@QRFMTOA
You need to prove what service you paid for, and that it is a qualified medical expense, not just the amount. That might not require saving every scrap of paper, but it's more than just a credit card statement.
My last visit to the optometrist, I paid over $1500 for the visit, 3 pair of glasses, and some vitamins that are supposed to reduce eye floaters. The visit and glasses are allowable but the vitamins are not. If I was audited and only had a credit card bill for $1500, what should the auditor do?
I use a pharmacy located in a grocery store. How would I prove without receipts that I paid for a prescription instead of groceries? If I have 100+ credit card charges for that grocery store over the course of the year, how does an auditor know which ones were for qualified medical expenses like prescriptions?
Here is a quote from a Tax Court case.
As we have observed in countless opinions, deductions are a matter of legislative grace, and the taxpayer bears the burden of proof to establish entitlement to any claimed deduction. This burden requires the taxpayer to substantiate expenses for deductions claimed by keeping and producing adequate records that enable the Commissioner to determine the taxpayer's correct tax liability. A taxpayer claiming a deduction on a Federal income tax return must demonstrate that the deduction is allowable pursuant to some statutory provision and must further substantiate that the expense to which the deduction relates has been paid or incurred. [citations omitted]
Here's a quote from an IRS training guide for tax preparers.
When the TP establishes that the TP paid or incurred deductible expenses but does not establish the amount of the deduction to which TP is entitled, TP may be entitled to estimate the amount allowable. Cohan v. Comm’r, 39 F.2d 540 (2d. Cir. 1930).
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“To qualify for the estimation treatment under Cohan, the taxpayer must establish that he is entitled to some deduction.”
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“A court should allow the taxpayer some deductions if the taxpayer proves he is entitled to the deduction but cannot establish the full amount claimed”
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“bearing heavily ... upon the taxpayer whose inexactitude is of his own making”
