The software will choose whichever deduction (standard or itemized) results in the lowest federal tax. If your refund is the same either way, it usually means your taxable income is already zero, so itemizing doesn’t change your federal result. Also, medical expenses are only deductible to the extent they exceed 7.5% of your AGI,and there is no federal carryforward of excess medical expenses. For your state return, the rules can be different. Many states either require you to follow the federal deduction choice or have their own standard/itemized rules, and some allow medical expenses without the same 7.5% AGI limitation or calculation method. Check your state’s Department of Revenue website for its specific deduction rules, since state treatment is controlled by state law, not IRS rules.
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