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In the USA, total medical expenses above a threshold may be deducted from taxes. If a medical expense occurs in December and the bill is paid in January, for tax purposes, does this expense occur in the December year or the next (January) year?

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  • And right now the floor is changing: it is 7.5% for 2018, but 10% starting in 2019 (except for 65+). But with the TCJA-increased standard deduction, fewer people (perhaps many fewer) will get any benefit from itemizing. Commented Dec 28, 2018 at 23:31
  • @dave_thompson _085 Are you sure about the 7.5% floor in 2019 for people over 65? My Google search said the floor is going to 10% for everybody.
    – ab2
    Commented Dec 29, 2018 at 4:13
  • @ab2: you're right. The new pub 502 isn't out (and the 2017 one was 'printed' while TCJA was still under consideration) so I just assumed it would go back to 2016 rules, but on checking the nearly-official source (see (f) at the end) it does go 'back' to 10% for everybody. Down with the geezers! Commented Dec 29, 2018 at 23:49

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The expense occurs when you pay it, so the expense would be deductable for the year of that January. (Source: working with a tax accountant last year when I was in a similar situation. Disclaimer: I am not an accountant.)

Additional source, IRS pub 502, at the end of page 2:

You can include only the medical and dental expenses you paid this year, regardless of when the services were provided.

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