and the medical deduction.
Free tax-help service or qualified tax preparer · Official page ↗
Missed years
- Earlier tax years can still be claimed; each has its own deadline.
- The ordinary tax-year-2025 filing deadline was April 15, 2026. A timely valid extension gives until November 16, 2026 to file the Indiana return, without extending the payment deadline. A valid federal filing extension is recognized. DOR or a preparer confirms late-refund, amendment, military and case-specific deadlines; the ordinary deadline passing does not automatically erase a refund claim.
Good to know
A credit, a refundable amount and a deduction are three different things; a preparer should check them before anyone promises a refund. Today’s benefit-screening income is not the tax-year figure.
Other details
- Federal credits and deductions change by tax year; confirm the year’s figures when you file.
- Indiana also lists a refundable adoption credit of 20% of the federal adoption credit, up to $2,500 per child, and an ABLE contribution credit of 20%, up to $500. A preparer checks eligibility and the ABLE credit's treatment on the actual return. The current annual rule points to April 15, 2027 for a calendar-year-2026 return; DOR confirms the final 2026 forms, limits and any later relief.
Official sources
- IRS: medical-expense deduction
- ssa.gov: text child ussi.htm
- secure.ssa.gov: 0501715020
- ecfr.gov: section 438.408
- ecfr.gov: section 438.420
- anthem.com: inin caid hhw memberhandbook eng.pdf
- in.gov: third party liability.pdf
- in.gov: contact us
- law.cornell.edu: 246.7
- law.justia.com: section 6 3 1 21 6
- law.justia.com: section 27 8 15 31 1
- legiscan.com: Indiana 2024 HB1385 Enrolled.pdf
- provider.indianamedicaid.com: 2.2a 18 23f.pdf
- in.gov: H and W WaiverDEC2025.PDF
- in.gov: tax credits
- in.gov: current
- irs.gov: earned income and earned income tax credit eitc tables
- in.gov: tax filing deadlines
- in.gov: ib92.pdf
- in.gov: file extension
- in.gov: Income Get on CCDF.pdf
- irs.gov: standard mileage rates
“Is there free tax help you recommend, and should we be keeping treatment receipts and mileage for a medical deduction?”
Why I’m asking: We want to claim any refund we are due in a year with different income and high bills.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Keep the mileage log, parking and lodging receipts and every medical bill; file even in a year you owe nothing.
Your social worker
Points you to a free VITA tax site and, if a parent is paid by Medicaid for home care, to the paperwork that marks that pay as excludable.
The care team
Records and letters when the application asks for them.
- Who decides
- The IRS, on the return you file
- Ask your social worker
- “Is there a free tax help site for families here? If a parent is paid through Medicaid for our child's home care, what paperwork marks that pay as excludable?”
How to apply
First step: Start a mileage and lodging log now, keep every medical bill, and ask the social worker for the free VITA tax site near you.
- Start a mileage and lodging log the week of diagnosis.
- Ask HR about the dependent-care account when a sibling needs paid care so a parent can work.
- File even in a year with no tax owed; the child tax credit and earned income credit can still pay.
Where it starts: Federal tax return; free VITA tax sites for lower-income families
What to gather
- A mileage log with dates and destinations
- Parking, toll and lodging receipts
- Every medical bill and the insurance statements showing what you paid
- The employer's dependent-care account form, if offered
How long: Settled on the tax return for the year. A refund follows filing.
What a yes looks like
A smaller tax bill or a refund that reflects the deduction and the credits.
What a no looks like, and the next move
The standard deduction beats itemizing: the mileage and lodging are then unused, but the child tax credit and earned income credit still apply.
Watch out
- Throwing away the mileage log. Hospital trips at 20.5 cents a mile (January to June 2026) and 23.5 cents (July to December), plus parking and tolls, add up over a treatment year.
- The lodging cap is $50 a night per person, meals not included, and only for stays needed for care at a hospital.
- The $7,500 dependent-care account is for care that lets the parents work, such as a sibling's daycare. It is set up through an employer, usually at open enrollment or after a family change.
- Not every Medicaid-paid wage is excludable. The exclusion is for care of someone living in the provider's home under a Medicaid program; ask the program for its form.
- Retirement money is a last resort with tax costs. A medical hardship withdrawal does not itself waive the early-withdrawal penalty. The medical-expense penalty exception covers only qualifying expenses above 7.5% of adjusted gross income; ordinary income tax still applies to untaxed money.
- The emergency personal-expense withdrawal exception has separate balance, annual and repeat-use limits. Ask the plan administrator or tax preparer before using it; penalty relief is not an exemption from ordinary income tax.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 10, 2026.
What it is worth
Medical costs above 7.5% of income deductible if you itemize; mileage 20.5 cents (January–June 2026) and 23.5 cents (July–December); lodging $50 a night per person; dependent-care account $7,500; child tax credit up to $2,200 a child.
- $7.5 (only the part above this counts, and only if you itemize) — Medical-expense deduction floor
- $20.5 — Medical mileage, January to June 2026
- $23.5 — Medical mileage, July to December 2026
- $50 (an accompanying parent counts; meals do not) — Lodging away from home for care, per person per night
- $7,500/year — Dependent-care account (FSA) limit, 2026
- $3,750/year — Dependent-care account limit, married filing separately, 2026
- $2,200/year (maximum; not a guaranteed refund) — Child tax credit per qualifying child, 2026
Legal protection: Pay from Medicaid to a parent who provides the child's home care in the same home can be left out of federal income (IRS Notice 2014-7, since January 3, 2014) · That excluded pay can still be counted as earned income for the earned income credit, all of it or none · Parking and tolls count on top of the mileage rate
What it costs the family: None. A free VITA tax site or a preparer can run the numbers.
The eligibility facts, as published
- Deduction
- itemizers; unreimbursed medical costs above 7.5% of adjusted gross income
- Dependent care account
- through an employer plan; care that lets the parents work; limited by earned income
- Child tax credit
- per qualifying child; maximum $2,200 in 2026
- Notice 2014 7
- qualifying Medicaid waiver payments to a provider living in the same home as the person cared for; not every Medicaid-paid wage
Decisions this site cannot make: The tax return
Expect friction on: Receipts and a mileage log · Itemizing versus the standard deduction
The trap: Throwing away the mileage log. The rate is 20.5 cents a mile for January to June 2026 and 23.5 cents from July; parking and tolls are on top. The lodging cap is $50 a night per person, meals not included.
What changes by state: Nothing here is state law. Some states add their own credits; a tax preparer or a free VITA site can check.
Where I read this
- IRS Topic 502: Medical and dental expenses — Internal Revenue Service, read September 8, 2026
- IRS: 2026 standard mileage rates (initial) — Internal Revenue Service, read September 8, 2026
- IRS Announcement 2026-11 (IRB 2026-29): revised mileage rates from July 1, 2026 — Internal Revenue Service, read September 8, 2026
- IRS Publication 502 (2025): Medical and dental expenses — Internal Revenue Service, read September 8, 2026
- IRS Publication 15-B (2026): Employer's tax guide to fringe benefits — Internal Revenue Service, read September 8, 2026
- IRS FAQ: Child and dependent care credit and flexible benefit plans (outdated $5,000) — Internal Revenue Service, read September 8, 2026
- IRS Rev. Proc. 2025-32: 2026 inflation adjustments — Internal Revenue Service, read September 8, 2026
- IRS Notice 2014-7 (IRB 2014-04): Medicaid waiver payments — Internal Revenue Service, read September 8, 2026
- IRS: Certain Medicaid waiver payments may be excludable from income (FAQ) — Internal Revenue Service, read September 8, 2026
