Can I deduct kid's medical/care expenses overseas ?

[trapezewdc]

I am a US citizen.  I have a baby 10 months old also a US citizen with an SSN. My spouse is a foreign national without an SSN/ITIN and has no financial ties to the US. All 3 of us now live together overseas for the long term.

Questions on 2025 tax return for next year  :

1. Can I e-file the 2025 tax return with my baby as a dependent without my foreign national spouse ? If so, what filing status can I use ?

2. Can I deduct out-of-pocket expenses for my baby on hospitals, Dr offices, vaxes, Rx...etc when the services/meds are provided by non-US citizens/institutions overseas ?

3. Can I deduct out-of-pocket expenses or claim the Child and Dependent Care Credit for my baby's care provided by nannies, sitters, and/or day care centers when they are non-US citizens/institutions overseas ?

Thanks

[Opus 17 · Accepted solution]

1. You probably can't e-file.  

As a US citizen, you are required to file a US tax return no matter where you live in the world.  You have the option of filing jointly with your spouse, but to do this, you must elect to treat your spouse as a US person for taxes.  That means their income is reported and taxed on your return (but you will get an offsetting credit if they also pay tax in their home country).  To file jointly, you would have to file by mail and include an application for an ITIN, international tax ID number.  (If your spouse already has a valid ITIN, and you file jointly, you can probably e-file.)

Or, you can file married filing separately and only report your income.  To file MFS, you write "NRA" in the box for your spouse's name under Filing status, and you leave your spouse's SSN blank.  In the past, you could not e-file this way, I don't know if that is a Turbotax rule or an IRS rule, and I don't know if it will change for the 2025 season.   You should probably plan to file by mail, but wait and see if the program handles this situation differently.

2. Yes, you can deduct medical costs for yourself, your spouse, and your dependents, even if provided overseas.  But, only procedures and drugs that are legal in the US.  For example, if your child receives a medication that is approved in the country where you are living but is not approved by the FDA for use in the US, that is not deductible.

3. The child care credit is not allowed if you file as married filing separately, by law.   If you file as married filing jointly, the credit is allowed.  You must write “LAFCP” (Living Abroad Foreign Care Provider) in the space for the provider's SSN.  You probably can't e-file without a real SSN, so this again would mean filing by mail. 

[Mike9241]

since you are married your only options are a joint return or married filing separately. without your spouse having an ITIN or SSN, you cannot file a joint return which is generally better. e-filing using Turbotax may require you to have a US phone number.

foreign medical expenses are deductible on schedule A but must be converted to US $.

you may be able to claim the child tax credit (form 8812). you won't be able to deduct or claim child and dependent care expenses if you use the MFS filing status (form 2441). If you file jointly both you and your spouse must have taxable earned income or be actively looking for work. 

see this website for additional requirements

https://www.expatustax.com/child-and-dependent-care-tax-credit/ 

from the article. The key is that they must be providing care so you can work or look for work. the same holds true for your spouse (joint return). If they don’t have a US Taxpayer Identification Number (TIN), you can write “Foreign Provider” on Form 2441, along with their name and address. 

Don't know if Turbotax will have issues with this

[trapezewdc]

Thanks.

Following up on my question 1. Let's say I "paper-file" the 2025 tax return. Can I do that with my baby as a dependent without my foreign national spouse ? If so, what filing status can I use ?

[Opus 17]

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@trapezewdc wrote:

Thanks.

Following up on my question 1. Let's say I "paper-file" the 2025 tax return. Can I do that with my baby as a dependent without my foreign national spouse ? If so, what filing status can I use ?

---

Yes, your child can be your dependent regardless of whether you file as married filing jointly or married filing separately.  You don't need to include your spouse in order to claim your child.  

[trapezewdc]

Thanks.

Following up on my question 2.

"Yes, you can deduct medical costs for yourself, your spouse, and your dependents, even if provided overseas."

If I file as married filing separately with my baby as a dependent, can I still deduct out-of-pocket medical/Rx expenses for my foreign national spouse ?

[Opus 17]

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@trapezewdc wrote:

Thanks.

Following up on my question 2.

"Yes, you can deduct medical costs for yourself, your spouse, and your dependents, even if provided overseas."

If I file as married filing separately with my baby as a dependent, can I still deduct out-of-pocket medical/Rx expenses for my foreign national spouse ?

---

Yes, the law just says "spouse", it does not prescribe their location, citizenship, or tax filing status. 

[trapezewdc]

Thanks.

For the entire tax year of 2025 :

- My foreign national spouse is a nonresident alien and I will not choose to treat my spouse as a resident alien

- I pay 100% of the household costs

- I have a US citizen child who lives with me all the time

Do I qualify to file as HoH for 2025 tax return ?

[Opus 17]

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@trapezewdc wrote:

Thanks.

For the entire tax year of 2025 :

- My foreign national spouse is a nonresident alien and I will not choose to treat my spouse as a resident alien

- I pay 100% of the household costs

- I have a US citizen child who lives with me all the time

Do I qualify to file as HoH for 2025 tax return ?

---

Yes.  Usually, living with your spouse prevents this, but there is an exception for spouses who are non-resident aliens.

Nonresident alien spouse.

You are considered unmarried for head of household purposes if your spouse was a nonresident alien at any time during the year and you don't choose to treat your nonresident spouse as a resident alien. However, your spouse isn't a qualifying person for head of household purposes. You must have another qualifying person and meet the other tests to be eligible to file as head of household.

[trapezewdc]

Thanks.

"Yes, you can deduct medical costs for yourself, your spouse, and your dependents, even if provided overseas.

If I choose to file as HoH with my US citizen baby as a dependent, can I still deduct out-of-pocket expenses for my foreign national spouse on hospitals, Dr offices, vaxes, Rx...etc when the services/meds are provided by non-US citizens/institutions overseas ?

[Opus 17]

---

@trapezewdc wrote:

Thanks.

"Yes, you can deduct medical costs for yourself, your spouse, and your dependents, even if provided overseas.

If I choose to file as HoH with my US citizen baby as a dependent, can I still deduct out-of-pocket expenses for my foreign national spouse on hospitals, Dr offices, vaxes, Rx...etc when the services/meds are provided by non-US citizens/institutions overseas ?

---

Yes, your spouse is your spouse.  The section of the tax law allowing medical expense deductions does not require that you file a joint return or that your spouse be a US person.   The same requirement applies that the treatment or drug must be legal in the US.