Written by a parent, not a doctor. Nothing here is medical advice.

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Federal, exists in every state

Tax refunds and treatment-related deductions

A change in annual earnings can change tax credits. Treatment costs can also make itemizing worthwhile.

What it is

A change in annual earnings can change tax credits. Treatment costs can also make itemizing worthwhile.

Credits phase in and out at different incomes, so a pay change can move the earned income credit or child tax credit either way. A preparer can check. Only unreimbursed medical costs above 7.5% of adjusted gross income count toward an itemized medical deduction.

Rules
  • For tax years 2025–2026, Virginia's refundable EITC is 20% of the federal EITC actually allowed for an eligible full-year resident. A preparer should compare the separate nonrefundable low-income and EITC alternatives, apply any residency or dependency limits, and check the return and refund deadlines for each year.
  • 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 only on a filed return, including when no tax is owed.
What you get
  • Federal credits, part of them refundable, paid on a filed return.
  • A Virginia earned income credit for eligible returns: generally refundable at 20% of the allowed federal EITC for full-year residents in tax years 2025–2026.
  • 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
  1. Discuss which treatment receipts and mileage records a tax preparer would need.
  2. Ask a qualified tax preparer to review both the federal and Virginia returns, including any unclaimed earlier years.
  3. Ask a free tax-help service (VITA) or a qualified preparer to review credits and the medical deduction at filing time.

Qualified tax preparer or free tax-help service · Official page ↗

Missed years
  • Earlier tax years can still be claimed; each has its own deadline.
  • For tax year 2025, the ordinary Virginia return deadline was May 1, 2026. A filing extension does not extend the payment deadline. A preparer can check filing and refund options for a missed year.
  • Virginia ordinarily uses May 1 after the tax year as the individual return due date, with weekend/holiday adjustment and a qualifying six-month filing extension. Refund claims generally have a three-year deadline measured from the legally applicable timely-filing date, with separate federal-change and other statutory exceptions. A preparer should check the original filing/extension history for each missed year rather than assume every old return is still refundable.
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.
  • The refundable Virginia EITC rate is 15% for tax years 2022–2024 and 20% for 2025–2026. A preparer checks each year’s filing history and refund deadline; an older year is not automatically closed.
Official sources
Ask your social worker

“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

How this works

For tax years 2025 and 2026, eligible full-year Virginia residents can claim a refundable Virginia earned income tax credit equal to 20% of the federal EITC actually allowed. The maximum depends on qualifying children and earnings, not just household size: with one qualifying child, the maximum is $865.60 for 2025 or $885.40 for 2026 before return rounding; with three or more it is $1,609.20 or $1,646.20. A separate nonrefundable low-income credit of $300 per eligible person may be an alternative, not an extra credit to stack. Your social worker can help locate a qualified or free tax preparer to compare the options and filing deadlines.

For federal taxes, qualifying unreimbursed medical expenses are deductible only when you itemize and only above 7.5% of adjusted gross income. Keep medical bills, insurance payment statements and travel records; a large bill does not automatically produce a deduction or refund.

  1. Ask a qualified tax preparer to review both the federal and Virginia returns, including any unclaimed earlier years.
  2. Ask a qualified tax preparer or free tax-help service to review federal credits and your medical-expense records.

Before you start

  • Tax-year income and family rules differ from today's benefit-screening income.
  • Virginia's 2025–2026 refundable earned income credit is generally 20% of the federal EITC allowed for an eligible full-year resident. The $300-per-person low-income credit is a separate nonrefundable alternative; the preparer must compare the choices rather than add them together.

Tax-year income and family rules differ from today's benefit-screening income.

Virginia credit amounts depend on the tax year, federal EITC and qualifying children. Part-year/nonresident limits and prior-year refund deadlines need a preparer's review; the refundable 20% provision is not automatically available for tax year 2027.

Special rules govern medical lodging, mileage, employer dependent-care accounts and Medicaid caregiver payments. Have the preparer verify the applicable tax year.

Do not withdraw retirement funds or change ownership of assets based only on an expected tax benefit.

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.

  1. Start a mileage and lodging log the week of diagnosis.
  2. Ask HR about the dependent-care account when a sibling needs paid care so a parent can work.
  3. 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

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